Unsatisfactory Result Research Articles

Smart farming based on IoT to predict conditions using machine learning

<span>Smart farming is a type of technology that utilizes the internet of things (IoT) to provide information on agricultural and environmental conditions as well as perform automation. Some of these ecological conditions can be used and analyzed in machine learning (ML) data management. This study focuses on utilizing ML algorithms to find the best prediction; typically used methods include linear regression, decision tree (DT), random forest (RF), and extreme gradient boosting (XGBoost). In the application of smart farming, research on IoT and artificial intelligence (AI) is still uncommon since most IoT cannot make predictions like AI. Because basically, some IoT can't make predictions as AI does. In this Study, predictions were made by looking at the regression results in the form of root mean square error (RMSE) and absolute error. The results show a strong and weak correlation between features (positive or negative). The best prediction results are obtained by XGBoost when predicting temperature (RMSE 6.656 and absolute error 3.948) and (soil moisture 17.151 and absolute error 11.269). However, using different parameters (RMSE RF and absolute error DT) on RF and DT resulted in good and distinct results. Linear regression, on the other hand, produced unsatisfactory and poor result.</span>

GINGIVAL MARGIN, CORRECTION IN ORTHOPEDIC DENTISTRY

A big problem for obtaining aesthetic and functional results of dental treatment is the condition of the gingival papillae. The effectiveness of orthopedic interventions without high-quality correction of the marginal edge of the gums can lead to an unsatisfactory result and the occurrence of numerous complications Materials and methods. A literature search was conducted in the PubMed and Medline databases for the period 2000-2024, for which the following keywords were used: correction of soft gingival tissues, fixed dentures, effectiveness, front group of teeth. A general search revealed 112 sources regarding gingival margin correction in fixed dentures. The primary exclusion referred to literary sources in which the correction of the gingival margin applied to all types of prosthetics. Literary sources that contained only reference information were included in the secondary exclusion. As a result, only relevant full-text articles in professional journals remained (n=25). The purpose of the research is to analyze the methods of gingival margin correction in orthopedic dentistry at the current stage, to formulate relevant tasks for further research. Research results. Methods of restoration of the aesthetics of the marginal part of the gums during orthopedic treatment are divided into the following groups: plastic of soft and bone tissues; laboratory and technical procedures; use of materials for artificial gums. It has been established that the plastic-surgical method is used for the loss of the gingival papilla, defects of the ridge of the alveolar process, asymmetric contour of the gums, and their unaesthetic shape. Correction of the gums allows to achieve satisfactory aesthetic results both at the final stage of orthopedic treatment (prosthetics with fixed orthopedic prostheses) and at the intermediate stage of temporary prosthetics with plastic fixed prostheses. It was found that the most common methods of gingival margin correction are flap operations on the gums using the technique of lateral movement of the muco-osseous flap. These include the following types of interventions: endothelial modification from the tooth-alveolar ridge; oblique displaced flap; periosteally stimulated flap; partial or complete split flap. The positive effect of hyaluronic acid on the healing of the gingival margin and tissue regeneration has been proven. Several researches have shown the positive effects of hyaluronic acid on gingival margin healing and tissue regeneration due to its properties to stimulate cell adhesion, migration and proliferation, mediate cell signaling. The authors indicate a better effectiveness of hyaluronic acid in relation to periodontal parameters during the correction of the marginal gingival margin. The use of a laser scalpel is characterized by less pronounced traumatization of tissues, lower temporary costs for intervention, reduced blood loss, less pronounced signs of inflammation in the postoperative period, relative simplicity and cost-effectiveness of use. Conclusions. To date, only a combination of various orthopedic and surgical manipulations allows to achieve an optimal aesthetic result during prosthetics with fixed dentures of the front group of teeth.

Buzhong Yiqi decoction attenuates acquired myasthenia by regulating the JAK2/STAT3/AKT signaling pathway, inhibiting inflammation, and improving mitochondrial function.

