Search

Background. The first day-care hospital (DCH) in the Russian Federation with 30 beds was established in the departments of general surgery, urology, and gynecology of the Botkin Hospital in 2016 in Moscow. Aim. To analyze the six-year experience of the gynecological DCH based on the Botkin Hospital. Materials and methods. The six-year experience (20162021) of the gynecological DCH based on the Botkin Hospital was analyzed. Results. The number of patients treated in the DCH increased progressively from 2016 to 2019. Due to the gain in the experience of DCH, patients with a broader spectrum of diseases can receive care in DCH settings, the number of hospitalized patients with a higher anesthetic risk has increased, and the proportion of patients over 65 years of age has also increased. Conclusion. Analysis of the activities of the DCH based on the Botkin Hospital showed that the pilot project can be considered successful due to good clinical and economic indicators. This activity format can be widely implemented, and it is optimal to establish such hospitals in multidisciplinary clinics.

Higher education is immersed in unpredictable environments and is facing challenges during the Coronavirus Disease 2019 (COVID-19) pandemic. It needs to adapt to external changes constantly, especially to the level of development of science and technology as the most important component of education courses for future engineers are facing development difficulties within achieving their goals as the core of higher education. Curriculum serves as basis for realization of goals of higher education and curriculum for future engineers needs updating. The paper analyzes dilemma of updating of higher education curriculum for future engineers within its content and structure. During the learning process students participated in curriculum renewal and accelerated the upgrading of curriculum content and structure. Finishing the course, students conducted reflection, improved their understanding during the reflection process continuously that helped them to develop the habit of lifelong learning. The authors propose to expand teaching methods for the courses, to adapt engineering courses to the needs of economic development during the COVID-19 pandemic, to strengthen students' interaction and participation, to supply multiple participation in curriculum "customization" countermeasures to update higher education curriculum for future engineers.

Bleomycin, which is widely used as an antitumor agent, possesses serious adverse effects such as pulmonary toxicity. Local nanoaerosol deposition for lung cancer treatment is a promising alternative to drug delivery to lung lesions. The aim of this work is to test the hypothesis that bleomycin nanoaerosol can be effectively used to treat multiple lung metastases. To obtain bleomycin nanoaerosol, an aerosol generator based on electrospray of a solution of a nonvolatile substance with gas-phase neutralization of charged aerosol particles was used. Lung metastases in murine Lewis lung carcinoma and B16 melanoma animal models were counted. The effect of inhaled bleomycin nanoparticles on the number and volume of metastases, as well as pulmonary side effects, was investigated. Using a mouse exposure chamber, the dose-dependent effect of inhaled bleomycin on tumor volume was evaluated in comparison with intraperitoneal administration. Bleomycin nanoaerosol reduced the volume of metastases and produced a higher antitumor effect at much lower doses. It has been established that long-term exposure to nanoaerosol with a low dose of bleomycin is capable of suppressing cancer cell growth. The treatment was well tolerated. In the lungs, minor changes were found in the form of focal-diffuse infiltration of the lung parenchyma.

Mango is one of the most popular and nutritious fruits in the world and Mexico is the world’s largest exporter. There are many diseases that directly affect fruit yield and quality. During the period 2016–2017, leaves with grey leaf spots were collected from 28 commercial mango orchards distributed in two main production areas in Sinaloa State of Mexico, and 50 Neopestalotiopsis isolates were obtained. Fungal identification of 20 representative isolates was performed using morphological characterization and phylogenetic analysis based on the internal transcribed spacer (ITS) region of ribosomal DNA, part of the translation elongation factor 1-alpha (TEF) and the β-tubulin (TUB) genes. Phylogenetic analysis indicated that the 20 isolates from this study formed four consistent groups, however, overall tree topologies do not consistently provide a stable and sufficient resolution. Therefore, even though morphological and phylogenetic separation is evident, these isolates were not assigned to any new taxa and were tentatively placed into four clades (clades A–D). Pathogenicity tests on detached mango leaves of cv. Kent showed that the 20 isolates that belong to the four Neopestalotiopsis clades from this study and induce lesions on mango leaves. This is the first report of species of Neopestalotiopsis causing mango grey leaf spot disease in Mexico.

In this paper, we propose a new approach to constructing similarity measures using the entropy measure for Interval-Valued Intuitionistic Fuzzy Sets. In addition, we provide several illustrative examples to demonstrate the practicality and effectiveness of the proposed formula. Finally, we use the new proposed similarity measure to develop a new approach for solving problems of pattern recognition and multi-criteria fuzzy decision-making.

