Use Of Additional Methods Research Articles

Polymer materials used in medicine processed by additive techniques

The article presents an overview of currently used polymer materials in various areas of medicine. Most often, polymeric materials are used in the production of medical equipment, cardiology, surgery, dentistry. They are mainly used, among others for the production of gloves, surgical sutures, various type of containers, specula or drip. Currently, by using additive manufacturing techniques, anatomical models of bone structures, surgical templates and implants are made of polymer materials. Thanks to their use, it is possible to significantly reduce the duration of the procedure and increase its precision. By using biodegradable polymers, it is possible to regenerate or replace damaged or diseased tissues or organs. Based on the analysis carried out, huge progress was noted in the use of polymeric materials in the field of medicine through the use of additive methods. However, there is a need for further synthesis of new and modification of existing polymers in the aspect of contact with the patient’s body.

Influence of plasma torch design on cutting quality during precision air-plasma cutting of metal

Optical interferometry and metallographic analysis were used to study structure of cutting seams obtained after 09G2S steel cutting by PMVR-5 plasma torch. These plasma torches have a number of design features in the system of gas-dynamic stabilization of plasma arc. It is shown that application of new plasma torch allows obtaining higher quality of cutting 09G2S steel of medium thickness with high productivity and lower energy costs. Metallographic analysis has shown that qualitative composition of the cut surface structure is almost the same, so priority criteria for comparative quality analysis are parameters of surface microgeometry. Evaluation of this parameter shows high quality of cutting almost along the entire length of a cut, since the influence of technological features of plasma arc cut into the metal affects at a distance of less than 0.3 mm from the edge of the sheet. The use of additional methods of gas-dynamic stabilization in PMVR -5.2 plasma torch (feed symmetry with a double swirl system of plasma-forming gas) allows to achieve additional advantages in terms of surface quality compared to PMVR -5.1. A number of features that affects quality of cut when cutting metals of different thicknesses for welding, is noted depending on the angle of inclination of plasma torch during cutting. Estimates of the surface layer hardness indicate minimal deviations from the requirements of GAZPROM Standard 2-2.4-083 (instructions on welding technologies in the construction and repair of field and main gas pipelines), which allows further use of cutting seams obtained by studied plasma torches for welding without removing zones of thermal influence. Thus, application of new plasma torches makes possible precision finishing plasma cutting of metals, including production of welded joints.

Influence of Plasma Torch Design on Cutting Quality during Precision Air-Plasma Cutting of Metal

Optical interferometry and metallographic analysis were used to study the structure of cutting seams obtained after 09G2S steel cutting by a PMVR-5 plasma torch. These plasma torches have many design features in the gas-dynamic stabilization system of the plasma arc. The application of a new plasma torch can obtain higher quality and lower energy costs of cutting medium-thick 09G2S steel. Metallographic analysis has shown that the qualitative composition of the cut surface structure is almost the same, so priority criteria for comparative quality analysis are surface microgeometry parameters. The parameter evaluation shows high quality of cutting almost along the entire length of a cut, since the technological feature influence of plasma arc cut into the metal affects less than 0.3 mm from the sheet edge. The use of additional methods of gas-dynamic stabilization in PMVR-5.2 plasma torch (feed symmetry with a double swirl system of plasma-forming gas) makes it possible to achieve additional advantages in terms of surface quality compared to PMVR-5.1. A number of features that affects cut quality when cutting metals of different thicknesses for welding depends on the inclination angle of a plasma torch during cutting. Estimates of the surface layer hardness indicate minimal deviations from the requirements of GAZPROM Standard 2-2.4-083 (instructions on welding technologies in the construction and repair of field and main gas pipelines), which allows further use of cutting seams obtained by studied plasma torches for welding without removing thermal influence zones. Thus, the application of new plasma torches for precision-finishing plasma cutting of metals, including production of welded joints, is possible.

Uzasadnienie interwencji motywacyjnych jako kluczowego elementu projektu wielopoziomowej edukacji i motywacji u pacjentów z zawałem serca (MEDMOTION)

Introduction. The Multilevel EDucational and MOtivational intervention in patients after myocardial infarcTION (MEDMOTION) project has been designed to test the comprehensive strategy of treatment after acute coronary syndrome. The aim of MEDMOTION is to improve the efficacy of secondary prevention, complementing patients’ education with motivational interventions. Material and methods. Individualised motivation and complex health education, started during hospitalisation and continued after discharge, explaining the pathophysiology and symptoms of the disease, elucidating goals and potential benefits of treatment, and highlighting the risk of premature termination of therapy, with the use of additional methods helping patients to remember the treatment schedule, will be applied to enhance adherence to treatment, resulting in improved clinical outcomes. Interventions targeting the attitudes and knowledge of nurses and physicians form part of the MEDMOTION project, including analysis of the strengths and weaknesses of medical staff in the context of motivation and therapeutic education, workshops on interpersonal (medical staff and patient) communication, motivational and educational strategies. Conclusion. We believe that motivational actions, complementing educational interventions, are essential for successful secondary prevention after ACS.

Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets

BackgroundThis study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour.MethodsThe study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes.One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour.Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature > 38.5 °C), prolonged rupture of membranes, and use of tocolysis.ResultsNo significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol.ConclusionsInduction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia.Trial registrationClinicaltrials.gov ID: NCT02693587 on February 262,016.EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered.

Tremorography in the clinical practice

Tremor is the most common type of movement disorders. In practice this differential diagnosis of hyperkinesis is diagnosed clinically and the use of additional methods of objective assessment of tremor increases the accuracy of diagnosis. The use of paraclinical methods of objective assessment of tremor improves the accuracy of diagnosis. Comparison of the neurophysiological parameters of tremor with clinical characteristics has a high diagnostic value, which justifies its use in the routine practice of neurologists. The purpose of the review is to analysis basic electrophysiological characteristics of pathological tremor, as well as the presentation of the material of its own observation.

Results of enzyme-linked immunoassay of the blood serum in patients with infectious and inflammatory diseases of the anterior segment of the eye

To evaluate the clinical significance of the data obtained during enzyme-linked immunosorbent assay (ELISA) of the blood serum of patients with inflammatory diseases of the anterior eye segment compared to a group of healthy volunteers. A retrospective analysis of the results of serum ELISA of 200 patients with chronic keratoconjunctivitis and keratouveitis was performed using the solid-phase IFA method in order to detect the presence of antibodies to herpes simplex viruses of 1 and 2 types (HSV 1, 2), cytomegalovirus (CMV), Chlamydia trachomatis and Toxoplasma gondii. The control group consisted of 34 healthy volunteers with no signs of inflammation of the eye tissue. There were no significant differences in the frequency of detection of both «acute-phase» IgM and «chronic» IgG to HSV and CMV between patients of the main group and healthy volunteers (ρ≥0.05). The levels of IgG to Toxoplasma gondii in the study group were three times higher than in the control group (ρ≤0.05). A comparative analysis of the frequency of detection of antibodies to Chlamydia trachomatis showed statistically significant differences between the groups and more frequent detection of immunoglobulins classes A, G and M in patients with inflammatory eye diseases (ρ≤0.05). The absence of statistical differences with the control group in the frequency of detection of active HSV and CMV infections in patients with inflammatory diseases of the anterior eye segment when using ELISA allows to recommend the use of additional methods of examination such as polymerase chain reaction (PCR) and real-time PCR (RT-PCR) with identification of pathogen genetic material in the available biological secretions. The increase in IgG titers to toxoplasma in patients of the main group apparently indicates a cross-stimulation of antibody synthesis against the background of a chronic inflammatory process. Significant differences in the frequency of detection of all types of antibodies to chlamydiae suggests a significant etiological role of this pathogen in the development and maintenance of chronic inflammation in the anterior eye segment.

Intravascular Visualization in Carotid Artery Stenosis Treatment: One-centre Experience