Acquired myasthenia (AM), a debilitating autoimmune disease, is typically characterized by skeletal muscle fatigue and weakness. Despite advances in myasthenia gravis treatment, current approaches remain unsatisfactory and many result in unexpected side effects. Traditional Chinese medicine has shown great potential in the treatment of myasthenia gravis, including relieving myasthenic symptoms, improving patients' quality of life, and reducing Western medicine side effects. This study investigates the protective effects and mechanism of BZYQD in mice with acquired myasthenia. BZYQD alleviates the reduced grip strength and increased expression of MAFbx and MuRF-1 in mice with acquired myasthenia. It also reduces levels of pro-inflammatory factors IL-1β, IL-6, and TNF-α in the mouse serum. In addition, BZYQD reduces ROS accumulation and the mitochondrial ROS production rate, while increasing ATP levels and mitochondrial membrane potential in mice with acquired myasthenia. Moreover, BZYQD decreases the expression of p-JAK2, p-STAT3, and p-AKT in the skeletal muscle of mice with acquired myasthenia. In summary, BZYQD reduces inflammation, enhances mitochondrial function, and regulates the JAK2/STAT3/AKT signaling pathway to treat acquired myasthenia.

Drug-coated balloon angioplasty with rescue stenting versus intended stenting for the treatment of patients with de novo coronary artery lesions (REC-CAGEFREE I): an open-label, randomised, non-inferiority trial

The long-term impact of drug-coated balloon (DCB) angioplasty for the treatment of patients with de novo coronary artery lesions remains uncertain. We aimed to assess the non-inferiority of DCB angioplasty with rescue stenting to intended drug-eluting stent (DES) deployment for patients with de novo, non-complex coronary artery lesions. REC-CAGEFREE I was an open-label, randomised, non-inferiority trial conducted at 43 sites in China. After successful lesion pre-dilatation, patients aged 18 years or older with de novo, non-complex coronary artery disease (irrespective of target vessel diameter) and an indication for percutaneous coronary intervention were randomly assigned (1:1), via a web-based centralised system with block randomisation (block size of two, four, or six) and stratified by site, to paclitaxel-coated balloon angioplasty with the option of rescue stenting due to an unsatisfactory result (DCB group) or intended deployment of second-generation thin-strut sirolimus-eluting stents (DES group). The primary outcome was the device-oriented composite endpoint (DoCE; including cardiovascular death, target vessel myocardial infarction, and clinically and physiologically indicated target lesion revascularisation) assessed at 24 months in the intention-to-treat (ITT) population (ie, all participants randomly assigned to treatment). Non-inferiority was established if the upper limit of the one-sided 95% CI for the absolute risk difference was smaller than 2·68%. Safety was assessed in the ITT population. This study is registered with ClinicalTrials.gov, NCT04561739. It is closed to accrual and extended follow-up is ongoing. Between Feb 5, 2021, and May 1, 2022, 2272 patients were randomly assigned to the DCB group (1133 [50%]) or the DES group (1139 [50%]). Median age at the time of randomisation was 62 years (IQR 54-69), 1574 (69·3%) of 2272 were male, 698 (30·7%) were female, and all patients were of Chinese ethnicity. 106 (9·4%) of 1133 patients in the DCB group received rescue DES after unsatisfactory DCB angioplasty. As of data cutoff (May 1, 2024), median follow-up was 734 days (IQR 731-739). At 24 months, the DoCE occurred in 72 (6·4%) of 1133 patients in the DCB group and 38 (3·4%) of 1139 in the DES group, with a risk difference of 3·04% in the cumulative event rate (upper boundary of the one-sided 95% CI 4·52; pnon-inferiority=0·65; two-sided 95% CI 1·27-4·81; p=0·0008); the criterion for non-inferiority was not met. During intervention, no acute vessel closures occurred in the DCB group and one (0·1%) of 1139 patients in the DES group had acute vessel closure. Periprocedural myocardial infarction occurred in ten (0·9%) of 1133 patients in the DCB group and nine (0·8%) in the DES group. In patients with de novo, non-complex coronary artery disease, irrespective of vessel diameter, a strategy of DCB angioplasty with rescue stenting did not achieve non-inferiority compared with the intended DES implantation in terms of the DoCE at 2 years, which indicates that DES should remain the preferred treatment for this patient population. Xijing Hospital and Shenqi Medical. For the Chinese translation of the abstract see Supplementary Materials section.