Abstract Background Sleep helps in improving the functions of all systems of human body. Disturbance in sleep can cause immediate adverse effects on normal human physiologic functions. Main objective of this study was to explore the psychometric properties of the Dari version of the of Pittsburgh Sleep Quality Index (PSQI) among general adult population of Afghanistan. Methods This methodological study has been conducted during July to November 2023. Reliability and validity of PSQI were evaluated using Cronbach’s Alpha and confirmatory factor analysis, respectively. Pearson correlation analysis was conducted to assess the convergent validity of the components of PSQI, comparing results with those obtained from the DASS-21 subdomains. Results In this cross-sectional study, 965 Afghan adults were studied during five months of duration between July and November, 2023. Mean age of the study participants was 35.2 years. The prevalence of sleep disturbance was 44.6% (430/965). Among them, 59.3% (572/965) reported experiencing subjective sleep quality disturbances less than once a week, 36.2% (349/965) had sleep latency issues less than once a week, 17.6% (170/965) had sleep duration disruption once or twice a week, while 36.3% (350/965) had daytime dysfunction less than once a week. The Cronbach’s alpha coefficient for the seven-component scale was 0.677, indicating acceptable internal consistency. Substantial and statistically significant positive correlations were present among the component of PSQI subjective sleep quality and sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, daytime dysfunction, DASS-Depression, DASS-Anxiety, and DASS-Stress. The overall PSQI exhibited favorable fit indices, supporting the proposed single-factor structure among adult Afghan population. Conclusion Prevalence of sleep disturbance was very high among adult population of Afghanistan. This study provided useful information that will help policy makers (such as ministry of public health as well as international donor agencies like WHO, USAID, and UNICEF) to design a better strategy to reduce the prevalence of sleep disturbance that affects health of the Afghan community at large.

Abstract Introduction Perivascular epithelioid cell tumors are uncommon mesenchymal tumors. The genital tract is the most common extrarenal location. Preoperative diagnosis is rarely achieved owing to non-specific symptoms and imaging features. Consensus on treatment strategies remains elusive. Case presentation We report the case a 38 year-old north African woman with a primary sterility, who was diagnosed with a uterine Perivascular epithelioid cell tumor of uncertain malignant potential on a resection specimen of an intracavity polypoid mass. Immunohistochemistry confirmed the diagnosis and we opted for conservative surgery to preserve the patient’s fertility desires. Conclusion Uterine perivascular epithelioid cell tumor is a rare entity that warrants consideration in the differential diagnosis of uterine tumors. Treatment modalities, follow-up protocols, and prognosis remain ambiguous. Given their unpredictable behavior, accurate diagnosis and long-term monitoring are imperative.

Background: Anxiety is a common psychological disorder in school-aged children and adolescents. The present study aimed to assess the prevalence of anxiety symptoms and sleep disturbances and their relationship with academic achievement among female students in Herat, Afghanistan. Methods: A cross-sectional survey of 737 female students (mean age 11.8 years old) was conducted across 10 randomly selected schools in Herat, Afghanistan, covering Grades 1 to 6. Students were randomly chosen within these schools. The Depression Anxiety Stress Scale for Youth (DASS-Y) and Pittsburgh Sleep Quality Index (PSQI) assessed anxiety and sleep disturbance, while academic achievement ratings were provided by schoolteachers. Results: Using the DASS-Y and the PSQI, 65.5% reported anxiety symptoms and 46.4% reported sleep disturbance. Low academic achievement correlated significantly with anxiety (r = 0.228) and sleep issues (r = 0.161). Multiple logistic regression analysis identified predictors for anxiety and sleep disturbance. Predictors for anxiety included being aged 13–16 years, having lower class grade, being of low economic status, and having unemployed parents. Predictors for sleep disturbance included being aged 13–16 years, having lower class grade, having an uneducated father, being of low economic status, and having unemployed parents. Conclusion: There is a high prevalence of anxiety symptoms and sleep disturbances among female school students in Herat, Afghanistan. Significant correlations exist between students' academic achievement, anxiety, and sleep disturbances. Addressing anxiety and sleep disturbances among Afghan female school students could be facilitated by revising current government policies concerning students' health. Educational campaigns focused on sleep hygiene and anxiety management for both students and their parents may also prove beneficial.

