bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Hepatic Toxicity of Chitosan and Chitosan- Functionalized Iron Oxide Nanoparticles in a Rat Model of Peripheral Nerve Injury — Relevance for Rehabilitation Medicine
Authors: Pop Nadina Liana , Nan Alexandrina , Florea Adrian , Toma Vlad Alexandru , Moldovan Remus , Decea Nicoleta , Urda-Cimpean Andrada Elena , Orasan Remus , Mitrea Daniela Rodica
Published: August 2024

Background: Peripheral nerve injuries (PNI) can generate important medium- and long-term disability, as patients mostly complain about associated pain, sensibility and, or motor deficit, and even psychological manifestations. Chitosan and different nanoparticles types were previously used in several studies as treatment of peripheral nerve injuries. The present study aimed to assess the hepatic responses at oral administration of simple chitosan solution and of magnetic iron oxide nanoparticles functionalized with chitosan (CMNPs) solution in an experimentally induced peripheral nerve injury. (2) Methods: Chitosan or CMNPs were oral administrated, for 21 days, to animals with peripheral nerve injury. The treated groups were compared with a control group (peripheric nerve injury without any treatment). The hepatic toxicity of administered solutions was analyzed histologically, through transmission electron microscopy (TEM) and through the oxidative stress parameters, in comparison with the control group. (3) Results: Liver tissue histological evaluation showed non-significant degeneration of hepatocytes in Chitosan group and, in CMNPs group, slight periportal inflammation. TEM investigation revealed nuclear and mitochondrial polymorphism and lipid accumulation in hepatocytes in Chitosan group, and in CMNPs group, irregular nucleus profiles and increased glycogen storage in cytosol. Oxidative stress analysis showed antioxidant hepatic effect of both treatments. (4) Conclusions: Compared to control group, both treatments produced significant increases of hepatic antioxidant protection, probably induced by chitosan properties. Histological modifications of the liver were minimal for both treatment groups. TEM investigation showed unspecific alterations of the hepatocytes structure.

Keywords: chitosan; iron oxide magnetic nanoparticles; peripheral nerve injury; toxicity
Efficacy and Safety of Balneotherapy using Diverse Natural Resources in Lithuania: A Multicenter Study
Authors: Rapolienė Lolita , Rapolis Dovydas , Jočienė Jovita , Taletavičienė Giedrė , Varžaitytė Lina
Published: August 2024

Background: Balneotherapy or spa therapy, with its multimodal effects, has shown clinical efficacy in treating various pathological conditions. However, further studies are needed to assess its impact on mental health and to evaluate treatment safety. This study aimed to evaluate the effectiveness of different natural resources of the Lithuanian medical spa for stress-related disorders and skin health and to disclose the safety profile of using natural resources. Methodology. We performed a multicenter randomized controlled single-blinded study in 6 Lithuanian medical spas. The 1- 2-week treatment combining mineral water, therapeutic mud, and salt procedures was provided for the 364 participants with moderate stress levels and the effect was evaluated using surveys, instrumental, and laboratory measures. Results. The findings highlighted that the effects of BT using different natural resources significantly improve mental and skin health, as well as contribute to overall health status for up to 6 months. A significant reduction of anxiety, depression, and fatigue as well as improvement in sleep, skin moisture, subjective skin state, and integrative outcomes was achieved in all centers after treatment, while stress and saliva cortisol, working speed, skin oiliness, and elasticity improved in a few centers. A positive result was related to the duration of the treatment, and possibly- to the features of natural resources. Mineral water most commonly caused side effects; it varied among centers, however, they were predominantly local, mild, and transient. Conclusions. Balneotherapy using natural resources is effective for the enhancement of mental and skin health. Further research is necessary for a better understanding of the role of different natural resources on health status and safety profile.