Physical health of high school students with different levels of motor activity

The physical health of children and adolescents is an indicator of the sanitary and hygienic well-being of an educational establishments, reflects the efficiency of the physical education system at schools and the level of physical activity of schoolchildren. An analysis of physical health indicators (height, body weight, hemodynamic and physiometric indicators) in 252 tenth graders was carried out. It was noted that the majority of adolescents (70–82 %) had functional indicators within the age-sex norm; normal physical development was determined in 60 % of schoolchildren. The results of physical fitness tests showed that the «60 m run» was performed at the level of the gold GTO sign, with an unsatisfactory result of the «flexion and extension of the arms in a lying position» test in girls and low results of the «bend forward from a standing position» test in boys. Statistically significant differences were established in the results of pedometer testing among adolescents of health groups I and II (group 1) and schoolchildren with chronic diseases of health groups III and IV (group 2). The physical activity of adolescents in group 1 was 1817 steps higher on weekdays (p=0.000) and on weekends compared to peers in group 2. According to the survey and pedometer data, every third student (34.6 %) was characterized by a low level of physical activity, an average level was found in 49.5 % of tenth graders, and a high level in 15.9 % of schoolchildren. Thus, the average level of physical activity in most adolescents was at the level of 8–9 thousand steps per day and was characterized by low involvement in sports sections, which requires a system of measures to increase the motivation of children and adolescents to engage in physical education.

CLINICAL AND INSTRUMENTAL PREDICTORS OF THE EFFICIENCY OF CONSERVATIVE AND OPERATIVE TREATMENT OF MEDIAN NERVE NEUROPATHY IN THE CARPAL TUNNEL

Introduction. Clinical and instrumental predictors of the efficiency of conservative and surgical treatment of median nerve neuropathy in the carpal tunnel still remain a topical issue. Aim. To identify clinical and instrumental predictors of clinical outcomes and patients’ satisfaction after conservative and surgical treatment of carpal tunnel syndrome. Materials and methods. Analysis of clinical outcomes and patients’ satisfaction in 93 cases with carpal tunnel syndrome: the first group included 49 patients (68 wrists) after conservative and the second group included 44 patients (50 wrists) after surgical treatment. To identify predictors of the efficiency of treatment, analyzed the following clinical-instrumental values: patients’ age, duration of the disease, discriminative sensation, pain intensity according to VAS, values of DASH, BCTQ, CTS scales, clinical stage by Hi-Ob scale, electromyography severity grade according to Bland J.D., nerve conduction study and sonography results. Results. The nerve conduction study and clinical examinations data (discriminative sensation, clinical stage, duration of the disease, BCTQ and DASH values) show reliable effects on clinical outcomes and patients’ satisfaction after conservative treatment. The sensory nerve action potential amplitude and electromyography severity grade have the highest prognostic accuracy (91.4% and 84.5% respectively) for poor (unsatisfactory) result. For surgical treatment, identified results of nerve conduction study, sonography, and patients' age show reliable effects on clinical outcomes and patients’ satisfaction. The values of the highest prognostic accuracy for poor (unsatisfactory) result were nerve deformity index established by sonography (77.8%) and thenar compound muscle action potential amplitude – by nerve conduction study (78.7%). Conclusions. We identified clinical-instrumental predictors of clinical outcomes and patients’ satisfaction after conservative and surgical treatment of carpal tunnel syndrome. Specific results of instrumental examination demonstrated excellent diagnostic quality and the highest prognostic accuracy.

Enhancing Guided Bone Regeneration with a Novel Carp Collagen Scaffold: Principles and Applications.

