Farewell, champion of change Mathur, Sanjay; Dickey, Beth; Mecklenborg, Mark
Journal of the American Ceramic Society,
December 2022, 2022-12-00, 20221201, Letnik:
105, Številka:
12
Journal Article
Introduction. Radial vesicovaginal fistulas are one of the most difficult problems of urogynecology, despite the fact that modern technologies make it possible to personalize the use of radiation ...therapy. Standard surgical techniques in the treatment of such patients are ineffective. The search for alternative surgical solutions can improve the results of treatment of patients with radial fistulas and microcystis. Study objective. To compare the effectiveness of augmentation ileocystoplasty and two-stage surgical treatment, represented by expanding intestinal cystoplasty in combination with the use of a Martius or Martius-Symmonds flaps. Materials and methods. The study included 8 patients. The first group included 4 patients who underwent laparotomy, augmentation ileocystoplasty. In 3 patients relapsed fistulas were closed with vaginal access using a Martius flap a few months later. The second group included 4 patients who underwent expanding intestinal cystoplasty by laparotomy, with further formation of Martius or Martius-Symmonds flaps by perineal access and moving them into the pelvic cavity for fixation from the abdominal cavity. Results. The average duration of the operation in the first group was 337.5 minutes, in the second group – 470 minutes. The patients of the first group had no complications of the III-V groups according to Clavien-Dindo. Natural urination was eventually recovered in all patients. In 2 patients of the second group, postoperative complications were recorded: in 1 patient – complication of group IIIa according to Clavien-Dindo – marginal necrosis of the skin flap after abdominoplasty, which required stage necrectomy and secondary skin sutures, in another 1 patient – complication of group IIIb according to Clavien-Dindo – dynamic intestinal obstruction, which required relaparotomy and nasointestinal intubation. There were no relapses of vesicovaginal fistulas. After urination was restored, all patients retained the urge to urinate. Conclusion. The proposed two-stage operation allows not only to eliminate the vesicovaginal fistulas, but also to increase the capacity of the bladder, restore voluntary urination.
The implementation of new automation technologies together with the development of artificial intelligence can free up a significant amount of labor. This sharply increases the risks of digital ...transformation. At the same time, certain regions and cities differ greatly in their ability to adapt to future changes. In this article, we seek to determine the capabilities of Russian regions to reduce risks and adapt to digital transformation. The literature stipulates that there are several factors able to reduce these risks. First of all, they are associated with retraining, ICT and STEAM-technologies’ development, the promotion of economic activities that are less subject to automation. As a result of econometric calculations, we identified several factors that contribute to the new industries’ development (in our case, ICT development), and, accordingly, increase regional adaptivity. These factors include diversification, the concentration of human capital, favorable entrepreneurship conditions, the creative potential of residents, and the development of ICT infrastructure. We identified several regions with high social risks and low adaptivity, which are mainly the poorly developed regions of southern Russia, where entrepreneurial risks are high, STEAM specialists are not trained, shadow economy is large. This work contributes policy tools for adaptation to digital transformation.
The system of cooperative and integrative associations (corporations and holdings) is analyzed, the principles and mechanism of corporate management and its efficiency are shown, and the advantages ...of corporative associations (holdings) are presented. The main directions and parameters of corporative management are defined. Among them are: organization structure development, production technologies development, labor resources improvement, financial stability provision, efficient reaction on market changes, innovation development. The notion 'the essence of corporate culture' is defined and the methods of state regulative impact on cooperative and integrative structures are formulated, the prospects for creation of cooperative and integrative structures in the agro industrial complex of Belarus are identified.
The authors explore current problems of public administration of processes related to combating corruption, focusing on its theoretical, methodological, political and legal aspects. This is due to ...the fact that the society has formed a demand to ensure resolute counteraction to corruption, the spread of which creates an existential threat to Russian society. Therefore, it is necessary to combine the efforts of the government, business and civil society, including the scientific and expert community, aimed at solving this problem. Special attention is paid to the search and use of adequate theoretical and methodological approaches to the corruption problem, which has a complex nature, and the development of effective anti-corruption technologies. In this regard, a critical analysis was carried out and the inconsistency of biologizing and sociologizing interpretations of corruption, recognition of its “eternal” nature, etc., was shown, which leads to the development and use of ineffective anticorruption tools. On the contrary, heuristic possibilities of dialectical, concrete-historical and interdisciplinary approaches to the development of anti-corruption system are postulated. It is concluded that the deep origins, causes and factors that generate corruption in modern Russia are rooted in the model of social structure chosen in the 1990s. The necessity of developing and implementing an updated state anti-corruption policy in the context of ongoing and expected socio-economic and political transformations is substantiated. It is shown that the updated anti-corruption policy should be implemented in dialectical unity with the state policy on the preservation and strengthening of traditional spiritual and moral values.
Aim: to estimate efficacy, tolerability, and safety of Ambenium® parenteral phenylbutazone sodium 400 mg and lidocaine hydrochloride 4 mg used for treatment of patients with low back pain. Methods. A ...total of 100 patients with low back pain (LBP), who received a single intramuscular injection of Ambenium® parenteral, were included in the study. The follow-up period was 3 days. The change in pain severity on VAS (mm) was selected as a primary outcome measure for efficacy. The pain syndrome severity was estimated before administration of the drug (visit 1) and 4, 6, 8 and 12 h after the drug administration, as well as during visits 2 (day 2) and 3 (day 4). The McGill Pain Questionnaire, muscle syndrome index (MSI), Roland-Morris Disability Questionnaire pain estimates were used as the secondary diagnostic criteria. The percentage of patients with the positive response relative to baseline (the decrease in pain severity on VAS by more than 50%) was also determined. Results. The dynamics of the primary efficacy measure (pain severity on VAS) was as follows: 7.4 ± 0.92 cm (mean ± standard deviation) during visit 1, 5.6 ± 1.49 cm after 2 h, 4.6 ± 1.74 cm after 4 h, 3.0 ± 1.79 cm after 8 h; the VAS score was 2.3 ± 1.70 cm after 12 h (р<0.001). The share of patients who responded to therapy (with the decrease in pain severity on VAS by more than 50% relative to baseline) was 84% 95% CI: 75.0 – 91.0 24 h after the first administration, 94% during visit 3 95% CI: 87.0 – 98.0, р<0.001. The secondary efficacy criteria (muscle syndrome index and McGill Pain Questionnaire score) showed significant positive dynamics (р<0.001). No systemic adverse events were reported. Conclusion. The study showed that a single intramuscular injection of Ambenium® parenteral was an efficient, well-tolerated and safe treatment option for low back pain. Administration of a single drug dose makes it possible to ensure a significant clinical effect reflected in the pain severity decrease and restoration of the patient’s motor activity.
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