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Background: End-point based studies have demonstrated a direct relationship between coronary disease and elevated serum levels of low density lipoprotein cholesterol (LDL-C) and total cholesterol, as well as the benefits of lowering LDL-C with statins on clinical end-points. Policosanol is a mixture of very long chain fatty alcohols purified from sugar cane wax, with dislipidemia controlling effects, proved in numerous clinical assays in which patients with different conditions were included. The efficacy and tolerability of policosanol in the elderly have been also investigated in several clinical trials, being effective, safe and well tolerated. Objectives: To investigate the effects of policosanol treatment during three years on lipid profile with a proportional intensity to the initial dislipidemia severity in older hypercholesterolemic patients. Methods: The present analysis was obtained from the data of all patients treated with policosanol included in a previous prevention study. One thousand, ford hundred seventy old patients of both sexes, between 60 to 85 years old, with type II hypercholesterolemia, and ³ 1 non-lipid coronary risk factors, were randomized in two groups and treated with policosanol or placebo, during three years. Significant changes on lipid profile with a proportional intensity to the initial dislipidemia severity were considered primary efficacy variables. The analysis was done by Intention-to-treat method. Results: An analysis of the response intensity show that after treatment, reductions of LDL-C, total cholesterol and triglycerides were greater, and according to the initial hypercholesterolemia severity, so that, patients with severe hypercholesterolemia showed the better responses, followed by moderate and mild hypercholesterolemia. An opposite pattern, however, was observed for HDL-C serum concentration. Triglycerides did not respond in the same way. The frequency of vascular serious adverse events was lower in the policosanol group (15 events) compared with those on placebo group (49 events). There were 109 patients who experienced serious adverse events: 83 (11.3 %) in placebo and 26 (3.5 %) in policosanol group (p

Background: A shortage of beds, high case volume, decreased availability of outpatient medical doctors, and limited disease knowledge resulted in the premature discharge and poor follow up of COVID-19 patients in the New York Metropolitan Area. Objective: The primary objective of this retrospective study and phone survey was to characterize the demographics and clinical outcomes (e.g., readmission rates, comorbidities, mortality, and functional status) of COVID-19 patients discharged without follow-up. The secondary objective was to assess the impact of race and comorbidities on readmission rates and the extent to which patients were escalated to another care provider. Methods: Electronic medical records were reviewed for COVID-19 patients discharged from 3 NYMA hospitals in March 2020. Follow up data regarding medical status, ability to perform activities of daily living and functional status was also obtained from patients via phone call. The Chi-square, Fishers exact test and t-tests were used to analyze the data. Results: 349 patients were included in the analysis. The hospital readmission rate was 10.6% (58.8% for pulmonary reasons) and did not differ by race. 74.3% of readmissions were

Stock price prediction is important in both financial and commercial domains, and using neural networks to forecast stock prices has been a topic of ongoing research and development. Traditional prediction models are often based on a single type of data and do not account for the interplay of many variables. This study covers a radial basis neural network modeling technique with multiview collaborative learning capabilities for incorporating the impacts of numerous elements into the prediction model. This research offers a multiview RBF neural network prediction model based on the classic RBF network by integrating a collaborative learning item with multiview learning capabilities (MV-RBF). MV-RBF can make full use of both the internal information provided by the correlation between each view and the distinct characteristics of each view to form independent sample information. By using two separate stock qualities as input feature information for trials, this study proves the viability of the multiview RBF neural network prediction model on a real data set.

BACKGROUND: Determination of the complete blood count (CBC) and reticulocyte reference range helps diagnose a disease related to changes in erythrocyte indices, white blood count, platelets, and reticulocytes, especially in newborns. AIM: The aim study is to establish a reference range for CBC and reticulocyte in healthy term newborns 1 week after birth. MATERIAL AND METHODS: The study method is prospective analyses of CBC and reticulocyte in term newborns within 1 week after birth. Inclusion criteria are term newborn (gestational age 37–42 weeks) with good tone, breathing, or crying immediately, do not have resuscitation, and the birth weight is ≥2500 g. RESULTS: Two hundred and seventy-seven term newborns met the inclusion criteria. There were 145 (52.35%) male infants and 132 (47.65%) female infants. The reference range of newborns for hemoglobin (Hb) at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 standard deviation (SD) was 11.70–19.60 g/dL, 11.90–19.57 g/dL, 12.20–19.20 g/dL, and 11.35–19.63 g/dL, respectively. In addition, reference range of male newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2SD was 12.20–20.14 g/dL, 12.28–19.91 g/dL, 12.63–19.38 g/dL, and 11.47–20.15 g/dL, respectively. The reference range of female newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 SD was 11.37–19.20 g/dL, 11.50–19.20 g/dL, 11.80–19.20 g/dL, and 11.37–18.93 g/dL, respectively. CONCLUSION: The reference range of CBC and reticulocyte for healthy term newborns, male newborns, and female newborns in this study can be used as a benchmark.

Objective Data harmonization is essential to integrate individual participant data from multiple sites, time periods, and trials for meta-analysis. The process of mapping terms and phrases to an ontology is complicated by typographic errors, abbreviations, truncation, and plurality. We sought to harmonize medical history (MH) and adverse events (AE) term records across 21 randomized clinical trials in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Methods We developed and applied a semi-automated harmonization pipeline for use with domain-expert annotators to resolve ambiguous term mappings using exact and fuzzy matching. We summarized MH and AE term mapping success, including map quality measures, and imputation of a generalizing term hierarchy as defined by the applied Medical Dictionary for Regulatory Activities (MedDRA) ontology standard. Results Over 99.6% of both MH (N = 37,105) and AE (N = 58,170) records were successfully mapped to MedDRA low-level terms. Automated exact matching accounted for 74.9% of MH and 85.5% of AE mappings. Term recommendations from fuzzy matching in the pipeline facilitated annotator mapping of the remaining 24.9% of MH and 13.8% of AE records. Imputation of the generalized MedDRA term hierarchy was unambiguous in 85.2% of high-level terms, 99.4% of high-level group terms, and 99.5% of system organ class in MH, and 75% of high-level terms, 98.3% of high-level group terms, and 98.4% of system organ class in AE. Conclusion This pipeline dramatically reduced the burden of manual annotation for MH and AE term harmonization and could be adapted to other data integration efforts.

Several international human rights conventions focus on ensuring access to justice for all. Based on their unique lived experiences, legal practitioners with disabilities have much to offer in term...

