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Selective metallization on glass surface technique has lot of potential applications in optoelectronics. Particularly, ultra-fine copper lines provide better optical transparency, which may enable to meet the demands of novel optoelectronic devices. In this paper, we propose a new manufacturing procedure to overcome the limitations of the traditional process and to achieve narrower copper lines on the glass surface. We, first, irradiate the glass surface by the femtosecond laser for more precise ablation, and then deposit the silver nitrate particles onto the irradiated region by using a supersonic particle deposition system. Copper lines with a linewidth of 1 µm were achieved by means of this new procedure, which is, to best our knowledge, the narrowest linewidth ever reported so far using laser direct writing and the subsequent electroless copper plating. We also demonstrate a highly transparent heater (i.e., 97% optical transparency) as an application of the proposed manufacturing approach.

Background Venous resection of the superior mesenteric or portal vein is increasingly performed in pancreatic cancer surgery, whereas results of studies on short- and long-term outcomes are contradictory. The aim of this study was to evaluate the impact of the type of venous resection in pancreatoduodenectomy for pancreatic cancer on postoperative morbidity and overall survival. Methods This nationwide retrospective cohort study included all patients who underwent pancreatoduodenectomy for pancreatic cancer in 18 centres (2013-2017). Results A total of 1311 patients were included, of whom 17 per cent underwent wedge resection and 10 per cent segmental resection. Patients with segmental resection had higher rates of major morbidity (39 versus 20 versus 23 per cent, respectively; P < 0.001) and portal or superior mesenteric vein thrombosis (18 versus 5 versus 1 per cent, respectively; P < 0.001) and worse overall survival (median 12 versus 16 versus 20 months, respectively; P < 0.001), compared to patients with wedge resection and those without venous resection. Multivariable analysis showed patients with segmental resection, but not those who had wedge resection, had higher rates of major morbidity (odds ratio = 1.93, 95 per cent c.i. 1.20 to 3.11) and worse overall survival (hazard ratio = 1.40, 95 per cent c.i. 1.10 to 1.78), compared to patients without venous resection. Among patients who received neoadjuvant therapy, there was no difference in overall survival among patients with segmental and wedge resection and those without venous resection (median 32 versus 25 versus 33 months, respectively; P = 0.470), although there was a difference in major morbidity rates (52 versus 19 versus 21 per cent, respectively; P = 0.012). Conclusion In pancreatic surgery, the short- and long-term outcomes are worse in patients with venous segmental resection, compared to patients with wedge resection and those without venous resection.Of 1311 patients who underwent pancreatoduodenectomy, 17 per cent underwent venous wedge resection and 10 per cent underwent venous segmental resection. Venous segmental, but not venous wedge, resection was associated with higher major morbidity rates (odds ratio = 1.93, 95 per cent c.i. 1.20 to 3.11) and worse overall survival (hazard ratio = 1.40, 95 per cent c.i. 1.10 to 1.78), compared to no venous resection. This nationwide study found worse short- and long-term outcomes in patients who had venous segmental resection. The results of this study urge the need for improving outcomes in patients who require venous segmental resection.

Sound and vibration analysis are prominent tools for machine health diagnosis. Especially, neural network (NN) strategies have focused on finding complex and nonlinear relationships between the sensor signal and the machine status to detect machine faults. However, it is difficult to collect enough amount of fault data as much as normal status data for training general NN models. To resolve the issue, this paper proposes the autoencoder-based anomaly detection framework for industrial robot arms using an internal sound sensor. The autoencoder uses signals in the normal state of the robots for training the model. It reconstructs the input signals as output, and anomalous states are found from high reconstruction error. Two stethoscopes were attached to the surface of the robot joint as sensors, and the sounds were recorded by USB microphone attached to the outlet of the stethoscopes. Features were extracted from STFT spectrogram images of the gathered sound, then used to train and test an autoencoder model. The reconstruction errors of the autoencoder were compared to distinguish the abnormal status from normal one. The experimental results suggest that the stethoscopes prevent the interference of noise, and the collected sound signals can be utilized for detecting machine anomalies.

У роботі удосконалено методику пластичного закриття хронічних ранових дефектів у хворих із синдромом діабетичної стопи (СДС) шляхом використання шкірних клаптів на перфорантній судинній ніжці. У дослідження включалися хворі на цукровий діабет 2-го типу із СДС нейроішемічної форми та наявністю хронічних ран нижніх кінцівок, що не загоювалися більше ніж 21 день із часу виникнення. Очищення ран здійснювали методом ультразвукової кавітації. На рану накладали пов’язку із сорбційно-антибактеріальною нанокомпозицією на основі нанодисперсного діоксиду силіцію. На третю добу на рану накладали вакуумну дренуючи пов’язку (ВАК-терапія). Формується клапоть, що за розмірами та конфігурацією відповідає дефекту на стопі. Серед хворих основної групи в 14 осіб (93 %) спостерігалося приживлення клаптя. Віддалені спостереження через 6 місяців показали повне збереження опорної функції кінцівки та добре приживлення трансплантата, відсутність виразок на кінцівках. У контрольній групі через 6 місяців у 7 пацієнтів відмічався рецидив виразок. Удосконалена методика автодермопластики при лікуванні ранових дефектів у хворих із синдромом діабетичної стопи, яка полягає в корекції гіперглікемії, підготовці рани з використанням вакуумної апаратної пов’язки. Використання розщепленого шкірного клаптя в поєднанні з вакуумною апаратною пов’язкою дозволяє ефективно закривати хронічні та гострі рани, зберігати опорну здатність кінцівки, покращити якість життя хворих, зменшити час перебування хворого в стаціонарі. Адекватне закриття ранових дефектів на стопі є методом профілактики високих ампутацій нижніх кінцівок у хворих на цукровий діабет.