Bone defects resulting from trauma, surgery, and congenital, infectious, or oncological diseases are a functional and aesthetic burden for patients. Bone regeneration is a demanding procedure, involving a spectrum of molecular processes and requiring the use of various scaffolds and substances, often yielding an unsatisfactory result. Recently, the new collagen sponge and its structural derivatives manufactured from European carp (Cyprinus carpio) were introduced and patented. Due to its fish origin, the novel scaffold poses no risk of allergic reactions or transfer of zoonoses and additionally shows superior biocompatibility, mechanical stability, adjustable degradation rate, and porosity. In this review, we focus on the basic principles of bone regeneration and describe the characteristics of an "ideal" bone scaffold focusing on guided bone regeneration. Moreover, we suggest several possible applications of this novel material in bone regeneration processes, thus opening new horizons for further research.

DEVELOPMENT OF SYSTEM SOFTWARE BASED ON THE CHATGPT CHAT-BOT

The article discusses the main aspects of system software development, namely writing program code for a simple device driver using the ChatGPT chat bot. The introduction outlines the main difficulties (hardware, software, complexity of debugging and testing, and security issues) that developers may encounter during driver development, as well as ways to possibly solve them: for example, by increasing the level of their theoretical knowledge or using modern tools, such as neural networks. The main part of the article reviews existing research in the field of system software development and testing. Existing software development tools are reviewed: such as development environments, tools for debugging, profiling, testing and static analysis of program code, as well as solutions in the field of version control and collaboration. A comparative table is provided showing the pros and cons of developing device drivers for Windows and Linux operating systems. The stages of the process of generating driver program code for a computer mouse using the ChatGPT chat bot are described. Conventionally, the article identifies five main stages: preparing training data, training, creating a query, generating and repeating stages in case of an unsatisfactory result. Examples of generated program code for a computer mouse driver for Windows and Linux operating systems are provided. In conclusion, conclusions are given regarding further prospects for using the ChatGPT chatbot in system software development tasks.

Robust GEPSVM Classifier: An Efficient Iterative Optimization Framework

The proximal support vector machine via generalized eigenvalues (GEPSVM) is a well-known pattern classification method. GEPSVM, however, is prone to outliers due to its use of the squared L2-norm distance criterion. A robust GEPSVM version is proposed to tackle this problem using L1-norm distance optimization technique (GEPSVML1). As optimizing a GEPSVML1 with L1-norm terms can be challenging, we have developed an iterative algorithm to address the L1-norm ratio problem associated with GEPSVML1. Furthermore, an efficient iterative optimization framework has been developed to conveniently address related optimization problems. The research contribution of this paper lies in providing a theoretical analysis of the algorithm’s convergence. Besides, we find that the L1-norm distance-based methods in real-world applications, especially for handling samples with outliers, sometimes provides an unsatisfactory recognition result. Thus, a generalized version of GEPSVML1 is proposed. The L1-norm distance is replaced with a Lp-norm distance in GEPSVML1 (GEPSVMLp). It is the robust counterpart of GEPSVML1 and GEPSVM. It is worth noting that we fine-tune GEPSVMLp’s parameters to strike a balance between training time and classification accuracy, an especially crucial step for larger datasets. Our experiments indicate that the proposed GEPSVMLp is more efficient and robust than the competitors in numerous experimental settings. Overall, our work demonstrates the importance of developing robust pattern classification methods in the presence of outliers and provides a practical solution for handling such cases in real-world applications.

A Study on Paradiguna (Samskara) W.S.R to “Samaskarohi Gunantaradhanam Uchyate” and ITS Applied Aspect in the Management of Mukhadushika with an Indiginous Drug