PURPOSE There is an increase in medical students with long term conditions applying for accommodations in assessment. Medical school responses to such applications appear inconsistent, possibly reflecting insufficient guidance for policy. We aimed to inform an approach by developing guidance. METHODS Within a New Zealand and Australian context, we used a four-stage action research methodology: discussion with medical educators and survey of all 21 medical schools, including responding to 22 hypothetical scenarios; developing an approach; applying the approach to the hypothetical scenarios; and seeking feedback from stakeholders on the proposed approach. RESULTS Current practice varied among the 13 responding medical schools. Medical schools were consistent in their responses for 10 hypothetical scenarios but inconsistent in 12. An approach based on a matrix of authenticity to practice, including regulatory and employment factors, and feasibility to educational institutions was developed. This was applied to the hypothetical scenarios and highlighted how consistency could be better achieved, and where further discussion between regulators and employers might be needed. CONCLUSION This approach and the matrix based on authenticity and feasibility provides guidance to consider assessment accommodation applications. It highlights the need for discussions among regulators, employers, educational institutions and the disability sector.

У статті розглянуто результати понад 30-річного досвіду застосування інноваційної в Україні системи підтримки й реабілітації осіб з особливими потребами. Основною метою цього проекту була розробка та впровадження в реальну практику сучасних моделей реабілітації для таких форм відхилень на відміну від існуючих інституційних систем. Така модель була розроблена Інститутом реабілітації осіб з вадами психофізичного розвитку імені Януша Корчака в тісній співпраці з КЗ «Центр реабілітації осіб з вадами психофізичного розвитку». Спільними зусиллями була створена система реабілітації, що включає відділення ранньої реабілітації, групи дитячого садка, групи денного перебування для дітей та дорослих із тяжкими формами психічних порушень, майстерню для осіб із вадами розвитку та гуртожиток для дорослих. За 25 років роботи реабілітаційний комплекс довів свою ефективність та доцільність як альтернативи інституційній системі.

Short-term electricity load forecasting (STLF) plays a key role in operating the power system of a nation. A challenging problem in STLF is to deal with real-time data. This paper aims to address the problem using a hybrid online model. Online learning methods are becoming essential in STLF because load data often show complex seasonality (daily, weekly, annual) and changing patterns. Online models such as Online AutoRegressive Integrated Moving Average (Online ARIMA) and Online Recurrent neural network (Online RNN) can modify their parameters on the fly to adapt to the changes of real-time data. However, Online RNN alone cannot handle seasonality directly and ARIMA can only handle a single seasonal pattern (Seasonal ARIMA). In this study, we propose a hybrid online model that combines Online ARIMA, Online RNN, and Multi-seasonal decomposition to forecast real-time time series with multiple seasonal patterns. First, we decompose the original time series into three components: trend, seasonality, and residual. The seasonal patterns are modeled using Fourier series. This approach is flexible, allowing us to incorporate multiple periods. For trend and residual components, we employ Online ARIMA and Online RNN respectively to obtain the predictions. We use hourly load data of Vietnam and daily load data of Australia as case studies to verify our proposed model. The experimental results show that our model has better performance than single online models. The proposed model is robust and can be applied in many other fields with real-time time series.

У статті подані результати дослідження застосування препарату Мексиприм методом ендоназального електрофорезу в пацієнтів — учасників АТО працездатного віку з комоційно-контузіонними ураженнями різного ступеня вираженості. Проведено аналіз динаміки психовегетативного синдрому, балансу вегетативної дисфункції, ступеня вираженості тривожного та депресивного синдромів, посттравматичного стресового розладу за допомогою стандартизованих шкал і опитувальників, а також оцінки низки показників електроенцефалограми (ЕЕГ) до та після процедур електрофорезу. Показано, що терапія препаратом Мексиприм методом ендоназального електрофорезу сприяла ефективній реабілітації пацієнтів із травматичним пошкодженням мозку: було відзначено тенденцію до нормалізації вегетативних функцій і психоемоційного стану учасників АТО, а також позитивну динаміку комплексу показників ЕЕГ (зокрема, вірогідне зниження судомної готовності після лікування). Під час терапії пацієнтів не було зареєстровано випадків виникнення небажаних реакцій.