Purpose In this study, we compare readout-segmented echo-planar imaging (rs-EPI) Diffusion Weighted Imaging (DWI) to a work-in-progress single-shot EPI with modified Inversion Recovery Background Suppression (ss-EPI-mIRBS) sequence at 3 T using a b-value of 2000 s/mm2 on image quality, lesion visibility and evaluation time. Method From September 2017 to December 2018, 23 women (one case used for training) with known breast cancer were included in this study, after providing signed informed consent. Women were scanned with the conventional rs-EPI sequence and the work-in-progress ss-EPI-mIRBS during the same examination. Four breast radiologists (4–13 years of experience) independently scored both series for overall image quality (1: extremely poor to 9: excellent). All lesions (47 in total, 36 malignant, and 11 benign and high-risk) were evaluated for visibility (1: not visible, 2: visible if location is given, 3: visible) and probability of malignancy (BI-RADS 1 to 5). ADC values were determined by measuring signal intensity in the lesions using dynamic contrast-enhanced (DCE) images for reference. Evaluation times for all assessments were automatically recorded. Results were analyzed using the visual grading characteristics (VGC) and the resulting area under the curve (AUCVGC) method. Statistical analysis was performed in SPSS, with McNemar tests, and paired t-tests used for comparison. Results No significant differences were detected between the two sequences in image quality (AUCVGC: 0.398, p = 0.087) and lesion visibility (AUCVGC: 0.534, p = 0.336) scores. Lesion characteristics (e.g benign and high-risk, versus malignant; small (≤10 mm) vs. larger (>10 mm)) did not result in different image quality or lesion visibility between sequences. Sensitivity (rs-EPI: 72.2% vs. ss-EPImIRBS: 78.5%, p = 0.108) and specificity (70.5% vs. 56.8%, p = 0.210, respectively) were comparable. In both sequences the mean ADC value was higher for benign and high-risk lesions than for malignant lesions (ss-EPI-mIRBS: p = 0.022 and rs-EPI: p = 0.055). On average, ss-EPI-mIRBS resulted in decreased overall reading time by 7.7 s/case (p = 0.067); a reduction of 17%. For malignant lesions, average reading time was significantly shorter using ss-EPI-mIRBS compared to rs-EPI (64.0 s/lesion vs. 75.9 s/lesion, respectively, p = 0.039). Conclusion Based on this study, the ss-EPI sequence using a b-value of 2000 s/mm2 enables for a mIRBS acquisition with quality and lesion conspicuity that is comparable to conventional rs-EPI, but with a decreased reading time.

Background Despite the fact that primary percutaneous catheter drainage has become standard practice, some patients with pancreatic fistula after pancreatoduodenectomy ultimately undergo a relaparotomy. The aim of this study was to compare completion pancreatectomy with a pancreas-preserving procedure in patients undergoing relaparotomy for pancreatic fistula after pancreatoduodenectomy. Methods This retrospective cohort study of nine institutions included patients who underwent relaparotomy for pancreatic fistula after pancreatoduodenectomy from 2005–2018. Furthermore, a systematic review and meta-analysis were performed according to the PRISMA guidelines. Results From 4877 patients undergoing pancreatoduodenectomy, 786 (16 per cent) developed a pancreatic fistula grade B/C and 162 (3 per cent) underwent a relaparotomy for pancreatic fistula. Of these patients, 36 (22 per cent) underwent a completion pancreatectomy and 126 (78 per cent) a pancreas-preserving procedure. Mortality was higher after completion pancreatectomy (20 (56 per cent) versus 40 patients (32 per cent); P = 0.009), which remained after adjusting for sex, age, BMI, ASA score, previous reintervention, and organ failure in the 24 h before relaparotomy (adjusted odds ratio 2.55, 95 per cent c.i. 1.07 to 6.08). The proportion of additional reinterventions was not different between groups (23 (64 per cent) versus 84 patients (67 per cent); P = 0.756). The meta-analysis including 33 studies evaluating 745 patients, confirmed the association between completion pancreatectomy and mortality (Mantel–Haenszel random-effects model: odds ratio 1.99, 95 per cent c.i. 1.03 to 3.84). Conclusion Based on the current data, a pancreas-preserving procedure seems preferable to completion pancreatectomy in patients in whom a relaparotomy is deemed necessary for pancreatic fistula after pancreatoduodenectomy.

Objectives To examine whether acetabular dysplasia (AD), cam and/or pincer morphology are associated with radiographic hip osteoarthritis (rHOA) and hip pain in UK Biobank (UKB) and, if so, what distribution of osteophytes is observed.DesignParticipants from UKB with a left hip dual-energy x-ray absorptiometry (DXA) scan had alpha angle (AA), lateral centre-edge angle (LCEA) and joint space narrowing (JSN) derived automatically. Cam and pincer morphology, and AD were defined using AA and LCEA. Osteophytes were measured manually and rHOA grades were calculated from JSN and osteophyte measures. Logistic regression was used to examine the relationships between these hip morphologies and rHOA, osteophytes, JSN, and hip pain.Results6,807 individuals were selected (mean age: 62.7; 3382/3425 males/females). Cam morphology was more prevalent in males than females (15.4% and 1.8% respectively). In males, cam morphology was associated with rHOA [OR 3.20 (95% CI 2.41-4.25)], JSN [1.53 (1.24-1.88)], and acetabular [1.87 (1.48-2.36)], superior [1.94 (1.45-2.57)] and inferior [4.75 (3.44-6.57)] femoral osteophytes, and hip pain [1.48 (1.05-2.09)]. Broadly similar associations were seen in females, but with weaker statistical evidence. Neither pincer morphology nor AD showed any associations with rHOA or hip pain.ConclusionsCam morphology was predominantly seen in males in whom it was associated with rHOA and hip pain. In males and females, cam morphology was associated with inferior femoral head osteophytes more strongly than those at the superior femoral head and acetabulum. Further studies are justified to characterise the biomechanical disturbances associated with cam morphology, underlying the observed osteophyte distribution.

