Advantages of laparoscopic surgical techniques in the treatment of rectal prolapse

The authors reviewed the problems in the treatment of rectal prolapse and compared the results of the monitoring of a group of 124 patients over a period of 16 years. Based on the application of different surgical techniques and follow-up of short-term and long-term results, they suggested the use of laparoscopic surgical techniques in patients with high surgical risk and advanced stage of rectal prolapse

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Trapping of Charge Carriers in Organic Molecular Materials: Phthalocyanine Thin Films Revisited

The technique of temperature-modulated space-charge-limited currents was employed to study the energetic distribution of local states in thin films of metal-free phthalocyanine. Four well-defined local levels were detected within the energy range 0.5-0.3 eV, accompanied by an onset to a manifold of shallower states. The morphology of the films, depending on the deposition rate and changing from polycrystalline to nearly amorphous, affects the densities of local states but not their energies

Trapping of Charge Carriers in Organic Molecular Materials: Phthalocyanine Thin Films Revisited

The technique of temperature-modulated space-charge-limited currents was employed to study the energetic distribution of local states in thin films of metal-free phthalocyanine. Four well-defined local levels were detected within the energy range 0.5-0.3 eV, accompanied by an onset to a manifold of shallower states. The morphology of the films, depending on the deposition rate and changing from polycrystalline to nearly amorphous, affects the densities of local states but not their energies

Разработка макета городской улицы под управлением системы сбора данных «Smart Street»

Проблематика. Одним із нагальних завдань місцевої влади є скорочення використання енергії та людських ресурсів у сфері вуличних послуг. Вирішення цієї проблеми вимагає розробки системи управління прототипом, яка дозволить більш ефективно розподілити ресурси, необхідні для підтримки вулиці у належному вигляді. Розробка та реалізація такої системи можлива завдяки використанню концепції Інтернет речей. Мета досліджень. Метою роботи є створення вдосконаленого прототипу системи управління вулицями на основі 3D-макету міста. Методика реалізації. Особлива увага дослідження приділяється вибору протоколу обміну даними, покроковому налаштуванню топологічних шарів системи моніторингу та розробка і об’єднання компонентів макету вулиці. Результати досліджень. Кілька зібраних та персонально запрограмованих модулів кінцевих вузлів були розроблені як частина першого шару топології системи. Висновки. У статті пропонується використовувати протокол LoRaWAN для передачі даних від розроблених датчиків до центру обробки. Тестування розробленого прототипу системи управління показало задовільні результати у галузі надійності зв'язку, часу роботи датчиків від внутрішнього електроживлення та можливості інтеграції різних підсистем.Background. One of the urgent tasks of local authorities is to reduce the use of energy and human resources in the field of street services. The solution of this problem requires the development of a control system prototype that will allocate the resources needed to maintain the street in proper form more efficiently. The development and implementation of such a system is possible through the use of the concept of the Internet of Things. Objective. The purpose of the paper is creating advanced street management system prototype. Methods. Particular attention of the study is directed to the data exchange protocol selection, step-by-step system topology layers configuration, and mobile street layout development. Results. A few assembled and personally programmed end node modules were designed as a part of the first system topology layer. Conclusions. The paper proposes the use of the LoRaWAN protocol for data transmission from the designed sensors to the processing center. Developed control system prototype testing showed satisfactory results in the field of communication reliability, sensors operating time from the internal power supply and the possibility of different subsystems integration.Проблематика. Одной из важных задач местной власти является сокращение использования энергии и человеческих ресурсов в сфере уличных услуг. Решение этой проблемы требует разработки прототипа системы управления, которая позволит более эффективно распределить ресурсы, необходимые для поддержания улицы в надлежащем виде. Разработка и реализация такой системы возможна благодаря использованию концепции Интернет вещей. Цель исследований. Целью работы является создание усовершенствованного прототипа системы управления улицами на основе 3D-макета города. Методика реализации. Особое внимание исследования уделяется выбору протокола обмена данными, пошаговой настройке топологических слоев системы мониторинга, а также разработке и объединению компонентов макета улицы. Результаты исследований. Несколько собранных и персонально запрограммированных модулей конечных узлов были разработаны как часть первого слоя топологии системы. Выводы. В статье предлагается использовать протокол LoRaWAN для передачи данных от разработанных датчиков в центр обработки. Тестирование разработанного прототипа системы управления показало удовлетворительные результаты в области надежности связи, времени работы датчиков от внутреннего электропитания и возможности интеграции различных подсистем

Prevention and Management of Leakage After Rectal Resection with Extraperitonization of Drainage and Anastomosis

Background: The aim of surgical treatment in cases of carcinoma of the distal rectum is to save the anal sphincter, decrease the number of postoperative complications and limit the risk of reoperation. Therefore, mechanical /stapler/ anastomosis is currently widely used. In our study we discussed the complications and the preconditions leading to them, when manual and mechanical anastomosis are performed. We clarified the role of extraperitonization of anastomosis and drainage. Aim: To analyze the early postoperative results - the leakage rate when performing manual and mechanical anastomosis following resection of the lower rectum. We aimed to estimate the significance of extraperitonization of the anastomosis and the drainage in the postoperative period. Materials and Methods: In the period January 1, 1995 - December 31, 2015, in the Clinic of General and Liver-Pancreatic Surgery, 389 patients with rectal carcinoma, who suffered frontal rectal resection, were operated on.Results: Out of the 389 patients, 216 /55.52%/ were male and 173 /44.48%/ - females. Mechanical suture anastomosis was performed on 183 /47.04%/, and a handmade one - on 206 /52.96%/. Anastomosis leakage was registered in 58 cases /14.91%/. From those, with mechanical suturing were 34 /18.57%/, and with handmade anastomosis - 14 /6.79%/. There were two cases of relaparotomy and no deceased patients with this complication for the researched period.Conclusions: Mechanical staplers give the opportunity to keep anastomosis at the possible lower limit, almost impossible for manual suturing. But even with mechanical suturing, we face the risk of anastomosis leakage. This is why we think that the extraperitonization of anastomosis is a reliable prevention of reoperation and fecal peritonitis