Background. The secondary traumatic brain injury (TBI) consequences are associated with multiple cascades of biochemical reactions caused by initial neurotrauma. We assessed changes in radical oxidation and marker membrane-associated enzymes involved into various redox reactions reflecting basic metabolic processes by measuring creatine phosphokinase (CPK), CPK-BB, adenosine triphosphate (ATP), adenosine diphosphate (ADP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, lactate dehydrogenase (LDH) in the patients with long-term consequences after TBI. Materials and methods. Eighty-two patients (mean age (±SD) 39.04 ± 14.62 years), thirty controls (29.60 ± 4.73 years) were tested for serum CPK, CPK-BB, ATP, ADP measured using spectrophotometry methods according to standard manufacturer’s protocols. Serum AST, ALT, alkaline phosphatase, LDH levels were detected on gas-liquid chromatograph, by calorimetric methods. Results. We found elevated serum CPK level in patients with long-term consequences after TBI compared to controls (P < 0.001, t = 5.073, 95% CI –188.6 to –92.16) with the medians of total CPK of 163.5 ± 14.1 versus 92.6 ± 11.4 pg/ml in the basic and control groups, respectively. We found abnormal high serum CPK-BB level in the basic group with medians of total CPK-BB level of 24.7 ± 2.7 versus 16.14 ± 1.83 IU/L in controls (p < 0.05; t = 4.9). Metabolic changes in our patients were associated with higher LDH content being in direct proportion with disease duration (p < 0.05; r = +0.42); the median of total LDH level was 694.1 ± 16.3 and 381.9 IU/l in basic and control groups (p < 0.05), respectively. The patients investigated were detected with deficiency of macroergic compounds: ATP and ADP being in direct proportion with disease duration over 15 years (p < 0.05; r = +0.67); the medians of total ATP level were 627.60 ± 12.38 and 735.48 ± 14.57 μmol/l (p < 0.05) in the basic and control groups; for ADP: 256.20 ± ± 14.21 versus 273.88 ± 11.42 (p < 0.05), respectively. Conclusions. Patients with long-term consequences after TBI showed higher serum CPK level associated with increased LDH level reflecting bioenergy dyshomeostasis and severity of secondary brain injuries., Актуальность. Формирование отдаленных последствий закрытой черепно-мозговой травмы (ЗЧМТ) сопровождается каскадом биохимических реакций, которые инициируются первичной нейротравмой. Цель работы. Мы оценивали состояние и изменения радикального окисления и маркерных мембранасоциированных ферментов, которые участвуют в различных окислительно-восстановительных реакциях и отражают основные метаболические процессы организма, путем измерения уровней креатинфосфокиназы (КФК), КФК-ВВ, аденозинтрифосфата (АТФ), аденозиндифосфата (АДФ), аспартатаминотрансферазы (АСТ), аланинаминотрансферазы (АЛТ), щелочной фосфатазы, лактатдегидрогеназы (ЛДГ) у пациентов с отдаленными последствиями ЗЧМТ. Материалы и методы. Восемьдесят два больных (средний возраст (±SD) 39,04 ± 14,62 года), тридцать здоровых пациентов (29,60 ± 4,73 года) были протестированы на уровень КФК, КФК-BB, АТФ, АДФ, которые были определены в сыворотке крови спектрофотометрическим методом в соответствии с прилагаемыми стандартными инструкциями. АЛТ, АСТ, щелочная фосфатаза, ЛДГ были измерены хроматографическим и калориметрическим методами. Результаты. Был выявлен повышенный уровень КФК в сыворотке крови больных с отдаленными последствиями ЗЧМТ по сравнению с контролем (р < 0,001; t = 5,07), средний уровень КФК составлял 163,5 ± ± 14,1 против 92,6 ± 11,4 пг/мл у здоровых людей. Нами был выявлен очень высокий уровень КФК-BB в сыворотке крови в общей группе пациентов, у которых средний уровень КФК-BB составлял 24,7 ± 2,7 против 16,14 ± 1,83 МЕ/л в контрольной группе (р < 0,05; t = 4,9). Метаболические изменения у пациентов заключались в более высоких показателях ЛДГ, которые были прямо пропорциональны увеличению продолжительности посттравматического периода (p < 0,05; r = +0,42); в общей и контрольной группах средний уровень ЛДГ составлял 694,1 ± 16,3 и 381,9 МЕ/л соответственно (р, Актуальність. Формування віддалених наслідків закритої черепно-мозкової травми (ЗЧМТ) супроводжується каскадом біохімічних реакцій, які ініціюються первинною ней-ротравмою. Мета роботи. Ми оцінювали стан і зміни радикального окислення та маркерних мембранасоційованих ферментів, що беруть участь у різних окислювально-відновних реакціях та відображають основні метаболічні процеси організму, шляхом вимірювання рівнів креатинфосфокінази (КФК), КФК-ВВ, аденозинтрифосфату (АТФ), аденозиндифосфату (АДФ), аспартатамінотрансферази (AСT), аланінамінотрансферази (AЛT), лужної фосфатази, лактатдегідрогенази (ЛДГ) у пацієнтів із віддаленими наслідками після ЗЧМТ. Матеріали та методи. Вісімдесят два хворі (середній вік (±SD) 39,04 ± 14,62 року), тридцять здорових осіб (29,60 ± 4,73 року) були протестовані на рівень КФК, KФК-BB, ATФ, AДФ, що були вимірювані у сироватці крові спектрофотометричним методом згідно з доданими стандартними інструкціями. AЛT, AСT, лужна фосфатаза, ЛДГ були вимірювані хроматографічним та калориметричним методами. Результати. Було виявлено підвищений рівень КФК у сироватці крові хворих із віддаленими наслідками після ЗЧМТ порівняно з контролем (р < 0,001; t = 5,07), середній рівень КФК становив 163,5 ± 14,1 проти 92,6 ± 11,4 пг/мл у здорових осiб. Ми виявили дуже високий рівень KФК-BB у сироватці крові у загальній групі пацієнтів, де середній рівень KФК-BB становив 24,7 ± 2,7 проти 16,14 ± 1,83 МО/л у контрольній групі (р < 0,05; t = 4,9). Метаболічні зміни в пацієнтів полягали в більш високих показниках ЛДГ, які були прямо пропорційні збільшенню тривалості посттравматичного періоду (p < 0,05; r = +0,42); у загальній та контрольній групах середній рівень ЛДГ становив 694,1 ± 16,3 та 381,9 МО/л відповідно (р < 0,05). В обстежених хворих було виявлено дефіцит макроергічних сполук, а саме АТФ та АДФ, які знаходились у прямій залежності від тривалості захворювання, особливо понад 15 років (р < 0,05; r = +0,67); у загальній групі пацієнтів середній рівень АТФ становив 627,60 ± 12,38 мкмоль/л порівняно з 735,48 ± 14,57 мкмоль/л у групі контролю(р < 0,05); для AДФ: 256,20 ± 14,21 і 273,88 ± 11,42 (p < 0,05) відповідно. Висновки. У пацієнтів із віддаленими наслідками після ЗЧМТ були виявлені високий рівень загальної активності KФК у сироватці крові та підвищення рівня ЛДГ, що відображає біоенергетичний дисгомеостаз та тяжкість перебігу віддалених наслідків травми мозку.

Purpose: To investigate the safety of laser epithelial keratomileusis (LASEK) by drawing a comparison between two groups divided according to age (18-19 vs. 20-21 years old).Methods: The study was conducted as a retrospective analysis including 339 patients (678 eyes) who underwent LASEK between January 2017 and April 2020. Patients were divided by age group, group I (18-19 years old) and group II (20-21 years old). The objectives of the study included determination of visual acuity and refractive errors before and at 1, 3, and 6 months after the procedure.Results: The preoperative mean spherical equivalents (SEs) were -4.73 ± 0.88 diopters (D) in group I and -4.58 ± 0.87 D in group II (p = 0.34). At 1 month postoperatively, mean SEs were 0.32 ± 0.46 D in group I and 0.26 ± 0.59 D in group II (p = 0.18). At 3 months postoperatively, the mean SEs were 0.30 ± 0.47 D in group I and 0.28 ± 0.50 D in group II (p = 0.67). At 6 months postoperatively, the mean SEs were 0.15 ± 0.47 D in group I and 0.14 ± 0.50 D in group II (p = 0.89). There were no significant differences in postoperative best corrected visual acuity between group I and group II at 1, 3, or 6 months (p = 0.20, p = 0.13, and p = 0.11, respectively).Conclusions: There were no significant differences in postoperative mean SE or safety of LASEK between moderate myopia patients 18-19 years old and those 20-21 years old.

Purpose: This study evaluated the short-term safety of resident-performed intravitreal injections.Methods: We retrospectively reviewed the medical records of 503 patients (503 eyes) treated for the first time in our hospital from January 2018 to October 2020 via intravitreal bevacizumab, ranibizumab, aflibercept, or triamcinolone acetonide injections by residents or retina specialists. In terms of short-term ophthalmic complications, patients were followed-up 1 day, 1 week, and 1 month after injection.Results: A total of 503 eyes of 503 patients were included. Intravitreal injections were given to 211 and 292 eyes by residents (the resident group) and retina specialists (the retina specialist group), respectively. There were no between-group differences in baseline characteristics except in terms of the indications for injection. Intraocular pressure elevation >5 mmHg occurred in two eyes (0.95%) in the resident group and five (1.71%) in the retina specialist group, but the difference was not statistically significant. Subconjunctival hemorrhage occurred in 29 eyes (13.74%) of the resident group and 32 eyes (10.96%) of the retina specialist group; again, the difference was not statistically significant. No case of noninfectious endophthalmitis occurred in the resident group but two (0.68%) cases occurred in the retina specialist group; again, the difference was not significant. There were two (0.95%) cases of infectious endophthalmitis in the resident group and one (0.34%) case in the retina specialist group; again, the difference was not significant. No corneal erosion, traumatic lens damage, vitreous hemorrhage, or retinal tearing or detachment were noted in either group.Conclusions: Resident-performed intravitreal injections appear to be safe.