Purpose. Analysis of the effectiveness of surgical treatment of patients with primary open-angle glaucoma associated with cataract the first stage realization of cataract phacoemulsification with IOL implantation (PHACO), and the second stage - microinvasive nonpenetrating deep sclerectomy (MNPDS). Material and methods. The results of 234 cases of performing PHACO and MNPDS at various stages have been analyzed. The main group included patients who underwent PHACO, followed by MNPDS – 39 persons, 40 eyes. The group was divided into a subgroup based on the date of the second intervention. 1 subgroup – patients who underwent MNPDS 1 month after PHACO (11 cases); 2 subgroup – 3 months after PHACO (29 cases). The control group included patients who underwent MNPDS followed by PHACO – 180 persons, 195 eyes. Also, subgroups of patients were identified for whom PHACO + IOL was performed in the second stage after 1 month – 1 subgroup (99 cases) and after 3 months – 2 subgroup (96 cases). Results. Patients of the main group showed a significant decrease in intraocular pressure after each stage of treatment. in the control group, intraocular pressure decreased after the first stage of treatment, but increased 6 months after surgery. Conclusions. According to the study, in primary open-angle glaucoma associated with cataract, the most persistent hypotensive effect is observed when the first stage of cataract phacoemulsification is performed, and the second stage is antiglaucoma surgical intervention. Key words: glaucoma, cataract, cataract phacoemulsification, microinvasive nonpenetrating deep sclerectomy.

Introduction The study deals with the approaches to the analysis of the dynamics in the course of a long-term postoperative period in patients who underwent hip arthroplasty. Aim To feature the variants in the course of a long-term postoperative period in patients who underwent arthroplasty of the hip joint. Materials and methods 806 patients (age range, 9 to 88 years) suffering from osteoarthritis underwent primary total hip arthroplasty (THA). Statistical analysis was carried out using the R programming language, freely available at https://cran.r-project.org. The probability of maintaining satisfactory quality of life (QoL) at a certain time of observation t (year of observation) was assessed with the Kaplan-Meier method. To compare the likelihood of maintaining a satisfactory QoL level throughout the observation period in several groups (for example, patients of different sexes), the logrank test was used. Results By year 6 of follow-up, the following tendency emerges regarding the age of the patients. The indicators are the best in young patients (up to 44 years old), where the probability of maintaining a satisfactory QoL evaluation was 0.92 (0.84; 0.96). A somewhat lower values were observed in the patients of the middle age group (from 45 to 64 years old) – 0.87 (0.78; 0.92). Excellent and good QoL was found in patients aged 65 and older, 0.83 (0.76; 0.88). Discussion Survival analysis methods have been used for the first time in traumatology and orthopedics. Previous researchers assessed the long-term results of the quality of specialized traumatological and orthopedic care without considering censored observations. Thus, the coverage of the investigated clinical observations averaged 80-85%. Information about 10-15% of cases was excluded from the studies. The proposed method of analysis provides information about all patients. Conclusions Five years following THA, an excellent and good quality of life could be expected in 85 % of patients. Satisfactory and poor levels are observed in 15 % of patients. At 5-year follow-up after THA, the quality of life is worse in older female groups with severe concomitant pathology; however, there are no statistically significant differences. This is a tendency, and requires further study.

Introduction. 3D printing technology is being actively introduced into the urological practice. Apart from improving of patients counselling, this technology allows for improved planning end performance of surgery. Aim of study. To determine the current state of three-dimensional printing in the urological practice. Materials and methods. Embase, Medline, Google Scholar, Scopus databases were searched to find related publications until September 2020. Inclusion criteria were: the availability of the full article, the use of 3D models for teaching patients or residents, and their use in planning and performing surgery on patients over 18 years of age. Results. One hundred and ninety seven publications were included, of which 40 were selected for a further analysis. 11 articles were related to the study of the usefulness of printed models in counseling patients with urolithiasis, planning and training of retrograde lithotripsy and percutaneous nephrolithotripsy. In 20 articles, the printed model was used to counsel patients with renal neoplasms, planning and intraoperative navigation. In 9 papers, the results of the use of printed models in communication with patients with prostate tumor, in improving the determination of its localization and planning of the upcoming surgery were published. Conclusion. The creation of three-dimensional printed models is promising in urology. Despite the current limitations this field is becoming more accessible for both patients and doctors.

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Summary Although evidence for the superiority of continuous feeding over intermittent feeding is lacking, in most paediatric intensive care units (PICU) artificial feeding is administered continuously for 24 h per day. Until now, studies in PICU on intermittent feeding have primarily focused on surrogate endpoints such as nutritional intake and gastro-intestinal complaints and none have studied the effects of an extended fasting period. Intermittent fasting has been proven to have many health benefits in both animal and human studies. The observed beneficial effects are based on multiple metabolic and endocrine changes that are presumed crucial in critical illness as well. One key element is the transition to ketone body metabolism, which, among others, contributes to the stimulation of several cellular pathways involved in stress resistance (neuro)plasticity and mitochondrial biogenesis, and might help preserve brain function. Secondly, the fasting state stimulates the activation of autophagy, a process that is crucial for cellular function and integrity. Of the different intermittent fasting strategies investigated, time-restricted feeding with a daily extended fasting period appears most feasible in the PICU. Moreover, planning the fasting period overnight could help maintain the circadian rhythm. Although not investigated, such an overnight intermittent fasting strategy might improve the metabolic profile, feeding tolerance and perhaps even have beneficial effects on tissue repair, reperfusion injury, muscle weakness, and the immune response. Future studies should investigate practical implications in critically ill children and the optimal duration of the fasting periods, which might be affected by the severity of illness and by age.