Introduction: Acharya Charaka has clearly said that if one does not understand these Paradi Guna in proper way then he cannot perform Chikitsa in desire manner. Paradi Gunas are the one in which a physician needs to be expertise. Paradigunas are necessary in the field of pharmaceutical science, as well as by the physicians to treat the patients and researchers conducting research and creating new formulation. Samskara Guna is one of the important factors in the hands of Ayurvedic physician for improving other third padas of Bhesaja (i.e., Bahuta, Yogyatwa, and Sampat). Thus in this study, an attempt was made to know the comparative effect of Manjistha Lepa and Samskrita Manjistha with Madhu Lepa in the management of Mukhadushika. Aims and Objectives: The aim of the study was to study about the comparative clinical efficacy of Manjistha Lepa and triturated with Madhu Lepa in the management of Mukhadushika. Materials and Methods: This is a single-blind comparative clinical study with a pre-test and post-test design. The patients were randomly categorized into two groups. Forty patients of Group A (20) and Group B (20) patients were registered from outpatient department of Government Ayurvedic College and Hospital, Balangir, and Saradeswari Government Hospital, Balangir, presented with subjective parameters and objective parameters. After diagnosis, they were under trial with Ayurvedic formulations of Manjistha Lepa for local application and Manjistha triturated Madhu Lepa given 05 g in morning time daily, after drying face wash with normal water for 15 days, respectively. The subjective and objective parameters were assessed in 7-day interval to interpret the result by statistical evaluation. Observation and Results: It had been observed that the result of trial drug Group B patients was significant (<0.05) to reduce both subjective and objective parameters after 15 days of treatment as compared to Group A patients. In Group A, NO patients had marked improvement, while 15% of patients had moderate improvement, 65% mildly improved and 20% had shown unsatisfactory result. In Group B, no patients had marked improvement, 50% moderate, 40% mildly improved, and 10% of patients showed unsatisfactory results. In both groups, the result was statistically significant, but more improvement was noticed in Group B. Conclusion: On comparison between two groups, Manjistha triturated with Madhu Lepa in Group B had shown more effect than Manjistha Lepa in Group A. No adverse effects were noticed during clinical trial in both groups.

DETERMINATION OF THE RISK OF OBTAINING UNSATISFACTORY RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH STATIC DEFORMITIES OF THE FOREFOOT WHEN USING VARIOUS SURGICAL APPROACHES

The main method of treatment of static deformations of the forefoot (SDPVS) is surgical. The most static deformities of the foot in its front part most often include valgus deformity of the first toe — Hallux valgus (HV), hammer-like deformities of 2–4 toes, and Taylor's deformity. Objective. To assess the effectiveness of surgical treatment of SDPVS and to determine the risk of obtaining an unsatisfactory result with different surgical approaches. Methods. The treatment of 565 patients (1009 feet) was analyzed, the main group — 729 feet, control 280 feet. The groups of patients differed in the methods of surgical treatment of deformities of the forefoot. The choice of surgical intervention in the main group was carried out according to the algorithmized system of surgical treatment of patients with SDPVS. Results. The results of treatment of patients with static deformities of the front part of the foot in the main group were significantly (p < 0.001) better than the results in the control group of patients. In the main group, good results accounted for 55.0 % of cases, satisfied — 39.2 %, unsatisfactory — 5.8 %, compared to the control group — 26.1 %, 43.2 and 30.7 %, respectively. The reduction of the relative risk of obtaining an unsatisfied result (RRR) in the main group when using the proposed algorithmized system of treatment of SDPVS is 68 %. In the treatment of combined VDPPS with deformities of 2–5 toes, the risk of an unsatisfactory result is higher compared to isolated VDPPS in both groups. The risk of an unsatisfactory treatment result in patients with combined HV deformity and deformities of 2–5 toes in the control group is 15.9 % higher (RR = 0.159 ± 0.174) than in the main group. The use of the proposed approach to the selection of surgical treatment tactics based on the developed algorithmized system of surgical treatment of SDPVS can reduce the relative risk of obtaining unsatisfactory treatment results by 84 % (RRR = 0.841).

(Don’t) Play Again

How many times would you choose to be reborn? How many times would it take to get it right? In this work of philosophical short story fiction, the narrator lives and dies, and after death, sees the option to try living life again. In his first time he kills himself over a failed love. In his next life he chases power. In the next life, fame. The next time he tries the simple life with a spouse, a family, and an otherwise uneventful existence. Each time he lives and dies he is given the choice to try again while keeping the “instinctual memory” of the time before. How many times will he repeat the process when each time seems to give him an unsatisfactory result. Finally, he questions the being he keeps meeting in the afterlife and wonders if, perhaps, it’s not him, but the being, that has to “Play Again.”