Purpose: The purpose of this case was to report the inhibition of toxoplasma retinitis reactivation with long-term, low-dose antibiotics.Case summary: A 76-year-old woman complained of poor vision and floaters in her right eye. The corrected visual acuity (LogMAR) of the right eye was 0.5, and there was an area of yellow infiltration and dye leakage on the retinal fluorescein angiography images. Toxoplasma IgG were detected in the serum, the patient was diagnosed with toxoplasma retinitis, and the patient was advised oral trimethoprim-sulfamethoxazole, clindamycin, and steroids. Her visual acuity improved and the inflammation resolved. However, she again had decreased visual activity and retinal inflammation in her right eye after 5 months. The inflammation improved with oral steroids, but she was shifted to intravitreal dexamethasone because of the side effects of systemic steroids. Although the inflammation improved initially, there was worsening of inflammation (evidenced by vitreous opacity) after 2 months, which was treated with oral antibiotics. After vitrectomy for the removal of residual vitreous opacity, antibiotics were stopped because of the stable disease course. After discontinuation of the antibiotics, inflammation was noted again, and low-dose trimethoprim-sulfamethoxazole was administered. Low-dose antibiotics were continued for 5 months and the disease remained stable without any retinal inflammation.Conclusions: Long-term, low-dose oral antibiotics may prevent reactivation of recurrent toxoplasma retinitis.

Forecasting in wind energy is a crucial task to perform adequate wind farm flow control or to participate in the energy market. While many power forecasting methods exist, it is notoriously difficult to capture both short- and long-term variations in the wind farm system in real time. We demonstrate a data-driven real-time system identification approach to forecasting based on streaming dynamic mode decomposition methodology (sDMD). The method is capable of characterizing nonlinear, time-varying, multidimensional time series data in a computationally efficient manner. The algorithm is modified to work with data streams by adjusting the dynamic mode decomposition continuously as new data are made available. The method is applied to high-frequency SCADA data from the Lillgrund offshore wind farm. A 23.31% improvement over persistence forecasting is found for 5-min-ahead forecasts of the power output of all turbines in the wind farm. sDMD is shown to be a suitable tool for capturing short-term dynamics while adapting to long-term changes in wind speed and direction and has potential applications in real-time wind farm control.

Objective: this study aimed to investigate the effect of routine bilateral neck dissection on the survival outcomes of supraglottic laryngeal cancer patients with lateralized tumors and clinically negative necks. Methods: the data of 234 patients surgically treated for supraglottic squamous cell carcinoma between January 2000 and September 2014 were retrospectively collected. Patients treated previously for head and neck cancer, patients who could not be contacted, and those with missing data were excluded. Of the remaining 187 patients, 124 patients with early-stage primaries (T1-T2) (116 males, 8 females; mean age: 55.5±9.5 years; range, 33 to 82 years) were included. Age and sex of the patients, site of the primary tumor, TNM stage, type of the neck dissection, length of follow-up, and survival rates were evaluated. The tumors were classified into three groups according to their relationship with the median line of the larynx, and the neck dissections were recorded as unilateral or bilateral. Recurrences and survival outcomes were evaluated. Results: there was no statistically significant difference in the recurrences according to tumor site groups (p=0.39). Similarly, there was no statistically significant difference in 10-year overall survival rates in patient groups according to the tumor site (p=0.072). We found no statistically significant difference in 10-year overall survival rates between the patients who underwent unilateral and bilateral neck dissection (p=0.580). Conclusion: long-term survival analysis of 124 patients with supraglottic carcinoma did not show a survival benefit of elective contralateral neck dissection in lateralized supraglottic cancer with contralateral clinically negative neck. / Amaç: bu çalışmada lateralize tümörlü supraglottik larenks kanseri hastalarında, klinik olarak negatif boyun varlığında rutin iki taraflı boyun diseksiyonunun sağkalım sonuçlarına etkisi araştırıldı. Hastalar ve yöntemler: skuamöz hücreli supraglottik larenks karsinomu nedeniyle Ocak 2000 - Eylül 2014 tarihleri arasında cerrahi olarak tedavi edilen 234 hastanın verileri retrospektif olarak toplandı. Daha önce baş ve boyun kanseri nedeniyle tedavi gören hastalar ile ulaşılamayan veya verileri eksik olan hastalar çalışma dışı bırakıldı. Geriye kalan 187 hastadan, erken evreli primerleri (T1-T2) olan 124 hasta (116 erkek, 8 kadın; ort. yaş: 55.5±9.5 yıl; dağılım, 33-82 yıl) çalışmaya dahil edildi. Hastaların yaş ve cinsiyeti, primer tümörün yerleşim yeri, TNM evresi, boyun diseksiyonu tipi, takip süresi ve sağkalım oranları değerlendirildi. Tümörler larenks orta hat ile ilişkilerine göre üç gruba ayrıldı, boyun diseksiyonları da tek taraflı veya iki taraflı olarak kaydedildi. Rekürrensler ve sağkalım sonuçları değerlendirildi. Bulgular: tümör yerleşim yerine göre oluşturulan gruplarda, rekürrens oranları arasında istatistiksel olarak anlamlı bir fark bulunmadı (p=0.39). Benzer şekilde, tümör yerleşim yerine göre 10 yıllık sağkalım oranlarında da istatistiksel olarak anlamlı bir fark yoktu (p=0.072). Tek taraflı ve iki taraflı boyun diseksiyonu yapılan hastalar arasında da 10 yıllık genel sağkalım oranları açısından istatistiksel olarak anlamlı bir fark saptanmadı (p=0.580). Sonuç: supraglottik karsinomlu 124 hastanın uzun dönem sağkalım analizine göre, klinik olarak karşı taraf boynu negatif lateralize supraglottik kanserde, elektif karşı taraf boyun diseksiyonunun sağkalım üzerine avantajı gözlenmedi., NA

Transient Evoked Otoacoustic Emissions (TEOAE) are a class of oto-acoustic emissions that are generated by the cochlea in response to an external stimulus. The TEOAE signals exhibit characteristics unique to an individual, and are therefore considered as a potential biometric modality. Unlike conventional modalities, TEOAE is immune to replay and falsification attacks due to its implicit liveliness detection feature. In this paper, we propose an efficient deep neural network architecture, EarNet, to learn the appropriate filters for non-stationary (TEOAE) signals, which can reveal individual uniqueness and long- term reproducibility. EarNet is inspired by Google’s FaceNet. Furthermore, the embeddings generated by EarNet, in the Euclidean space, are such that they reduce intra-subject variability while capturing inter-subject variability, as visualized using t-SNE. The embeddings from EarNet are used for identification and verification tasks. The K-Nearest Neighbour classifier gives identification accuracies of 99.21% and 99.42% for the left and right ear, respectively, which are highest among the machine learning algorithms explored in this work. The verification using Pearson correlation on the embeddings performs with an EER of 0.581% and 0.057% for the left and right ear, respectively, scoring better than all other techniques. Fusion strategy yields an improved identification accuracy of 99.92%. The embeddings generalize well on subjects that are not part of the training, and hence EarNet is scalable on any new larger dataset.