This article proposes a method to monitor the machining depth during the electrochemical machining process using an optical fiber. The fiber was inserted and fixed coaxially in the center of the tool electrode with its axis perpendicular to the surface of the workpiece, and an Fabry–Perot cavity formed between the fiber tip and the workpiece was used to monitor the machining depth. By analyzing the reflected spectrum, the inter-electrode gap was calculated. The sensing mechanism was discussed in depth, and two different methods to obtain the inter-electrode gap was introduced. One of the methods has a theoretical precision of 4.45 nm, but a time-consuming spectrum alignment process is required. Another method can use a simple program but has a lower theoretical precision of 2.16 μm, and a precision of 11.05 μm during the experiment. Several groups of experiments with still tool electrode were implemented, and the machining depth-time curve was given. By comparing the final machining depth measured by our sensor and profilometer measurement, a difference of smaller than 4% was observed. This difference may be because of the change of the refractive index of the electrolyte during the machining process. This technique significantly improves the monitoring precision, and real-time monitoring is possible. This monitoring technique may provide a further understanding of the machining process and has a potential to increase machining accuracy to micrometer or even sub-micrometer scale.

Background Multi‐organ damage is a common feature of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, going beyond the initially observed severe pneumonia. Evidence that the testis is also compromised is growing. Objective To describe the pathological findings in testes from fatal cases of COVID‐19, including the detection of viral particles and antigens, and inflammatory cell subsets. Materials and methods Postmortem testicular samples were obtained by percutaneous puncture from 11 deceased men and examined by reverse‐transcription polymerase chain reaction (RT‐PCR) for RNA detection and by light and electron microscopy (EM) for SARS‐CoV‐2. Immunohistochemistry (IHC) for the SARS‐CoV‐2 N‐protein and lymphocytic and histiocytic markers was also performed. Results Eight patients had mild interstitial orchitis, composed mainly of CD68+ and TCD8+ cells. Fibrin thrombi were detected in five cases. All cases presented congestion, interstitial edema, thickening of the tubular basal membrane, decreased Leydig and Sertoli cells with reduced spermatogenesis, and strong expression of vascular cell adhesion molecule (VCAM) in vessels. IHC detected SARS‐Cov‐2 antigen in Leydig cells, Sertoli cells, spermatogonia, and fibroblasts in all cases. EM detected viral particles in the cytoplasm of fibroblasts, endothelium, Sertoli and Leydig cells, spermatids, and epithelial cells of the rete testis in four cases, while RT‐PCR detected SARS‐CoV‐2 RNA in three cases. Discussion and conclusion The COVID‐19‐associated testicular lesion revealed a combination of orchitis, vascular changes, basal membrane thickening, Leydig and Sertoli cell scarcity, and reduced spermatogenesis associated with SARS‐CoV‐2 local infection that may impair hormonal function and fertility in men.

The input of phosphorus-containing type clay minerals into the fertile soil, on the background of mineral fertilizers of the aluminum-silicate type, significantly improves the water-physical and agrochemical characteristics of the soil and improves its ecological condition. The both presence of clay minerals and mineral fertilizers in the soil creates the prerequisites for improving soil fertility due to the effect on mobile phosphorus

Maternal exercise has shown beneficial effects on mother and child. Literature confirm progeny’s cognition improvement, and upregulation in neurotrophins, antioxidant network, and DNA repair system. Considering that there is a lack of information demonstrating the impact of maternal exercise on offspring’s skeletal muscle, we aimed to investigate the mitochondrial and redox effects elicited by maternal swimming. Adult female Wistar rats were divided into three groups: control sedentary, free swimming, and swimming with overload (2% of the body weight). Exercised groups were submitted weekly to five swimming sessions (30 min/day), starting 1 week prior to the mating and lasting to the delivery. Gastrocnemius and soleus muscle from 60-day-old offspring were analyzed. Our results clearly showed a sex-dependent effect. Male soleus showed increased mitochondrial functionality in the overload group. Female muscle from the overload group adapted deeply. Considering the redox status, the female offspring delivered to overload exercised dams presented reduced oxidants levels and protein damage, allied to downregulated antioxidant defenses. We also observed an increase in the mitochondrial function in the gastrocnemius muscle of the female offspring born from overload exercised dams. Soleus from female delivered to the overload exercise group presented reduced mitochondrial activity, as well as reduced reactive species, protein carbonyls, and antioxidant network, when compared to the male. In conclusion, maternal exercise altered the redox status and mitochondrial function in the offspring’s skeletal muscle in a sex-dependent way. The clinical implication was not investigated; however, the sexual dimorphism in response to maternal exercise might impact exercise resilience in adulthood.

The demand for healthier foods with high nutritional value has resulted in intensive fish farming. In this production system, high-frequency infections occur, and antibiotics are administrated for control. Only two antibiotics are allowed for use in Brazilian aquaculture, one of which is florfenicol. In this work, a bioconcentration assay was performed to assess the accumulation of florfenicol in the muscle of Nile tilapia (Oreochromis niloticus). Tilapia was evaluated as it is the most produced fish species in Brazil. The fish were exposed to florfenicol at a nominal concentration of 10 mg/L, through the water. Muscle and water were collected at 0, 1.5, 3, 6, 24, and 48 h during the exposure phase and at 1.5, 3, 6, 24, 48, and 120 h during the depuration phase. Quantification was performed using an LC-MS/MS. The results showed rapid absorption and elimination of the antibiotic (half-life, t1/2 = 5 h), with low potential for accumulation of florfenicol in tilapia muscles. The study was performed to determine the bioconcentration factor (BCF) and withdrawal period of florfenicol, being 0.05 mL/μg and 1.8 h, respectively. The results contribute to set protocols for the safe use of florfenicol in tilapia transport, avoiding residues in fish that may pose risks to human health.

INTRODUCTION patients with urinary stone disease during consultation often cannot realize their condition and features of upcoming procedure. Creation of 3D printed models is also not always available or too expensive. AIM to create a special program that allows for virtual intrarenal visualization of the collecting system and kidney stone on devices based on the Android operating system and evaluate its efficiency in counseling patients before the upcoming percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS a total of 15 patients who were scheduled to PCNL, were included in the study. All of them had two consultations. During the second consultation, the newly developed program was used. Patient data from DICOM (computed tomography) format were converted to stereolithography (STL) format in order to display it in the application. Each patient assessed the quality of the consultation using a questionnaire. RESULTS patients understanding of the kidney anatomy improved by 55% (from 34 to 75 points, p=0.0001), and stone localization by 51% (from 37 to 75 points, p=0.0001). The stages of PCNL became clearer by 57% (from 32 points to 75, p=0.0001), and understanding of possible intra- and postoperative complications was improved by 48% (from 38 to 73 points, p=0.0002). Overall patient satisfaction with counseling improved by 53% (from 35 to 74 points, p=0.0001), and the number of patients who desired for better repeated counseling decreased by 89% (from 9 to 1, p=0.006). CONCLUSION The InsKid app is an affordable and easy-to-use program, which doesnt require significant costs and allows patients to understand their disease and upcoming procedure.