Introduction: The problem of cerebrovascular disease remains relevant and requires study. The main reason for the development of ischemic strokes is atherosclerotic damage to the bifurcation of the common carotid artery (CCA) with the transition to the internal carotid artery (ICA). The use of additional methods of intravascular imaging is a promising direction in endovascular surgery of the carotid arteries. In our opinion, this topic is poorly studied and requires the study of its clinical and scientific significance. We decided to evaluate stenting results in patients with significant stenosis of the ICA using intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Methods: For the period from November to December 2018 in the clinic of vascular surgery 30 procedures using IVUS and 28 procedures with the use of OCT were performed during the stenting of the ICA. All visualization procedures were carried out before and after stent implantation and its postdilatation to determine the reference diameter of the stent, detecting the protrusion of plaque and adoratrice stent. In 100 % of cases in both groups the device of protection against distal embolism was used. Results: Technical success in both groups was 100 %. There was no statistically significant relationship between the plaque structure and the occurrence of protrusion through stent cells. Protrusion of plaque was detected in 5 patients in the IVUS group, 4 of which were implanted stent with an open cell design. We used double-meshed stent in OCT group. In the OCT group residual stenosis was detected in 6 patients with severe calcification of plaques. Postdilatation balloon catheter was performed in 100% of cases in both groups. In both groups there were no complications at the site of vascular access, 30-day mortality was 0 %. In 1 (3.33 %) patient in the group of IVUS there was stent thrombosis intraoperatively with ischemic stroke (NIHSS 13 points, mRs 5 points). In 2 (7.14 %) patients in the group of OCT there was stent thrombosis in 30 days with no significant neurological signs (mRs 0-1 points). Postoperative hospital stay in both groups was 1 day. Conclusion: The use of methods of intravascular visualization (IVUS and OCT) in stenting of the internal carotid artery makes it possible to obtain additional information about the structure of the plaque, the intravascular picture of the implanted stent, residual stenosis and plaque protrusion, as well as to adjust the tactics of treatment of a particular patient. There is some limitations to use OCT due to artery size and repeated vessel lumen flushing. Disclosure: Nothing to disclose

ALGORITHMS FOR SOLVING PROBLEMS OF PRE-TRANSFUSION IMMUNOHEMATOLOGICAL TESTING

Introduction. Screening and identification of anti-erythrocyte alloimmune antibodies in recipients is an important and necessary step in their testing before blood transfusion.Aim. To formulate algorithms that could facilitate the process of pre-transfusion immunohematological testing.General findings. Such a testing allows the development of post-transfusion reactions and complications to be avoided. The presence of alloantibodies of various specificities and autoantibodies in the test blood may complicate pre-transfusion testing and require the use of additional methods (adsorption, elution, etc.). The author has proposed an effective system of algorithms for conducting immunohematological studies, which can be used to identify patients at risk of developing immune post-transfusion complications and ensure an individual selection of compatible donor blood-transfusion products.

Optimization of the pre-analytical stage of material processing for histochemical examination of skeletal muscle biopsies in the diagnosis of neuromuscular diseases

Diagnosis of neuromuscular diseases is complicated by the variety of clinical manifestations and requires the use of additional methods, an important place among which is the pathomorphological study of skeletal muscle biopsy. Despite the fact that the procedure for taking a muscle biopsy is not technically difficult, to obtain informative material a multitude of conditions must be observed at the stages of pre-analytical processing of the obtained tissue samples. Violation of the technology of taking, storing and fixing the material contributes to the formation of artifacts that limit the possibilities for further analysis of the morphological changes in tissue biopsy. A comparison was made of the effectiveness of various methods for cryoprocessing of muscle tissue samples and the manufacture of histological specimens with a subsequent assessment of morphological changes. As a result, the main causes of artifacts were identified. The optimal method for processing muscle biopsy specimens is indicated, which makes it possible to prevent the appearance of artifacts as much as possible and to ensure the preservation of tissue for research.

Adherence to treatment — a pivotal issue in long-term treatment of patients with cardiovascular diseases. An expert standpoint

The adherence to treatment is defined as the extent to which a person’s behavior including taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider. Non-adherence to medication may lead to increased morbidity, mortality, and costs to the healthcare system. Therefore it is pivotal to know the true patient's adherence to medication, understand the causes of low adherence and take actions to improve adherence. The authors assumed that the individual, complex health education started during hospitalization and continued after discharge, explaining the pathophysiology and symptoms of the disease, elucidating goals and potential benefits of treatment, highlighting the risk of premature termination of therapy, with use of additional methods helping patients to remember treatment schedule will enhance adherence to treatment. There is an urgent need to develop and test a dedicated procedure covering all of these activities.