Keywords: balneotherapy, health, mental state, mineral water, natural resources, peloids, peloi-dotherapy, safety, spa therapy, skin
Current evidence of extracorporeal shock wave therapy (ESWT) in soft tissue disorders
Authors: Gligor Șerban , Vutan Ana Maria , Sîrbu Elena , Lupu Alina , Puta Tiberiu
Published: August 2024

Objective. To assess the current evidence of extracorporeal shockwave therapy (ESWT) for patients with soft tissue disorders. This form of treatment involves ballistic shock waves, generated by a piezoelectric, electromagnetic or electrohydraulic source. Methods. This was a systematic review designed in accordance with the Preferred Reporting Items for Systematic Reviews. We identified relevant studies by searching multiple electronic databases, relevant publications in English from 2010 to 2024. Two levels of screening were applied. During the first screening, titles and abstracts were reviewed and irrelevant studies were excluded. For the second screening, full-text articles were reviewed using predetermined inclusion and exclusion criteria. Results: The electronic database search resulted in 391 articles. After removing duplicates (47), abstract articles (92), articles that did not meet eligibility criteria (154), and those that had poor design or provided inconclusive information for our study (68), we included a total of 30 studies in this review. The results showed that ESWT has a beneficial effect in soft tissue disorders by reducing pain and is recommended when other non-surgical therapies have failed. Conclusion: ESWT can play an important role in the treatment of soft tissue conditions, if there are appropriate indications, unitary treatment protocols that are correctly applied and reproducible.

Keywords: systematic review, musculoskeletal disorders, pain relief, non-invasive therapy
Overweight and Obesity in High School Students of 15-18 ages. A Cross-Sectional Study
Authors: Pavlović Ratko , Kozina Zhanneta , Badau Dana , Alexe Cristina Ioana , Radulović Nikola , Joksimović Marko
Published: August 2024

The purpose of the study was to evaluate and identifying the level of excess weight and obesity in older students between 15 and 18 years, as important benchmarks of the level of health in order to update the recommendations regarding the promotion of an active and healthy lifestyle. A cross-sectional study was conducted on a sample of 400 subjects, (186 boys and 214 girls), aged 15 to 18. Anthropometric data including: body height, body weight, Body Mass Index (BMI). Participants' BMI was estimated using the Percentile BMI calculator for children and teenagers aged 2 to 19. Study adolescents were defined as underweight, normal (healthy) weight, overweight, and obese according to the CDC child growth characteristics for age, sex, and BMI. 350 (85.5%) subjects were healthy weight; 26 respondents (6.5%) were overweight, 17 (4.25%), were obese, while 7 (1.75%) underweight. The analysis of the individual results of male and female subjects points to increased values of the body mass of males (18.81%), compared to female pupils (3%). Out of a total of 186 male students, 10.75% were in the overweight category, and 8.06% were categorized as obese, in constrast 2.80% of the girls were overweight and (1%<), in the obese category, which is an outstanding result, where obesity practically does not exist. According to the results of this study (for both sexes), in relation to gender, there were more malnourished girls (2.33%), compared to boys (1%<). Among high school students in Bosnia and Herzegovina, the number of children with overweight and obesity is relatively low compared to data from other countries. Based on the relevant results of this study, we consider it necessary to update strategies for promoting an active and healthy lifestyle regarding physical activity and eating habits for adolescents in relation to the specifics of the countries of residence and European trends.

Keywords: BMI; students; overweight; obesity; weight status category; high school.
Validation of the mathematical model of upper body biomechanics using neural networks
Authors: Mereuta Elena , Novetschi Monica-Iuliana , Ganea Daniel , Amortila Valentin Tiberiu , Nazer Tarek
Published: August 2024

The paper presents artificial neural networks (ANNs) as a tool for validating the mathematical model. The neural network architecture must learn the relationship between the inputs (which are the parameters of the biomechanical mathematical model, such as height and body mass) and the desired outputs (i.e. the perturbing forces of the biomechanical model elements. We used part of the perturbing force values of the muscle groups responsible for the spine, neck, and head movement, determined using the mathematical model and the C++ application, to train the neural network. We used the remaining data to validate the neural network. The neural network architecture was created using the Easy NN application. After training the network, we concluded that the subject's height has the most significant impact on generating muscle force and is also the most sensitive parameter. The muscle force values of the data used for validation are almost equal to those determined using the mathematical model. Therefore, we can conclude that the mathematical model is correct, and the neural network can make predictions for various subject dimensions, even if their values are not within the range of values for which we trained the network.