This article uses a relationality-sensitive perspective to analyse long-term breastfeeding. The data was gathered through open invitations to write, and the article is based on the written reflections of 39 long-term breastfeeding Finnish mothers. In Finland, the breastfeeding of babies is strongly supported, but long-term breastfeeding (over 12 months) is a more conflicted issue, and the cultural norm of one year of breastfeeding is strong. Through qualitative content analysis, the article shows how mothers reflect on long-term breastfeeding’s effects on their relations with their breastfed children, partners (if any), relatives and healthcare professionals. The findings show that long-term breastfeeding is often a rewarding experience, but that it takes place in a network of relations and has effects on those relations. With a relationality-sensitive approach to breastfeeding, we can better understand how mothering is done in and through relations with others, and how mothers express the need for a change in attitudes towards long-term breastfeeding. This article gives a voice to mothers who are often silent in our society, and therefore participates in the feminist empowerment of women and especially mothers. peerReviewed

Stemming is a common word conflation method that perceives stems embedded in the words and decreases them to their stem (root) by conflating all the morphologically related terms into a single term, without doing a complete morphological analysis. This article presents STEMUR, an enhanced stemming algorithm for automatic word conflation for Urdu language. In addition to handling words with prefixes and suffixes, STEMUR also handles words with infixes. Rather than using a totally unsupervised approach, we utilized the linguistic knowledge to develop a collection of patterns for Urdu infixes to enhance the accuracy of the stems and affixes acquired during the training process. Additionally, STEMUR also handles English loan words and can handle words with more than one affix. STEMUR is compared with four existing Urdu stemmers including Assas-Band and the template-based stemmer that are also implemented in this study. Results are processed on two corpora containing 89,437 and 30,907 words separately. Results show clear improvements regarding strength and accuracy of STEMUR. The use of maximum possible infix rules boosted our stemmer's accuracy up to 93.1% and helped us achieve a precision of 98.9%.

Appendicitis is classified as either complicated (CA) or uncomplicated (UA). Some authors have shown that the epidemiologic trends of CA and UA may differ. The aim of this study was to clarify differences in backgrounds and surgical outcomes between CA and UA patients.This study was a cohort study. We extracted case data from the Japanese Diagnosis Procedure Combination (DPC) database from January 2014 to December 2017. Patients were classified into three groups, depending on whether they underwent emergency appendectomy for CA (CA group), emergency appendectomy for UA (UA group), or elective appendectomy (EA group). We evaluated patient characteristics and surgical outcomes for each group.We included 89,355 adult patients in the study, comprising 29,331 CA, 48,691 UA, and 11,333 EA patients. Old age, larger body mass index, smoking, and medication with antidiabetic drugs, oral corticosteroids, oral antiplatelet drugs, and oral anticoagulant drugs were independent risk factors for CA. The percentage of CA increased with age. In-hospital mortality (0.15%, 0.02%, and 0.00%) and 30-d mortality (0.09%, 0.01%, and 0.00%), respectively, of CA patients were significantly higher than those of the UA and EA groups. The duration of postoperative antibiotic administration, duration of fasting, and time before removal of a prophylactic drain were significantly longer in the CA group than in the UA and EA groups.Backgrounds and treatment outcomes of CA and UA patients after emergency surgery are entirely different. Thus, the treatment strategy of CA and UA patients should differ accordingly.

The neonatal microbiome offers a valuable model for studying the origins of human health and disease. As the field of metagenomics expands, we also increase our understanding of early life influences on its development. In this review we will describe common techniques used to define and measure the microbiome. We will review in utero influences, normal perinatal development, and known risk factors for abnormal neonatal microbiome development. Finally, we will summarize current evidence that links early life microbial impacts on the development of chronic inflammatory diseases, obesity, and atopy.

Актуальность. 2020 год в истории человечества останется годом испытаний для населения более чем 180 стран мира, их правительств, экономик и систем здравоохранения в связи с пандемией острой респираторной болезни COVID-19, вызванной коронавирусом SARS-CoV-2. На конец мая в мире заболели коронавирусной инфекцией COVID-19 6 159 953 человек, 371 006 умерли, 2 738 179 выздоровели. Разработка вакцины против трех известных типов коронавируса может занять от одного до полутора лет и потребует дополнительно $2 млрд, считают во Всемирном банке. Цель исследования. Определить риски медицинской деятельности для учреждений первичной медицинской помощи в условиях эпидемии острой респираторной болезни COVID-19, вызванной коронавирусом SARS-CoV-2, и подходы к управлению ими. Материалы и методы. В качестве материалов исследования использованы научные источники (1 ед.), международные документы (7 ед.), законодательные и нормативно-правовые акты (10 ед.). Использованы методы системного подхода, системного и контент-анализа, концептуального моделирования. Результаты. Установлено, что в учреждениях первичной медицинской помощи Украины в период эпидемии острой респираторной болезни COVID-19, вызванной коронавирусом SARS-CoV-2, реализовались управленческо-организационные, нормативно-правовые, финансово-хозяйственные, операционно-технологические, кадровые риски за счет введения карантина на государственном уровне, утверждения нормативно-правовых документов по организации и оказанию медицинской помощи пациентам с COVID-19, в которые несколько раз вносились изменения за короткий период времени, начала второго этапа медицинской реформы с 01.04.2020 в учреждениях здравоохранения вторичной медицинской помощи. Предложено несколько направлений совершенствования подходов к управлению рисками в существующей системе риск-менеджмента учреждений первичной медицинской помощи: усиление руководства учреждением путем внедрения дополнительной специализированной функциональной структуры при руководителе – штаба управления учреждением в условиях эпидемии; разработка и реализация эффективной стратегии эпидемического мониторинга, профилактики и инфекционного контроля; обновления контента информации о рисках в целях обмена между всеми заинтересованными сторонами; пересмотр кадровой политики и кадрового обеспечения учреждения. Выводы. Существует необходимость оживления системы риск-менеджмента в учреждениях первичной медицинской помощи в связи со значительным усложнением эпидемической ситуации, которое может продолжаться длительный период времени. Необходимо пересмотреть подходы к управлению рисками в направлениях совершенствования управления учреждением, персоналом, эпидемической безопасностью, информационным обеспечением.