Introduction: First, this study aimed to assess the prognostic value of different definitions for resection margin status on disease-free survival (DFS) and overall survival (OS) in pancreatic ductal adenocarcinoma (PDAC). Second, preoperative predictors of direct margin involvement were identified.Materials and methods: This nationwide observational cohort study included all patients who underwent upfront PDAC resection (2014-2016), as registered in the prospective Dutch Pancreatic Cancer Audit. Patients were subdivided into three groups: R0 (>= 1 mm margin clearance), R1 (= 1 mm) was achieved in 277 patients (47%), R1 (= 1 mm) (hazard ratio (HR) 1.35 [95% and confidence interval (CI) 1.08-1.70); P < 0.01) and R1 (= 1 mm) and R1 (1 mm. Given that any vascular tumour involvement on preoperative imaging was associated with an increased risk of R1 (direct) resection with upfront surgery, neoadjuvant therapy might be considered in these patients. (C) 2020 Published by Elsevier Ltd.

The objective of the work is to design and analysis of a press tool for component clamping plate which is used in automobile to meet the production requirement of 2,00, 000 components for an automobile. To achieve this press tool having combination of operations like blanking, piercing and bending is designed for producing a clamping plate in a single stroke in two stages and to optimize production rate and manufacturing cost. Based on features in the component, compound die is designed which can perform blanking and piecing operation in first stage followed by bending operation in the second stage. The structural analysis was carried out for the forming dies and punches which shows that both the deflections and the stresses are well within the limits.

BACKGROUNDGenetic testing for breast cancer susceptibility is widely used, but for many genes,evidence of an association with breast cancer is weak, underlying risk estimatesare imprecise, and reliable subtype-specific risk estimates are lacking.METHODSWe used a panel of 34 putative susceptibility genes to perform sequencing onsamples from 60,466 women with breast cancer and 53,461 controls. In separateanalyses for protein-truncating variants and rare missense variants in these genes,we estimated odds ratios for breast cancer overall and tumor subtypes. We evaluatedmissense-variant associations according to domain and classification of pathogenicity.RESULTSProtein-truncating variants in 5 genes (ATM, BRCA1, BRCA2, CHEK2, and PALB2)were associated with a risk of breast cancer overall with a P value of less than0.0001. Protein-truncating variants in 4 other genes (BARD1, RAD51C, RAD51D,and TP53) were associated with a risk of breast cancer overall with a P value ofless than 0.05 and a Bayesian false-discovery probability of less than 0.05. Forprotein-truncating variants in 19 of the remaining 25 genes, the upper limit ofthe 95% confidence interval of the odds ratio for breast cancer overall was lessthan 2.0. For protein-truncating variants in ATM and CHEK2, odds ratios werehigher for estrogen receptor (ER)–positive disease than for ER-negative disease;for protein-truncating variants in BARD1, BRCA1, BRCA2, PALB2, RAD51C, andRAD51D, odds ratios were higher for ER-negative disease than for ER-positivedisease. Rare missense variants (in aggregate) in ATM, CHEK2, and TP53 wereassociated with a risk of breast cancer overall with a P value of less than 0.001.For BRCA1, BRCA2, and TP53, missense variants (in aggregate) that would be classified as pathogenic according to standard criteria were associated with a riskof breast cancer overall, with the risk being similar to that of protein-truncatingvariants.CONCLUSIONSThe results of this study define the genes that are most clinically useful for inclusion on panels for the prediction of breast cancer risk, as well as provide estimatesof the risks associated with protein-truncating variants, to guide genetic counseling. (Funded by European Union Horizon 2020 programs and others.)

This manuscript reports room-temperature one-step synthesis of earth-abundant semiconductor ZnSiN2 on amorphous carbon substrates using radio frequency reactive magnetron co-sputtering. Transmission Electron Microscopy and Rutherford Backscattering Spectrometry analysis demonstrated that the synthesis has occurred as ZnSiN2 nanocrystals in the orthorhombic phase, uniformly distributed on amorphous carbon. The technique of large-area deposition on an amorphous substrate can be interesting for flexible electronics technologies. Our results open possibilities for environmentally friendly semiconductor devices, leading to the development of greener technologies.

This is the paper written by our late colleague and friend, Boris G. Meshcheryakov, “The Chronotope of Cultural-Historical Science of Activity”. We have decided to publish it as it is, without any editorial corrections or changes. This decision was informed not only by our wish to honor the memory of a talented scientist, but also by the fact that this paper is highly professional, smart and challenging. No alterations needed. Boris D. Elkonin

Cerebrovascular diseases remain among the world`s most pressing problems due to the high mortality, disability, reduced quality of life, development of dementia and a high risk of recurrence of cerebral circulatory disorders. Over the last 15 years, there has been a tendency to increase the number of cerebrovascular diseases among young people. The clinical manifestations of the initial cerebrovascular disorders are nonspecific and require additional examination and development of individual treatment and prevention measures. This review of chronic cerebrovascular disorders in young people is based on the analysis of local and foreign literature. The article presents a comprehensive analysis of the problem of the initial manifestations of cerebral circulatory failure in young people: etiology, pathogenesis, clinical features, diagnosis, treatment and preventive measures.