ПРОБЛЕМА ДОСТОВЕРНОСТИ ЖАНРОВОГО ИСТОЧНИКА

This article is carried out in line with research on the problems of genre studies. The author tries to solve the problem of developing a method for describing the speech genre as a communicative unit of the ethical level. The relevance of the study is due to the unsatisfactory result of many years of attempts to develop a methodology for describing the genre that can identify the meaningful factors of a typical utterance as an object. As one of the solutions to the problem, it is proposed to put forward the theory of genre source studies with the development of a technology for modeling a genre source by introducing a formula of a communicative situation into the model of a typical utterance as a factor determining the reference of the genre.The novelty and significance of this work is due to the description of an original and potentially productive approach to determining the genre structures of an utterance through the construction of a genre source model through the prism of communicative components.

Creation of elbow joint in children with humeroradial synostosis. A clinical case

Humeroradial synostosis is a severe rare anomaly of the upper limb, leading to the development of disability. This congenital anomaly may be a separate nosological unit, or a part of a genetic syndrome. Multi-stage surgical treatment is correct for all components of the deformity. The most difficult stage of treatment is the creation of an elbow joint. There are few studies on this problem in the literature. The article presents the results of surgical treatment of two children with humeroradial synostosis, who had the elbow joint created using two techniques. Patient A. underwent microsurgical transplantation of 2–3 metatarsophalangeal joints into the area of the elbow joint that had been absent since birth. Patient B. underwent total arthroplasty of the elbow joint with an individual implant. The unsatisfactory result of the treatment of patient A. is associated with the impossibility of early development of movements in the elbow joint due to the presence of axial pins. The stable position of the endoprosthesis in patient B. made it possible to conduct a course of early development of movements and get a good long-term result. Due to small number of patients, it is impossible to reliably assess the advantage of one of the presented methods. Improvement of the results of treatment in children with humeroradial synostosis requires further research.

Correlation between thyroid fine needle aspiration and pathological examination: a 10 year retrospective study.

To establish the diagnostic performance of fine-needle aspiration in detecting benign and malignant neoplasm in comparison with post-thyroidectomy histopathological findings among patients who received a thyroidectomy. Retrospective observational data collected between 2011-2021 were included from patients who received partial or total thyroidectomy. The Bethesda system was used to classify neoplasms from fine-needle aspiration procedures as benign or malignant. Sample characteristics, diagnostic accuracy, sensitivity, specificity, and predictive values were evaluated. Patients (n=360) who underwent thyroidectomy were analyzed, of whom 142 (39.4%) and 218 (60.6%) had benign and malignant neoplasms, respectively. Using the Bethesda system, 23 (6.4%) were classified as unsatisfactory result (BI), 83 (23.1%) as benign (BII), 50 (13.9%) as atypia of undetermined significance (BIII), 23 (6.4%) as suspected follicular or Hürthle cell neoplasia (BIV), 102 (28.3%) as suspected malignancy (BV) and 79 (21.9%) as malignant (BVI). The fine-needle aspiration diagnostic accuracy for carcinomas was 92%, while the sensitivity and specificity were 94.4% and 86.9%, respectively. The negative and positive predictive values were 87.9% and 93.9%, respectively. Fine-needle aspiration has high diagnostic accuracy, sensitivity and specificity, and is a reliable test for distinguishing between benign and malignant thyroid pathologies.

Long-term evaluation of combined prosthetic-surgical approach and soft tissue augmentation in the esthetic zone.

There is no standard protocol for immediate implant placement and subsequent loading in the smile zone. We aimed to evaluate the long-term outcomes of simultaneous implant placement, soft tissue grafting, and immediate prosthetic loading in the esthetic zone. Thirty-five implants were placed in the maxillary aesthetic zone. Twenty-two patients were evaluated using the Pink Esthetic Score (PES) and White Esthetic Score (WES). Also, the degree of peri-implant bone resorption and patient survey were applied for the esthetic and functional outcomes. The esthetic and harmonizing outcomes were achieved according to the mean total PES/WES value (17.9±2.0). The mean overall PES was 8.5±1.66. The papilla level had the highest mean score (1.8±0.36). Furthermore, the combination of root convexity/color and soft tissue color and texture was one of the key values in evaluating the effectiveness of this method (the mean value was 1.5±0.5). The mesial and distal papillae were 1.6±0.5 and 1.8±0.4, respectively. None of the 35 implants reached below 6 points (which is considered an esthetically unsatisfactory result). The mean WES score was 9.5±0.57. The average degree of total peri-implant bone resorption was 1.05±0.3 mm after 12 months. According to the questionnaire, all the patients smiled without hesitation and were satisfied with the treatment (100%). This study showed that restoring one or more teeth in the smile zone using the concept of one-stage implant placement, soft tissue flap augmentation, and loading with provisional crowns was an esthetically successful and predictable method.