Background: Tonsillectomy is considered one of the most common major operations performed in pediatric population. Unfortunately, tonsillectomy is often associated with severe pain that may delay the patient discharge and influence his ability to return to the normal daily activities together with a 2–4% risk of hemorrhage. Among promising healing promoting agents is Platelet-rich plasma (PRP). It is considered as a potential adjuvant therapy improving the healing of surgical wounds and contains multiple growth and healing factors that are released upon their activation. Methods: This was a prospective randomized controlled study carried on forty patients who underwent tonsillectomy alone or adenotonsillectomy. In each patient, PRP was used on one side " test side " and other side was used as a control. The test side was randomly allocated in all patients, so the results will be of the 40 patients, total sides 80, (test side 40; 20 right side and 20 left side). Results: Our results revealed that mucosal healing was noted to be better in PRP treated side, particularly on 5th and 10th post-operative day, with documented less incidence of secondary post-operative hemorrhage. Pain scores were less on the PRP treated side through the post-operative period, but were statistically significant only on the 5th day postoperative. Conclusions: The preliminary results from this study, supported by literature, have revealed that PRP was beneficial in the amelioration of post-tonsillectomy pain, improvement of healing and bleeding risk in pediatric tonsillectomy patients.

Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis

Over the past few decades, models have been developed to accurately predict electrical charges. Long-term electricity forecast is the expansion of electrical equipment company management in the future. The short-term forecast for fuel and unit maintenance provides the information needed to systematically manage the unit's day-to-day operations and commitments. In this paper, we present the best in-class estimation method (OELF) to overcome micro grid problems. The proposed OELF system uses a hybrid convolutional neural network (CNN) and improved whale (IWO) to meet demand and facilitate economic growth. The main purpose of the CNN-IWO algorithm is to calculate the maximum demand for the micro grid and optimize the controllable load capacity for each project test. By investing in materials that reduce the performance of the micro grid, we can adjust the load on the micro grid and increase the controllable load. Therefore, OELF system for expanding micro grid expansion must carefully design cost control and load control strategies. The result showed that the performance of proposed OELF system is very effective in terms of mean MAPE and mean RMSE. The results clearly shows the average mean MAPE of proposed OELF system is 7.24%, 6.02% and 8.27% lower than the existing fuzzy based system in terms of 2 days, 1 days and 1 h ahead precision. The average mean RMSE of proposed OELF system is 9.37%, 8.34% and 5.41% lower than the existing fuzzy based system in terms of 2 days, 1 days and 1 h ahead precision.

Atopic dermatitis (AD) is a disease characterized by chronic skin inflammation and epidermal barrier dysfunction leading to decrease in patients' quality of life. AD is widespread in general population including children. This article covers the disease pathophysiological mechanisms including those that depend on the endotype, as well as core principles of systemic therapy for children with moderate and severe AD. Features of targeted therapy of such patients with dupilumab (IL-4 and IL-13 inhibitor) are presented. The studies' results on dupilumab efficacy and safety in the short- and long-term are shown.

In this paper, we applied a peer assessment scenario at the Technical University of Manabi (Ecuador). Students and professors evaluated some works through rubrics, assigned a numerical score, and provided textual feedback grounding why such a numerical score was determined, to detect inaccuracy between both assessments. The proposed model uses soft computing techniques to reduce the professor's workload in the correction process. Experiments were carried out with a data set in the Spanish language. We applied a supervised machine learning approach to obtain a sentiment score corresponding to specific textual feedback, and the fuzzy logic approach to detect inaccuracy between numerical and sentiment scores and obtain the assessment score. The results showed that the support vector machine model had a better performance with low computational costs when the feedback was represented as a 1-g and 2-g vector, whose relevance was weighted with term frequency-inverse document frequency; moreover, the grader's critical judgment validity was inferred from the similarities between numerical and sentiment scores. At the end, the outcomes assert the model is reliable and guarantees a fair peer assessment procedure.

Актуальность. Аутопластика при повреждении ­нерва не всегда приводит к удовлетворительным результатам. Особенно это важно учитывать при больших повреждениях нервов (более 10 см), когда за время прорастания аксонов к месту дистального шва происходит фиброз зоны дистального шва, что делает невозможным дальнейшую регенерацию ­нерва и приводит к неудовлетворительным функциональным результатам. Целью исследования было изучить влияние аспирата костного мозга и суспензии жировой ткани на регенерацию нервов при пластике больших дефектов. Материалы и методы. Эксперименты проведены на 25 половозрелых кроликах. Животные были разделены на 5 экспериментальных групп: 2 контрольные (в 1-й нерв оставался невредимым, во 2-й выполнялась только аутопластика дефекта), в 3-й группе применялись аутопластика нерва и трансплантация жировой ткани, в 4-й — пластика нерва с использованием суспензии костного мозга, в 5-й — пластика нерва с комбинированным применением клеточных суспензий. Результаты. Через 1 и 3 месяца животных выводили из эксперимента и образцы исследовались гистологически и морфометрически. Морфометрический анализ через 1 месяц показал, что прорастание аксонов через дистальный шов наблюдалось только в группах, в которых применялся аспират костного мозга, через 3 месяца в контрольной группе доля проросших аксонов составляла 49,7 %, в группах исследования она была значительно выше — до 64 % в группе, где применялась комбинация жировой ткани и аспирата костного мозга. Биохимические показатели, такие как DT-диафораза, уровень диеновых конъюгатов, ТБА-активных продуктов, через 3 месяца были ближе к норме в группах использования клеточной технологии. Выводы. В результате исследований установлено вероятное положительное влияние применения клеточных технологий на регенерацию нерва, как на морфологическую структуру, так и на биохимические процессы. Наилучшие результаты получены в группе применения комбинации аспирата костного мозга и жировой ткани.

Introduction: The number of babies delivered between 37 weeks to 38 weeks and 6 days has been on the rise with increase in lower segment caesarian section (LSCS). These early term neonates have increased risk of developing respiratory distress syndrome, neonatal hyperbilirubinemia, transient tachypnoea, prolonged hospital stays, hypothermia, and feeding difficulty, when compared to a term neonate. An audit of early term neonatal short-term outcomes was undertaken at our institute. Methodology: A retrospective descriptive cross- sectional study was carried out between July 2020 and December 2020 at a private medical college Neonatal Intensive Care Unit. Neonates with a gestation age of 37 weeks and 0 days to 38 weeks and 6 days born were included. Results: A total of 137 early term delivery data were obtained. Hypothyroidism (23%) and gestational diabetes (23%) were found to be the most common associated antenatal problems. The most common morbidity out of 137 early term neonates was neonatal jaundice 91(66.4%) followed by respiratory distress which affected 38 (28%) neonates. Conclusion: This study establishes the high incidence of neonatal jaundice and respiratory morbidities in early term neonates. Hence it is better to avoid elective LSCS before 39 weeks of gestation provided there are no medical indications for the same.