1707 Total Hip and Knee Arthroplasty had been retrospectively analyzed for the research. All patients’ data (non-complicated post- Hip and Knee Arthroplasty (1st group - 1579 patients) and post- Hip and Knee Arthroplasty with surgical site infection in 12 months (2nd group - 128 patients)) had been used as an educational matrix for a mathematic forecast and as a construction of a prevention algorithm for septic complications in primary THA and TKA. The study had shown 14 significant criteria which can influence the occurrence of surgical site infection in THA and TKA. 12-month testing period of the software in prospective research (467 cases) had shown a significant decrease rate of surgical site infection in comparison to retrospective research (decrease of 7.5% in the prospective cases and 4.1% - in retrospective).

Contains fulltext : 251552.pdf (Publisher’s version ) (Open Access) BACKGROUND: This study aimed to identify predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma (PDAC) resection with and without neoadjuvant therapy. METHODS: Included were patients who underwent PDAC resection (2014-2016). Multivariable multinomial regression was performed to identify preoperative predictors for manifestation of recurrence within 3, 6 and 12 months after PDAC resection. RESULTS: 836 patients with a median follow-up of 37 (interquartile range [IQR] 30-48) months and overall survival of 18 (IQR 10-32) months were analyzed. 670 patients (80%) developed recurrence: 82 patients (10%)

Purpose. To evaluate the results of the rational use of ophthalmic medicines with the use of pharmacoeconomical analysis. Material and methods. With the help of ABC-VEN analysis, a comparative study of the quality of pharmacotherapy and drug provision of patients who were monitored and treated by an ophthalmologist of the polyclinic in 2015 and 2019 was conducted. Results. As a result, it was found that the share of costs for vital drugs increased by 10.1% and amounted to 71.1% in 2019, which corresponds to the standardized criterion (70-80%). There was a reduction in the cost of purchasing secondary drugs by 7.6%, which indicates a rational drug supply of ophthalmic drugs. The most commonly used drugs for the treatment of glaucoma were 27.8% in 2015 and 35.1% in 2019. The share of their acquisition costs was 54.9% and 67.9%, respectively. There was a significant increase in the range and number of drugs for the treatment of patients with glaucoma: a 2.8-fold increase in the number of purchased eye drops for monotherapy and a 12% increase in the number of combined drugs. Conclusion. Pharmacoeconomical analysis showed an optimization of spending money on the purchase of drugs used in ophthalmology: an increase of 10.1% in the share of vital drugs and a decrease of 7.6% in the cost of purchasing secondary drugs. There was an increase in the range and quantity of drugs for the treatment of patients with glaucoma. Key words: ABC-VEN-analysis, drugs, ophthalmology, pharmacoeconomics.

Objectives: To investigate the effect of preoperative chemoradiotherapy on surgical complications in patients after pancreatic resection for (borderline-)resectable pancreatic cancer. Summary of Background Data: Preoperative chemoradiotherapy is increasingly used in patients with (borderline-)resectable pancreatic cancer. concerns have been raised about the potential harmful effect of any preoperative therapy on the surgical complication rate after pancreatic resection. Methods: An observational analysis was performed within the multicenter randomized controlled PREOPANC trial (April 2013-July 2017). The trial randomly assigned (1:1) patients to preoperative chemoradiotherapy followed by surgery and the remaining adjuvant chemotherapy or to immediate surgery, followed by adjuvant chemotherapy. The main analysis consisted of a per-protocol approach. The endpoints of the present analyses were the rate of postoperative complications. Results: This study included 246 patients from 16 centers, of whom 66 patients underwent resection after preoperative therapy and 98 patients after immediate surgery. No differences were found regarding major complications (37.9% vs 30.6%, P=0.400), postpancreatectomy hemorrhage (9.1% vs 5.1%, P=0.352), delayed gastric emptying (21.2% vs 22.4%, P=0.930), bile leakage (4.5% vs 3.1%, P=0.686), intra-abdominal infections (12.1% vs 10.2%, P=0.800), and mortality (3.0% vs 4.1%, P=1.000). There was a significant lower incidence of postoperative pancreatic fistula in patients who received preoperative chemoradiotherapy (0% vs 9.2%, P=0.011). Conclusions: Preoperative chemoradiotherapy did not increase the incidence of surgical complications or mortality and reduced the rate of postoperative pancreatic fistula after resection in patients with (borderline-)resectable pancreatic cancer.

Objective: This paper presents a multi-objective design optimization of MEMS disk resonator using two techniques. Methods: Determining the optimized dimensions of disk resonator for a particular resonance frequency so as to achieve higher quality factor and lower motional resistance is attempted. One technique used is constraint-based multi-objective optimization using the interior-point algorithm. The second technique is based on multi-objective genetic algorithm. Results: The algorithms are implemented using MATLAB. The two techniques of optimization are compared. Conclusion: The developed optimization methods can provide faster design optimization compared to full-wave simulators resulting in significant reduction of design time.

Background: Nasal carriage of methicillin resistant Staphylococcus aureus (MRSA) is a major factor for its transmission especially from the health workers and medical students to their patients. There are a number of published data on the prevalence of MRSA among health workers but data on nasal colonization of medical students by MRSA are sparse in Nigeria. The objectives of this study are to determine the prevalence of nasal carriage of MRSA among medical students of the Ben Carson School of Medicine, Babcock University, Ilishan-Remo, Ogun State, Nigeria, and identify risk factors associated with this nasal carriage. Methodology: A case control study involving 100 clinical (study group) and 100 pre- clinical (control group) medical students was undertaken between March 2018 and October 2019. Structured questionnaire was administered to obtain socio-demographic information and potential risk factors. Nasal swab was collected from each student and cultured for isolation of S. aureus by standard microbiology techniques. Phenotypic MRSA was detected by the cefoxitin 30μg disk diffusion method according to the guideline of Clinical and Laboratory Standards Institute. The mecA gene was detected by conventional polymerase chain reaction (PCR) assay. Results: The prevalence of S. aureus nasal carriage among the study group was 14% (14/100) while the prevalence among the control group was 6% (6/100) (p=0.097). The prevalence of phenotypic MRSA among the study group was 4% (4/100) and 1% (1/100) among the control group (p=0.3687) while mecA gene was detected in 3 of the 4 (75%) phenotypic MRSA positive study participants and in the only (100%) phenotypic MRSA positive (1%) control group. Antibiotics usage without prescription, antibiotic treatment of common cold, and use of antibiotics in the previous one year, were significantly associated with MRSA carriage among the study group. Conclusion: Although the prevalence of nasal carriage of S. aureus and MRSA among clinical and pre-clinical medical students was not statistically significant, the risk factors identified with carriage of MRSA among the study group indicates the need for antimicrobial stewardship program to reduce carriage and transmission of MRSA by medical students. Keywords: methicillin resistant, Staphylococcus aureus, mecA gene, nasal carriage, medical students