Aggregation in Children with Inflammatory Bowel Disease

Purpose: The aim of our research was to study the level of erythrocyte aggregation in blood of children with inflammatory bowel disease (IBD).Materials and methods: The study included 37 patients of both sexes ages 6 to 17 with IBD (17 with CD and 20 with UC). Blood was drawn after the hospitalization of patients and at the end of the treatment before their discharge. Erythrocyte aggregation was studied using a rheoscope constructed using the method of H. Schmid-Schönbein et al. at modification of G.Y. Levin et al. The process of aggregation was recorded during hydrodynamic mixing and upon its stop. The process of erythrocyte disaggregation was recorded when creating sheer stress set at the exact rate. The morphology of aggregates in autologous plasma was studied using a light microscope. The state of erythrocyte cytoskeleton was studied by the method of thermo induction. The state of erythrocyte membranes was determined by photometry on the laser aggregometer.Results: It was established that a significant increase in the degree and rate of aggregation of erythrocytes is observed at IBD. In the course of treatment aggregation of erythrocytes is normalized in children with UC, but remains elevated at CD. The aggregation character changes at IBD – pathological structures of aggregates appear along with the rouleaux. A correlation between ESR, fibrinogen concentration and the degree of erythrocyte aggregation was found. It was established that hyperaggregation of erythrocytes in IBD was caused by changes not only in plasma factors, but also in the cytoskeleton and in the erythrocyte membrane.Conclusion: Thus, disorders of the rheological properties of blood are an important factor in the pathogenesis of IBD in children causing ischemic damage to the intestine. This gives grounds for recommending the use of additional methods for combating hypoxia and microcirculatory disturbances during IBD.

Evaluation of Influence of Widening Apical Preparation of Root Canals on Efficiency of Ethylenediaminetetraacetic Acid Agitation Protocols: Study by Scanning Electron Microscopy

The purpose of this study was to evaluate the influence of widening the apical root canal preparation (RCP) on the efficiency of different ethylenediaminetetraacetic acid (EDTA) agitation protocols on smear layer removal: EDTA; EDTA + Easy Clean in rotary movement (ECROT); EDTA + Easy Clean in reciprocating movement (ECREC); and EDTA + Passive ultrasonic irrigation (PUI). A total of 80 mandibular premolars had their crowns sectioned and then were divided into two groups according to widening: size 25 or 40, 0.08 taper. Sequentially they were once again allocated to subgroups according to the agitation protocol performing eight experimental groups (n = 10). Ten additional teeth were prepared for controls (C+/C-). The specimens were then submitted to the cleaning protocols and thereafter cleaved and microphotographed by variable pressure scanning electron microscopy (SEM) at previously determined points along their root thirds (750*). Scores were attributed to the images, and data were analyzed by the Kruskal-Wallis, Student-Newman-Keuls and Friedman tests. A higher widening was observed to have a positive influence on cleaning efficiency offering significant differences in global and apical third evaluations (p < 0.05). Relative to the agitation, significant differences were observed mainly in the apical third, with PUI and ECROT providing the best results (p < 0.05); no difference for C+ was observed when higher widening was employed. A greater widening of the apical third provided a significant improvement in the action of the agitation/activation protocols. Moreover, the PUI and ECROT activation methods were shown to be superior to the use of EDTA solely, particularly in the apical third. The findings of this study reinforce the need for clinical use of additional methods to complement cleaning. Therefore, it is important for professionals to have knowledge and command of these protocols to obtain more satisfactory results.

Improvement of organizational and documentary security of vacation

The object of research is a system of organizational and documentary support for the design and provision of vacations in agricultural enterprises. One of the most problematic places is that ... information about the specifics of granting and documenting vacation, as well as their main types at enterprises and the amount of supply is not subject to official sources of the State Statistics Committee. Such information is not displayed in the reporting forms of enterprises, which requires the use of additional methods and sources of information collection. An experience of foreign countries to use vacation as one of the methods of motivating employees is used in the research. The introduction of an internal document into the activities of enterprises, which can have a form that is independent of other documents, and be part of the internal social report of the enterprise. The following generalized elements are defined as «vacation»: dismissal of the employee from performance of labor duties, preservation of the employee in the period of vacation of employment (position), payment. It is established that the term «vacation» is identified with the concept of «time». The main features of the majority of vacations are formulated. The main directions of improving the organizational and documentary provision of vacation and its use in the context of social activities of enterprises are outlined, namely: – use of vacation as one of the types of employee motivation; – use of the classification of vacations to improve its planning, analysis and control; – recording information on vacations in collective agreements of enterprises; – use of an internal document to display information on the volume of species, sources of coverage for vacation expenses.

A little more madness in our methods? A snapshot of how the educational leadership, management and administration field conducts research

ABSTRACTThe field of educational leadership, management and administration (ELMA) uses methods drawn primarily from cognate educational disciplines. But does this matter? This paper explores the methods used in recently published papers through a snapshot of six issues of six ELMA journals. The analysis showed a preponderance of survey, interview and case study methods, with one journal, JEAH, also publishing papers using methods drawn from history, philosophy and sociology. The snapshot also revealed the methods that were rarely used – for example, ethnography, visual and on-line methods. Through a Bourdieusian lens, the paper argues that the ELMA field appears to be somewhat removed from methods developments and debates in the wider educational and social science fields. There may thus be mileage in the ELMA field considering the use of additional methods, including the ‘wilder’ ones. The field might also benefit from understanding methods as more than tools and as practices possessed of a social life.