The paper considers the main methodological aspects of accounting for long-term receivables of state-owned enterprises in accordance with international financial reporting standards and national accounting regulations (standards) (NAR(S)). At the same time, attention has been focused on the valuation of the asset and the method of reflection its initial and book value in the accounting. The study examines the procedure for determining the initial and carrying amount of long-term receivables in accordance with IFRS and illustrates the difference in the essence of the terms "present value" and "amortized cost": the former is used at the initial recognition of an asset, and the latter - for its further evaluation in order to be included in the financial statements. The comparison of requirements of international and national standard concerning the above mentioned asset reveals the following problems regarding the latter: inconsistency in the use and scattered terminological apparatus, as well as the lack of a methodology for the formation of the initial value. The paper proposes to supplement the terminology contained in NAR(S)10 with the definitions " present value" and "amortized cost", as well as to clarify the scope of their application for harmonization with IFRS. In addition, a proposal was made to revise the procedure for calculating the effective interest rate provided for by the NAR(S). Regardless of the accounting system in which the state enterprise operates, the problem arises of the difficulty for monitoring the timeliness and completeness of repayment of long-term receivables, as well as reconciliation of the state of settlements with debtors, which affects the planning of cash flows. The study formulates the following options for solving this problem: the application of an off-balance account or a special sub-account to the account of long-term receivables.

Purpose This paper aims to study the short-term effects of a new procurement policy document on the inclusion of environmental requirements and green award criteria in tenders. The policy document is named “Procurement with Impact” and was released by the Dutch central government to further stimulate Sustainable Public Procurement (SPP). Design/methodology/approach Central government tenders were quantitatively analyzed in the six months prior and after the release of the new policy on their inclusion of environmental concerns. This judgment was made based on the role of environmental concerns in the requirements and the award criteria. As a control group, the same was done on a municipal level, for which the new policy document does not apply. Each of the four samples contained 60 tenders. Data was acquired via the European public procurement database TED. In the analysis, a chi-square test was used to measure whether a significant difference exists between the two periods for each group. Findings Results show that central government has procured in a more environmentally concerned way after the release of “Procurement with Impact.” Within a year, the number of green tenders conducted by central government significantly increased from 30% to 55%. No significant difference was found on a municipal level. Social implications SPP has received increasing attention over the past few decades but has not led to implementation of its principles in most public tenders. As SPP can have a major impact on a more sustainable and social society, it is important to understand how policy can influence the sustainability of tenders. The findings of our study show that “Procurement with impact” had a significant positive short-term effect on the inclusion of green award criteria and requirements in public tenders. Implementing similar SPP policies in other government sectors and other countries could have a substantial effect on the worldwide uptake of SPP. Originality/value “Procurement with Impact” contains a clear sustainable vision embracing the principles of SPP. This government policy takes into account several SPP barriers and drivers and satisfies several policy theory conditions. The authors show in the paper that this policy is an effective instrument for increasing the inclusion of environmental concerns in tenders. As the difference is already significant within a year, this could also reflect the readiness of tenderers to turn to SPP once there is a clear organization wide policy.

Target-specific sentiment classification has a dependency over the target term extraction. The majority of current studies in sentiment classification tasks do not utilize the complete linguistic and sentiment knowledge. Consequently, strenuous efforts are to be made for expressing the implications of each word from the sentences, which have significant amount of contextual dependencies. Hence, it leads to the problems like loss of semantics, missing of context-dependent information and also results in poor classification of the models. In this paper, we propose a Deep Finesse Network (DFN) to address these limitations and enhance the accuracy. The DFN employs a multichannel paradigm to exploit multi-grained sentiment features by leveraging the existing linguistic and sentiment knowledge more effectively without any human involvement. In each channel, the model firstly extracts the local features from the multi-grained sentiment features and then captures the global and spatial information of the identified local features. Secondly, it directly models the contextual relationships with enriched semantic information from the global features. Subsequently, the intra-sequence relations were also modeled among the contextual features to identify the target features in order to understand and predict the sentiments of identified contextual features. Finally, the effectiveness of the DFN is also evaluated on different datasets. The results proved that DFN outperforms all the current and advanced state-of-art models in classification accuracy in most cases.

Metformin is the first-line drug for the treatment of type 2 diabetes mellitus, but its role in gestational diabetes mellitus (GDM) management is not clear. Recent evidence suggests a certain beneficial effect of metformin in the treatment of GDM, but a high treatment failure rate leads to the initiation of additional medications, such as insulin. Moreover, since metformin crosses the placental barrier and reaches a significant level in the fetus, it is likely to influence the fetal metabolic milieu. The evidence indicates the long-term safety in children exposed to metformin in utero except for mild adverse anthropometric profiles. Diligent follow-up of metformin-exposed offspring is warranted from the clinician's point of view.

Multivariate time series forecasting has typically been a relevant and interesting topic in many fields, including economics, electricity consumption, solar energy, and traffic management. In these domains, owing to the complex dependencies among multiple variables and the mixed dependencies in the time dimension, it is challenging to forecast a multivariate time series precisely. Furthermore, most of the forecasting methods fail to capture the mixed influence of the different time-length dependencies among multiple variables. In this paper, a new deep learning framework is proposed for dealing with this challenging problem, named as mixed dependence time-series network (MDTNet). In this framework, stacked dilated convolutions and recurrent units are applied to extract the complex patterns in the long- and short-term mixed dependencies among multiple variables. The experiments show that our proposed framework yields significant results, outperforming the state-of-the-art baseline methods on three of the four benchmark datasets in large horizons and achieving a competitive performance in short horizons on all the benchmark datasets.

KSVCR is an effective algorithm to handle multiclass problems. But it cannot do variable selection and is time-consuming on large datasets. In this article, we propose a doubly sparse multiclass model DKSVCR which employs elastic net regularization term to improve the performance of KSVCR. And then, motivated by the sparsity of DKSVCR, a simultaneous safe feature and sample screening rule MFSS is further constructed to accelerate the solving speed of DKSVCR, which is termed as MFSS-DKSVCR. It has two major benefits. First, both classification and variable selection could be realized, the highly correlated features tend to be selected or removed together. Second, by using feature screening and sample screening rule alternatively rather than using each of them individually, our MFSS-DKSVCR can delete more redundant features and samples before the training stage. Hence, the solving speed is improved a lot. And our MFSS-DKSVCR is safe in the sense that the solutions obtained from the reduced problem and original problem are identical. Besides, a fast algorithm SDCA is used to solve the problem more efficiently. The experimental results on one artificial dataset, 28 benchmark datasets, and an image dataset verify the validity of our method.