Bifurcation PCI with a hybrid strategy with drug- eluting balloons versus a stepwise provisional two- stent strategy: Rationale and design of the hybrid DEB study

The Hybrid DEB study is a prospective, multicenter, randomized controlled trial investigating noninferiority of a hybrid DEB approach, using a combination of a drug-eluting stent (DES) in the main vessel and DEB in the side branch, compared to stepwise provisional two-stent strategy in patients with true bifurcation lesions. A total of 500 patients with de novo true coronary bifurcation lesions, treated with a stepwise provisional approach and an unsatisfactory result of the side branch after main vessel stenting (≥ 70% stenosis and/or < thrombolysis in myocardial infarction III flow), will be randomized in a 1:1 ratio to receive either treatment with a DEB or with a DES in the side branch. The primary endpoint is a composite endpoint of the occurrence of all-cause death, periprocedural or spontaneous myocardial infarction and/or target vessel revascularization at the anticipated median 2-year follow-up. The Hybrid DEB study will compare in a multicenter, randomized fashion a hybrid DEB approach with a stepwise provisional two-stent strategy in patients with true bifurcation lesions. ClinicalTrials.gov no. NCT05731687.

FUNCTIONAL OUTCOME OF PERCUTANEOUS TRANSOLECRANON AND LATERAL KIRSCHNER WIRE FIXATION FOR DISPLACED SUPRACONDYLAR FRACTURE OF HUMERUS IN CHILDREN

Background: Supracondylar fracture of the humerus is one of the most common fracture occurring in children. When the patients present with swelling of the elbow, there is a dilemma whether to wait for the swelling to subside or to perform closed reduction and percutaneous pinning immediately. The objective of this study was to assess the functional outcome of percutaneous transolecranon and lateral K wire fixation and to observe the outcomes associated with this K wire configuration. Methods: This was a prospective observational study done between 2021 and 2022 at Chitwan Medical College, Nepal. The study included 40 children with closed Gartland type II and III supracondylar fracture of the humerus with no neurovascular injury. They were treated within 3 days with closed reduction and percutaneous pinning using the transolecranon and lateral K-wire fixation technique. The outcome was assessed using the Flynn’s elbow Grading criteria. Results: At 12 week follow up, 7 (17.5 %) patients had excellent result, 21 (52.5%) patients had good, 8 (20%) patients had fair and 4 (10%) patients had poor result. According to Flynn’s grading system 90 % had satisfactory result and 10 % had unsatisfactory result. Four patients had loss of reduction out of which 2 had poor result and 2 had fair result. None of the patients had post operative iatrogenic ulnar nerve injury. Conclusions: The percutaneous transolecranon and lateral K-wire fixation for displaced supracondylar fracture of the humerus in children is a good treatment option when the elbow is swollen and is reliable as it prevents iatrogenic ulnar nerve injury.

Flistory and prospects of development of methods of osteosynthesis and osteosynthesis of the humerus diaphysis