Purpose To assess the feasibility of completely excising small breast cancers using the automated, image-guided, single-pass radiofrequency-based breast lesion excision system (BLES) under ultrasound (US) guidance. Methods From February 2018 to July 2019, 22 patients diagnosed with invasive carcinomas ≤ 15 mm at US and mammography were enrolled in this prospective, multi-center, ethics board-approved study. Patients underwent breast MRI to verify lesion size. BLES-based excision and surgery were performed during the same procedure. Histopathology findings from the BLES procedure and surgery were compared, and total excision findings were assessed. Results Of the 22 patients, ten were excluded due to the lesion being > 15 mm and/or being multifocal at MRI, and one due to scheduling issues. The remaining 11 patients underwent BLES excision. Mean diameter of excised lesions at MRI was 11.8 mm (range 8.0–13.9 mm). BLES revealed ten (90.9%) invasive carcinomas of no special type, and one (9.1%) invasive lobular carcinoma. Histopathological results were identical for the needle biopsy, BLES, and surgical specimens for all lesions. None of the BLES excisions were adequate. Margins were usually compromised on both sides of the specimen, indicating that the excised volume was too small. Margin assessment was good for all BLES specimens. One technical complication occurred (retrieval of an empty BLES basket, specimen retrieved during subsequent surgery). Conclusions BLES allows accurate diagnosis of small invasive breast carcinomas. However, BLES cannot be considered as a therapeutic device for small invasive breast carcinomas due to not achieving adequate excision.

Shallow lakes can shift between stable states as a result of anthropogenic or natural drivers. Four common stable states differ in dominant groups of primary producers: submerged, floating, or emergent macrophytes or phytoplankton. Shifts in primary producer dominance affect key supporting, provisioning, regulating, and cultural ecosystem services supplied by lakes. However, links between states and services are often neglected or unknown in lake management, resulting in conflicts and additional costs. Here, we identify major shallow lake ecosystem services and their links to Sustainable Development Goals (SDGs), compare service provisioning among the four ecosystem states and discuss potential trade-offs. We identified 39 ecosystem services potentially provided by shallow lakes. Submerged macrophytes facilitate most of the supporting (86%) and cultural (63%) services, emergent macrophytes facilitate most regulating services (60%), and both emergent and floating macrophytes facilitate most provisioning services (63%). Phytoplankton dominance supports fewer ecosystem services, and contributes most to provisioning services (42%). The shallow lake ecosystem services we identified could be linked to 10 different SDGs, notably zero hunger (SDG 2), clean water and sanitation (SDG 6), sustainable cities and communities (SDG 11), and climate action (SDG13). We highlighted several trade-offs (1) among ecosystem services, (2) within ecosystem services, and (3) between ecosystem services across ecosystems. These trade-offs can have significant ecological and economic consequences that may be prevented by early identification in water quality management. In conclusion, common stable states in shallow lakes provide a different and diverse set of ecosystem services with numerous links to the majority of SDGs. Conserving and restoring ecosystem states should account for potential trade-offs between ecosystem services and preserving the natural value of shallow lakes.

Background Conditional survival is the survival probability after already surviving a predefined time period. This may be informative during follow-up, especially when adjusted for tumor characteristics. Such prediction models for patients with resected pancreatic cancer are lacking and therefore conditional survival was assessed and a nomogram predicting 5-year survival at a predefined period after resection of pancreatic cancer was developed. Methods This population-based study included patients with resected pancreatic ductal adenocarcinoma from the Netherlands Cancer Registry (2005–2016). Conditional survival was calculated as the median, and the probability of surviving up to 8 years in patients who already survived 0–5 years after resection was calculated using the Kaplan–Meier method. A prediction model was constructed. Results Overall, 3082 patients were included, with a median age of 67 years. Median overall survival was 18 months (95% confidence interval 17–18 months), with a 5-year survival of 15%. The 1-year conditional survival (i.e. probability of surviving the next year) increased from 55 to 74 to 86% at 1, 3, and 5 years after surgery, respectively, while the median overall survival increased from 15 to 40 to 64 months at 1, 3, and 5 years after surgery, respectively. The prediction model demonstrated that the probability of achieving 5-year survival at 1 year after surgery varied from 1 to 58% depending on patient and tumor characteristics. Conclusions This population-based study showed that 1-year conditional survival was 55% 1 year after resection and 74% 3 years after resection in patients with pancreatic cancer. The prediction model is available via www.pancreascalculator.com to inform patients and caregivers.

Physical exercise practice has been increasingly recommended in the prevention and treatment of chronic diseases, causing a positive effect from body weight/fat loss to improved cognitive function. Maternal exercise seems to induce the same positive lifelong adaptations to the offspring. We hypothesized that maternal exercise can prevent redox imbalance in adult offspring’s hippocampus exposed to a high-fat diet (HFD). Female Wistar rats were divided into three groups before and during pregnancy: (1) sedentary, (2) swimming exercise, and (3) swimming exercise with overload. On 60 days of age, the male pups were divided into standard diet or HFD for one month, yielding normal and HFD subgroups for each maternal condition. Maternal interventions did not alter gestational parameters, birth outcomes, and offspring weight gain from weaning to 90 days of age. The HFD consumption increased body fat, which was not prevented by maternal exercise. Serum glucose levels were increased by HFD, an effect that was prevented by unload maternal exercise. In the hippocampus, both maternal exercise intensities could increase antioxidant defense. Hippocampal redox homeostasis was impaired by HFD, causing increased superoxide levels, which was prevented by exercise without load, while overload caused only a reduction of the effect. In summary, the practice of swimming exercise without overload during pregnancy seems to be more beneficial when evaluated in animal model, preventing HFD induced redox imbalance and increasing antioxidant defense while overload swimming exercise during pregnancy demonstrated a negative effect on offspring submitted to HFD consumption.