Hydroxyurea therapy is commonly used in the treatment of patients suffering from myeloproliferative diseases, such as polycythemia vera. It is supported by evidence that this type of therapy can generate mild skin lesions like leg ulcers, erythema, and hyperpigmentation. There are also some studies that show an increased risk of development of nonmelanoma skin cancers. We report a 56-year-old man with a 13-year history of polycythemia vera, treated chronically with hydroxyurea. In April 2020, the patient presented a skin lesion on the forehead, skin horn on the left forearm, and hyperkeratosis on the rims of both ears. In the patient’s history, in October 2019, complete excision of the skin lesion in the central area of the forehead was performed. After 4 months, a new skin lesion appeared at the same area of the forehead, which in May 2020 after resection in the histopathological examination was diagnosed as recurrence of squamous cell carcinoma. The aim of the case is to draw the clinicians’ attention to the increased risk of squamous cell carcinoma and basal cell carcinoma in patients treated with hydroxyurea. Increased vigilance would make it possible to recognize them earlier, and thus potentially reduce the undesirable effects associated with the delayed radical treatment of these skin cancers. Randomized clinical trials assessing the potential benefits of oral retinoids for chemoprevention of nonmelanoma skin cancers in the hydroxyurea-treated population should also be considered.

ZusammenfassungDaten sind für die Versorgungsforschung Material und Produkt zugleich. Als „Substrat“ oder Ausgangsbasis von gesundheitsbezogenen Analysen haben sie in den vergangenen Dekaden immens an Bedeutung gewonnen. Für die Beurteilung von Leistungen des Gesundheitssystems, für dessen Steuerung und Entwicklung sind Daten ein essenzieller Rohstoff. Im wissenschaftlichen Alltag und in Forschungsarbeiten, die diesen Rohstoff nutzen, kommt der Bedeutungsgehalt des Begriffs „Daten“ – insbesondere „Sekundärdaten“ – oft zu kurz. Der vorliegende Beitrag möchte den Bedeutungskontext der beiden Begriffe vertiefend beleuchten und den Versuch unternehmen, den Begriff „Sekundärdaten“ terminologisch einzuordnen.

BACKGROUND: Single-stage type I hybrid total aortic arch repair is a surgical treatment for extensive aortic arch disease, but the clinical outcomes were distinguishing. The purposes of this study were to share our experience and evaluate the perioperative safety and long-term durability. METHODS: Thirty-six patients who underwent single-stage type I hybrid total aortic arch repair in Fuwai Hospital between January 2010 and June 2020 were respectively reviewed. Early primary endpoint was defined as early composite adverse events, including mortality, multiple organ dysfunction syndrome (MODS), unplanned reoperation, stroke, paraplegia, acute renal failure (ARF) necessitating continuous renal replacement therapy (CRRT), respiratory failure and stents related complications. Long-term endpoints included late mortality, late aortic related reintervention and late adverse aortic events. When evaluating the early- and long-term outcomes, all patients were stratified into two subgroups by age (65 years). RESULTS: All patients acquired technical success. Early composite adverse events rate was 11.1% (4/36), in-hospital mortality was 8.3% (3/36). Average follow-up period was 48.0±35.3 months. Overall survival rate was 83.3% and 51.9% at 5 and 10 years respectively. Late aortic related reintervention occurred at one (3.0%, 1/33) patient and this patient died after reintervention. Overall freedom from adverse aortic events was 79.2% and 47.5% at 5 and 10 years respectively. Significant difference was not observed between the elderly and young subgroups, no matter in early- and long-term outcomes. CONCLUSIONS: Single-stage type I hybrid total aortic arch repair has achieved desirable outcomes in our center, which does not increase perioperative risk in the elderly patients, meanwhile, also acquire acceptable durability in the young patients. In conclusion, this surgery is a practical mini-invasive treatment for extensive aortic arch disease with strict and limited indications.

Aim:Limited data are available in the literature about the long-term results of smoking cessation and the relapse rate in older smokers. We aimed to demonstrate the efficacy of short- and long-term smoking cessation behaviors in individuals over 65 years of age.Methods:Patients’ data were analyzed retrospectively from hospital records between 2014 and 2018. All patients received individual behavioral therapy and were prescribed the drugs that were best suited for their individual circumstances, such as nicotine replacement therapy, bupropion, and varenicline. Patients who quit smoking during the three-month period of outpatient follow-up were contacted by phone at least two years later and asked whether they still smoked or not.Results:In total, 68 older participants (13 female and 56 male) were included. In the initial three-month follow-up period, 29 of the participants (42.6%) dropped out of the smoking cessation program after the first interview. Eleven of the smokers (16.2%) did not quit smoking, and 28 (41.1%) did quit smoking. Fourteen participants (20.6%) achieved long-term abstinence (i.e., were not smoking at the two-year follow-up), while the remaining 10 participants (14.7%) had started to smoke again. No statistically significant difference was found between quitters and non-quitters in terms of age, gender, duration of the smoking habit, the number of cigarettes smoked daily, the reason for starting smoking, the reason for the desire to quit smoking, and the treatment methods used.Conclusion:Smoking cessation strategies should be tailored and constantly re-evaluated in elderly people for safe management, and they should be followed up closely to avoid relapse risk.

In 2019, natural gas accounted for 25.4% of gross inland consumption in the European Union (EU), making it one of the most important energy sources in the EU. The importance of natural gas, together with the ongoing liberalization of the gas market, has made the natural gas sector significantly commercially sensitive. To reduce the risk of financial losses, balance group managers often need to have an accurate forecast of natural gas consumption. An accurate forecast will ensure small deviations between actual gas consumption and reserved gas volumes and transmission system capacity resulting in less balancing energy required, which is sold at a higher price in the final balancing process. This paper researches the optimal number of smart meters and best fitted consumption data distribution in order to achieve satisfactory results in terms of the accuracy by using simple forecasting methods. Beside mentioned, this paper provides accuracy overview of various already available forecasting methods, as well as the selection of input parameters for forecasting short term natural gas consumption. Using the calculated linear temperature dependence together with the lognormal distribution, the consumption of natural gas was simulated for 12 different cases. The simulation showed that, if more than 10 000 smart meters were installed, deviation between average estimated natural gas consumption and the real data would be less than ± 2.96 %. In case of 100 000 smart meters installed, deviation would be less than ± 1.20 %, but the “large” partly temperature independent consumers must be disregarded.

This study considers return variation across five sectors of the oil and gas industry. Between 2000 and 2020, firms in refining and marketing and exploration and production had the highest daily expected returns. Exploration and production and equipment and services had the greatest variation with equity market risk and was greater than downstream transportation and pipeline and refining and marketing. By sector, firms in refining and marketing and exploration and production had the greatest equity market risk, whereas integrated and transportation and pipeline had the lowest. Across all sectors, firm returns are positively related to size and value effects. Fracking and non-traditional recovery techniques have increased the likelihood of well completion, decreased equity risk, and decreased expected returns across the oil and gas industry.

Delivering increasingly complex software-reliant systems demands better ways to manage the long-term effects of short-term expedients. The technical debt (TD) metaphor has gained significant traction as a way to understand and communicate such issues. Almost 25 years after the term was coined in 1992 by Ward Cunningham, and more than 10 years after the first edition of the TechDebt workshop/conference series, we take a brief look at the past, present, and future of TD.