Investigating the Multi-memetic Mind Evolutionary Computation Algorithm Efficiency

При решении практически значимых задач глобальной оптимизации целевая функция зачастую имеет высокую размерность и вычислительную сложность, а также нетривиальный ландшафт. Исследования показывают, что зачастую одного метода оптимизации недостаточно для эффективного решения такого рода задач – необходима гибридизация нескольких методов оптимизации.

Powerful tools for resolving antibody problems

BackgroundIdentifying the specificity of antibodies in a patient's plasma can be as straightforward as testing selected reagent red cells on the basis of the antibody detection results. Many investigations, however, require the use of additional methods or supplemental tests for resolution.AimsSpecifics related to performance of these procedures, their interpretations and their limitations were reviewed.DiscussionGel microcolumn or solid phase methods, polyethylene glycol or low‐ionic strength saline enhancement media or unenhanced tests have appropriate uses for detecting or avoiding antibody reactivity. Useful red cell treatments include enzymes or thiol compounds to destroy antigens or enhance the antigen–antibody interaction and EDTA–glycine acid or chloroquine diphosphate to remove bound IgG from autologous cells. Separating autologous red cells from transfused donor cells for phenotyping or testing with plasma or eluate is critical. Alloantibodies or autoantibodies can be removed or separated by appropriate adsorption tests. Inhibition of antibody reactivity by a known soluble blood group substance confirms specificity or neutralizes interfering reactivity.ConclusionCombined into a logical investigation, these additional tests will aid in resolution of most antibody‐containing samples.

DIAGNOSTIC VALUE OF ULTRASOUND EXAMINATION IN PREOPERATIVE STAGING OF DISSEMINATED OVARIAN CANCER

The aim of the study was to compare the efficacy of the optimized ultrasound technique with the use of additional methods (change in the patient’s body position, forced type of breath and abdominal scanning with high-frequency probes) for assessing the preoperative staging in 47 patients with primary epithelial ovarian cancer. It was shown that the optimized ultrasound technique, especially in cases with low-volume ascites, allowed improvement in preoperative staging of ovarian cancer, with sensitivity of 87%.

Undergraduate Latina/o Students

A systematic review was conducted to produce an up-to-date and comprehensive summary of qualitative and quantitative evidence specific to the factors related to undergraduate Latina/o student academic success outcomes during college. The purpose of the study was to make sense of and provide critique to this rapidly growing body of research, as well as to direct future research efforts. Findings indicate that a combination of (a) sociocultural characteristics; (b) academic self-confidence; (c) beliefs, ethnic/racial identity, and coping styles; (d) precollege academic experiences; (e) college experiences; (f) internal motivation and commitment; (g) interactions with supportive individuals; (h) perceptions of the campus climate/environment; and (i) institutional type/characteristics are related to one or more academic success outcomes for Latina/o students. The article concludes with specific recommendations including the use of additional methods, frameworks and perspectives that we hope will be useful in advancing this line of work.

P174 Improving implant retention rates in an integrated sexual health service

Background Subdermal implants (SDI) are cost effective when used for the recommended time. Early removal of SDI reduces cost effectiveness and we were aware anecdotally that this was an issue within our service. Data was lacking however. Subsequently removal rates at 3 and 6 months have been included within our Public Health Quality Contract (PHQC). Various strategies were implemented to reduce early removal. These included: improving the consent process by amending consent form; encouraging the use of additional methods to manage unscheduled bleeding; starting a dedicated implant removal clinic in February 2014. Aim Have the outlined service changes impacted on SDI removal rates? Methods Data from our PHQC was obtained from 2014–15. This measured SDI removal rates as a proportion of the total SDI fitted by our service. Results In April 2014 the 3 months removal rate was 3.53%. By November 2014 it had fallen to 0.34%. Discussion The strategies that were implemented appear to have had the desired effect. Care was taken to ensure staff gave patients the right information prior to fitting to ensure that their expectations of how any side effects would be managed was clear at the outset. The implant removal clinics were initially slow to get established and now are fully booked for months in advance. This has led to some criticism that patients are now unable to get their implants removed easily. The challenge moving forward is to ensure that patients have any symptoms managed promptly whilst keeping retention rates high.