Relevance. About 800 thousand people die every year as a result of injuries and their consequences, in the Russian Federation the frequency of injuries is 12 %. Fractures of the humerus diaphysis account for 1-5 % of the total number of traumatic injuries of the skeleton, at the same time, there is no tendency to reduce injuries in modern society, therefore, the number of surgical interventions aimed at restoring the integrity of the bone does not decrease. Among the reasons for the unsatisfactory results of osteosynthesis, iatrogenic ones are distinguished: inconsistency from a biomechanical point of view, the choice of an unsuitable metal structure, insufficiently correct comparison of the ends of bone fragments and neglect of contraindications to the use of submerged structures with increased contamination of the wound with open fractures. Non-infectious complications of primary osteosynthesis include false joints, improperly fused fractures, untenable osteosynthesis, as well as fractures and migrations of implanted metal structures. The described complications are the basis for repeated (revision) surgery, or rheosteosynthesis. The purpose of this study is to analyze the historical aspects of the development of osteosynthesis and rheosteosynthesis methods, as well as to determine the prospects for their further development.Materials and methods. In the process of writing the article, the analysis of data from literary sources published in the period from 2016 to 2023 was carried out.Results. Speaking about the choice of osteosynthesis technique, it should be noted that no recommended and maximally described techniques will be able to fully cover the variety of situations that arise during osteosynthesis operations, therefore, first of all, a positive outcome depends on the experience of the surgeon and his ability to make situational decisions. Each of the methods used has both advantages and disadvantages, and which treatment tactics the surgeon would not prefer - there is always a risk of complications and, as a result, an unsatisfactory result. In such cases, patients undergo revision operations of osteosynthesis (rheosteosynthesis), minimizing or completely eliminating bone defects. The complexity of correcting the consequences of injuries of the humerus diaphysis is due to the variety of conditions leading to the development of various kinds of bone defects or false joints, as well as in a limited number of techniques that can fully repair the damage in a short time. Taking into account the rather long periods of consolidation of fragments, rehabilitation of patients with this type of pathology implies the use of devices capable of providing stable fixation and the possibility of early restoration of upper limb functions for fastening bone fragments. As a rule, revision surgical interventions include excision of scars from the interfragmental area or corticotomy, removal of deformation (if present), rimming of the medullary cavity and intramedullary osteosynthesis, to which, in rare cases, fixation with a short plate may additionally be applied. The range of revision surgical interventions may include rheosteosynthesis in combination with: segment elongation and corrective osteotomies, bone alio- and autoplasty, with bone elongation on a nail in an external fixation device.Conclusion. The development of modern technologies of osteosynthesis and osteosynthesis of the diaphyses of long tubular bones in general, and the humerus in particular, has passed a serious evolutionary path. In recent decades, methods and technologies of osteosynthesis have been actively developing and improving. With the development of knowledge in the field of the mechanism of bone fusion, implant designs and installation technologies are changing, new modifications of operative accesses are being developed. When choosing the method of fixation of bone fragments, minimally invasive osteosynthesis techniques are becoming increasingly popular. Currently, combinations of different rheosteosynthesis methods are being actively introduced, which significantly expands their capabilities, in comparison with their application separately.

Management of Radius and / Or Ulna Fracture by Screw Intramedullary Nail in Skeletally Mature Patients

The standard nailing of both bone forearm fractures of the radius and ulna poses a possible complication of nail migration androtational instability, despite being one of the best reduction techniques. This study has strived to evaluate how effectively screw elasticintramedullary nail is useful in the therapy for mature diaphyseal fractures of both bone forearms. The issues faced with conventional nailingtechniques for managing forearm fractures have also been discussed. A prospective evaluation of twenty-one cases with forearm fractures (radiusand ulna or isolated fracture of the single bone) was done. Out of the twenty-one cases studied, eighteen patients had undergone closedreduction, and three cases required mini-open reduction. The fracture was categorized as claimed by Arbeitsgemeinschaft furOsteosynthesefragen (AO) Foundation/Orthopedic Trauma Association(OTA). The results were evaluated according to Anderson criteria, inwhich 13 cases had excellent results, 4 had good results, 3 had an unsatisfactory result, and 1 was reported as failure. Also, there was 1 case ofsynostosis and 1 case of delayed union in radius. We concluded that the intramedullary screw nail for forearm fractures in adults could be used asa good internal fixation therapy giving excellent functional and radiological results. This technique is easy to learn, and the implant used is alsocost-effective, thus, providing a good fixation of the fracture. The most accepted technique for forearm fracture, as per current recommendationand AO, are open reductions and internal fixation with plating, but our study is exclusive since it helped to overcome the failure of conventionalnailing of both forearm bones with the potential complication of nail migration and rotational instability in spite the best reduction.