Beverages based on sprouted cereals are an excellent basis for creating new types of functional foods, as they are rich in nutrients. Beverages made from sprouted grains aim to improve daily nutrition, prioritising food safety. The proper storage of these drinks depends on the processing techniques used, including chemical preservatives and the conditions under which they are stored. Thus, using a mathematical model, this study aimed to determine the optimal storage zone of functional beverages from sprouted raw materials with preservatives. The results of our study showed that the optimum storage temperature and citric acid content of wheat extract were 2.9% and +11°C; barley 2.4% and 18°C; triticale 2.2% and +11°C; sunflower 2.8% and +14°C; rapeseed 2.7% and +16°C; safflower 2.3% and +17°C; flax 2.6% and +17°C; soya 2.4% and +18°C; pea 2.3% and +18°C; chickpea 2.3% and +18°C, respectively. Overall, these outcomes theoretically support the processing of beverages from sprouted grains. Thus, for practical application, it is recommended to implement controlled storage environments with the recommended temperatures and ensure that citric acid is correctly dosed at the identified optimal levels to enhance the shelf life of beverages.

The field of medicine is witnessing rapid development of AI, highlighting the importance of proper data processing. However, when working with medical data, there is a problem of class imbalance, where the amount of data about healthy patients significantly exceeds the amount of data about sick ones. This leads to incorrect classification of the minority class, resulting in inefficient operation of machine learning algorithms. In this study, a hybrid method was developed to address the problem of class imbalance, combining oversampling (GenSMOTE) and undersampling (ENN) algorithms. GenSMOTE used frequency oversampling optimization based on a genetic algorithm, selecting the optimal value using a fitness function. The next stage implemented an ensemble method based on stacking, consisting of three base (k-NN, SVM, LR) and one meta-model (Decision Tree). The hyperparameters of the meta-model were optimized using the GridSearchCV algorithm. During the study, datasets on diabetes, liver diseases, and brain glioma were used. The developed hybrid class balancing method significantly improved the quality of the model: the F1-score increased by 10-75%, and accuracy by 5-30%. Each stage of the hybrid algorithm was visualized using a nonlinear UMAP algorithm. The ensemble method based on stacking, in combination with the hybrid class balancing method, demonstrated high efficiency in solving classification tasks in medicine. This approach can be applied for diagnosing various diseases, which will increase the accuracy and reliability of forecasts. It is planned to expand the application of this approach to large volumes of data and improve the oversampling algorithm using additional capabilities of the genetic algorithm.

Maize production in Indonesia faces challenges of climate change, affecting the deviation of planting seasons and overall yield stability. This study evaluates the impact of biosullary application on maize growth and yield across two planting periods using a Randomized Complete Block Design (RCBD). With twenty-one experimental units and treatments replicated three times, the study encompassed 252 plants and 63 sample plants. Findings indicate Treatment P6 consistently produced the tallest plants (199.67 cm), highest number of leaves (13.33 at planting period 1, 12.00 at planting period 2), and fastest flowering period (39.00 days at planting period 1, 45.00 days at planting period 2). P6 also showed notable cob length (11.67 cm in period 1), while Treatment P5 excelled in period 2 with 13.00 cm. Treatment P5 recorded the highest 100-seed weight (26.33 grams at planting period 1, 22.67 grams at planting period 2). To sustain maize productivity, increasing fertilizer dosage at the planting period 2 is recommended. Biosullary application not only enhances maize growth and yield but also improves soil physical properties, boosts microbial vitality, and stabilizes soil pH. These findings highlight biosullary potential as a sustainable approach to mitigate climate impacts and enhance maize production in Indonesia.

Abstract Background Depression is a global burden with profound personal and economic consequences. Previous studies have reported that the amount of physical activity is associated with depression. However, the relationship between the temporal patterns of physical activity and depressive symptoms is poorly understood. In this exploratory study, we hypothesize that a particular temporal pattern of daily physical activity could be associated with depressive symptoms and might be a better marker than the total amount of physical activity. Methods To address the hypothesis, we investigated the association between depressive symptoms and daily dominant activity behaviors based on 24-h temporal patterns of physical activity. We conducted a cross-sectional study on NHANES 2011–2012 data collected from the noninstitutionalized civilian resident population of the United States. The number of participants that had the whole set of physical activity data collected by the accelerometer is 6613. Among 6613 participants, 4242 participants had complete demography and Patient Health Questionnaire-9 (PHQ-9) questionnaire, a tool to quantify depressive symptoms. The association between activity-count behaviors and depressive symptoms was analyzed using multivariable logistic regression to adjust for confounding factors in sequential models. Results We identified four physical activity-count behaviors based on five physical activity-counting patterns classified by unsupervised machine learning. Regarding PHQ-9 scores, we found that evening dominant behavior was positively associated with depressive symptoms compared to morning dominant behavior as the control group. Conclusions Our results might contribute to monitoring and identifying individuals with latent depressive symptoms, emphasizing the importance of nuanced activity patterns and their probability of assessing depressive symptoms effectively.