'Forest management' aims to maintain forests as producers of goods and services, while ensuring their conservation for future generations. Forest certification has become one of the most widely used mechanisms to encourage and recognize this 'forest stewardship', with the Forest Stewardship Council (FSC) among the most well-known systems worldwide. FSC is widely used in several Management Units on the American Continent, which is home to large forest areas. Therefore, we evaluated the main difficulties in complying with the principles of the FSC standard in 18 American countries based on verification of non-conformities generated in the process. The data were obtained from information contained in the certification audit reports available on the FSC official website, covering all organizations with valid certificates from 1995 to 2013. We found that the United States presented the lowest mean of non-conformities per audit, which may indicate better capacity of managers to implement practices of its forestry activities. Regarding the deviation type, the United States and Canada presented higher indices in relation to the adequacy of the environmental impacts (P6) of their activities. Meanwhile, the greatest non-conformities in the Central and South America countries occurred in the labor and social area (P4), followed by environmental issues (P6). All organizations presented some type of non-compliance with the criteria set by the FSC and needed to adapt. The major difficulties encountered were related to compliance with environmental requirements. The need to implement corrective actions to maintain the certificate demonstrates a change of management influenced by the forest certification process, thus contributing to minimizing socio-environmental impacts resulting from forest operations.

Relevance. According to the modern realities of hostilities in the East of Ukraine, the medical community has grown a request for information about the nature of the most dangerous defeats of the participants of the Joint Forces Operation (JFO) in Donbass. Objective: analysis and generalization of the nature of heart injuries received during the hostilities in the East of Ukraine, the stages of medical support of such wounded. Materials and methods. Analysis of scientific publications in scientific journals of Ukraine by keywords for the period 2014-2018. Results. The nature of injuries among participants in the JFO has been analyzed. The first place is occupied by injuries of blood vessels with bleeding (60%), 2 - pneumothorax (34%), and 3 - airway obstruction (6%). All this can be combined and supplemented by damage to the nervous system and other organs. In the conditions of the modern war in Donbass, shrapnel injuries (50.5%), bullet wounds (25.3%), and closed injury (20.3%) are considered frequent types of injuries. The classification of heart injuries, clinical symptoms, the levels of support for such a wounded are described: first aid at the prehospital stage ("golden minutes") on the battlefield, qualified medical assistance ("golden hour"), specialized medical care in a hospital. Post-traumatic stress disorders have been described that last from one to 6 months and require complex treatment. Conclusion. According to NATO's new military medical doctrine, "an effective and reliable medical support system contributes to maintaining the trust of the military and the general public in the army and its political leadership".

PURPOSE Preoperative chemoradiotherapy may improve the radical resection rate for resectable or borderline resectable pancreatic cancer, but the overall benefit is unproven. PATIENTS AND METHODS In this randomized phase III trial in 16 centers, patients with resectable or borderline resectable pancreatic cancer were randomly assigned to receive preoperative chemoradiotherapy, which consisted of 3 courses of gemcitabine, the second combined with 15 × 2.4 Gy radiotherapy, followed by surgery and 4 courses of adjuvant gemcitabine or to immediate surgery and 6 courses of adjuvant gemcitabine. The primary end point was overall survival by intention to treat. RESULTS Between April 2013 and July 2017, 246 eligible patients were randomly assigned; 119 were assigned to preoperative chemoradiotherapy and 127 to immediate surgery. Median overall survival by intention to treat was 16.0 months with preoperative chemoradiotherapy and 14.3 months with immediate surgery (hazard ratio, 0.78; 95% CI, 0.58 to 1.05; P = .096). The resection rate was 61% and 72% ( P = .058). The R0 resection rate was 71% (51 of 72) in patients who received preoperative chemoradiotherapy and 40% (37 of 92) in patients assigned to immediate surgery ( P < .001). Preoperative chemoradiotherapy was associated with significantly better disease-free survival and locoregional failure-free interval as well as with significantly lower rates of pathologic lymph nodes, perineural invasion, and venous invasion. Survival analysis of patients who underwent tumor resection and started adjuvant chemotherapy showed improved survival with preoperative chemoradiotherapy (35.2 v 19.8 months; P = .029). The proportion of patients who suffered serious adverse events was 52% versus 41% ( P = .096). CONCLUSION Preoperative chemoradiotherapy for resectable or borderline resectable pancreatic cancer did not show a significant overall survival benefit. Although the outcomes of the secondary end points and predefined subgroup analyses suggest an advantage of the neoadjuvant approach, additional evidence is required.

Coal is the most widely available fossil fuel energy resource. This work was carried out to compare the composition, Sulphur content and combustibility of the Nigerian and Nigerien coal samples. Coal samples were obtained from Enugu, Nigeria, Tahuoa and Agadez of Niger Republic. Results indicated that, coal samples from Tahuoa (RS/T) and coal from Agadez (RS/A) have highest percentage of fixed carbon (71.2% and 61.0% for Tohoua and Agadez respectively), while the coal from Enugu (RS/E), Nigeria, have the least percentage (49.2%) which made them to have high fuel ratio enabling them to be more combustible, as determined by the thermal efficiency test. The study revealed that the coal from Niger is of higher grade with ease of combustion and less smoke as found in the combustibility test. Keywords: Coal, Sulphur, fuel ratio, carbon content, combustion and thermal efficiency.