Abstract Introduction Vaginal metastasis from colorectal cancer is a rare occurrence, typically associated with other metastatic lesions. Isolated metastasis is exceedingly uncommon, with only a few cases documented in the literature. Vaginal involvement in colorectal cancer primarily results from direct contiguous spread from the primary tumor. Case presentation We present the case of a 70-year-old African woman diagnosed with adenocarcinoma of the middle rectum. She underwent chemotherapy, radiotherapy, and subsequent anterior resection. After 2 months, an isolated metastasis of rectal cancer was identified in the lower third of the left vaginal wall, confirmed by biopsy. Colonoscopy ruled out colorectal recurrence. Thoraco-abdominal computed tomography scan showed no distant metastases. The patient underwent abdominoperineal resection, removing the lateral and posterior vaginal wall with free macroscopic margins and a definitive colostomy. The final histopathological analysis confirmed the diagnosis of moderately differentiated adenocarcinoma of the vagina, measuring 5 × 4.5 cm. The rectal wall was extrinsically invaded by the tumor down to the muscularis propria while respecting the rectal mucosa. Resection margins were negative. The patient was discharged 1 week postoperation with no complications. Adjuvant chemotherapy was indicated, and the patient is currently tolerating the treatment well. Conclusion Vaginal metastases from colorectal cancer are extremely rare. A vigilant gynecological examination is recommended during the follow-up of colorectal cancer patients. Diagnosis can be challenging, especially if the metastatic lesion is small and asymptomatic, even after standard radiological examination. Surgical resection followed by chemotherapy is a valid option for patients with early isolated metastases.

Abstract Background Sex cord-stromal tumors with annular tubules are a rare tumor accounting for less than 1% of all ovarian malignancies. However, they are characterized by very late recurrence, which can be as late as 30 years after diagnosis and treatment. Case presentation A 16-year-old female Caucasian patient was treated in our department for a stage IA ovarian sex cord-stromal tumors with annular tubules. She underwent a left salpingo-oophorectomy and ipsilateral pelvic node biopsy with no adjuvant treatment. She was seen for amenorrhea after being lost to follow up for 16 years. The diagnosis of recurrence was made by radiology and the elevation of serum inhibin B level. The patient underwent resection of the tumor, left segmental colectomy, and paraaortic lymphadenectomy because the mass was massively adherent to the left mesocolon. Histology confirmed the diagnosis with no metastatic lymph nodes. No adjuvant therapy was indicated. The patient was lost to follow-up again for 4 years and re-presented for amenorrhea. Serum inhibin B level was high. A second recurrence was suggested, and the patient underwent a laparoscopic surgery. We performed left pelvic and paraaortic lymphadenectomy, and 3 months after surgery the patient was pregnant. Conclusion Sex cord-stromal tumors with annular tubules is a slow-growing ovarian tumor with a high potential for recurrence and metastasis. Surgery is the mainstay of treatment. Due to the rarity of these tumors, they are often unsuspected and thus incompletely staged before primary surgery; the diagnosis is made by histological examination. The prognosis of these patients is unknown, and they require long-term follow-up.

Abstract Introduction Infectious affections are the most frequent post-operative complications, the rate have been reducing due to the administration of perioperative antibiotics and they are rarely serious. They are usually associated to pelvic collections, fistulas, urinary tract stenosis and, exceptionally, necrotizing fasciitis (FN) and pelvic organ necrosis. There is no well-codified treatment. Case presentation A 42-year-old female patient, was referred to our department for a stage IIIC2 adenocarcinoma of the uterine cervix. Two months after surgery, the patient presented with fever. Abdominal CT scan revealed a recto-vaginal fistula. The patient underwent a surgical evacuation of the collection and a bypass colostomy. Post-operative period was marked by the occurrence of an extensive necrosis to pelvic organs and medial left leg’s thigh compartments muscles. She also presented a thrombosis of the left external iliac vein and artery. Given the septic conditions, a revascularization procedure was not feasible. A bilateral ureterostomy was required and a ligature of the left external iliac vessels. Then she received palliative treatment.she died one month after surgery because of multivisceral failure due to sepsis. Conclusion Necrotizing fasciitis is extremely rare and serious condition, the diagnosis is clinical and radiological, CT scan is helpful for the. There are predisposing factors such as diabetes, neoadjuvant radiotherapy or chemotherapy. The prognosis can be improved with rapid management and appropriate medical and surgical excisions of necrotic tissue, and antibiotic therapy adapted to the suspected germs, essentially anaerobic ones.