Keywords: mathematical model; neural networks; human body
„Digital therapeutics” in musculoskeletal pain management: a narrative review of Gamification, Virtual Reality and Augmented Reality approaches
Authors: Ciubean Alina Deniza , Popa Theodor , Ciortea Viorela Mihaela , Dogaru Gabriela Bombonica , Ungur Rodica Ana , Borda Ileana Monica , Irsay Laszlo
Published: August 2024

This review aims at highlighting the potential of the „digital therapeutics” as adjuncts to traditional physical medicine and rehabilitation methods, to explore the clinical effects and relevance of using them in the rehabilitation of patients experiencing musculoskeletal pain, acute or chronic, and to provide a comprehensive understanding of how these technologies can improve pain management, enhance rehabilitation outcomes, and contribute to the overall well-being of patients. A comprehensive analysis of existing literature, clinical trials, and observational studies was conducted to assess the benefits and outcomes associated with rehabilitation interventions in this specific patient population. Multiple studies have suggested that „digital therapeutics” in musculoskeletal pain management have the potential to complement traditional interventions, improve treatment outcomes, and enhance patient engagement. Gamification, virtual reality and augmented reality are promising tools for managing musculoskeletal pain, offering innovative approaches to pain relief, rehabilitation, assessment, education, and remote care delivery.

Keywords: digital therapeutics; musculoskeletal pain; gamification; virtual reality; augmented reality
Mineral metabolism assays and osteoporotic fracture risk
evaluation in menopausal population diagnosed with adrenal
incidentalomas: a sub-analysis of PRECES study
Authors: Trandafir Alexandra-Ioana , Stanciu Mihaela , Valea Ana , Sima Oana-Claudia , Nistor Claudiu , Iliescu Mădălina Gabriela , Ciobanu Ileana , Popa Florina Ligia , Carsote Mara
Published: August 2024

Adrenal incidentalomas (AIs) are clinically silent adrenal masses that are unintentionally found during various abdominal imaging procedures. Our objective was to evaluate the bone profile in menopausal females diagnosed with AI versus a non-AI control group. This was an observational, retrospective, multi-centric, case-control study, a sub-analysis of PRECES study (“Parameters of Romanian Patients with Endocrine Conditions with or without Endocrine Surgery: real-world-evidence and retrospective study”), a multi-centric, Romanian collaborative in the field of endocrinology and connected specialities (real-world community setting). Inclusion criteria: women in menopause between 40 and 85 years. Ex-clusion criteria: active endocrine tumours or cancers, prior or current medication against osteoporosis. Assessments included bone turnover markers, central DXA, FRAX-based os-teoporotic fracture risk evaluation. AIs were defined as having a value of second day plas-ma morning cortisol after 1-mg dexamethasone suppression test of < 1.8 µg/dL [without mild autonomous cortisol secretion (MACS free), as seen in control group that did not dis-play the imaging evidence of an adrenal tumour] or between 1.8 and 5 µg/dL (MACS sub-group). Results: Demographic features of both groups (N=39 versus 95 patients) were simi-lar in terms of age (60.95±10.46 versus 61.55±7.2 years), years since menopause (14.92±10.32 versus 14.52±8.85 years), body mass index (28.03 versus 27 kg/sqcm); (p>0.1 for each). Osteopenia was the most prevalent DXA category in each group (43.6% versus 53.7%), followed by osteoporosis (20.5% versus 22.1%), while lumbar, total hip, femoral neck BMD were similar between AIs and controls. A statistically significant lower osteocal-cin in subjects with AIs, with a median (Q1, Q3) of 16.5 (11.96-20.09) ng/mL compared with the value in control groups of 23.17 (15.9-31.46) ng/mL (p=0.003) was found. In AIs group, serum baseline morning cortisol positively correlated with lumbar Z-score, and correlation coefficient reached a statistical significance (p = 0.035). Of note, a tendency for correlation with total hip BMD was found, too. To conclude, decreased osteocalcin might be the signa-ture of mild cortisol anomalies in AIs, but DXA-BMD and FRAX algorithm revealed similar parameters in AI group versus controls, as found between MACS and MACS free sub-groups.

Keywords: study, osteoporosis, adrenal incidentaloma, hormone, surgery, cortisol, functional, FRAX, bone turnover marker
Physical exercise as part of the rehabilitation in primary osteoporosis: insights into the signal transduction bone formation pathways
Authors: Stanciu Mihaela , Nistor Claudiu , Iliescu Mădălina Gabriela , Ciobanu Ileana , Popa Florina Ligia , Ciobica Mihai-Lucian , Sima Oana-Claudia , Popa-Velea Ovidiu , Carsote Mara
Published: August 2024

Primary osteoporosis, a geriatric bone metabolic condition affecting both the mineral density and the microarchitecture, comes with a complex burden. Bone turnover markers tidily reflect the changes of skeleton status that are part of the physiological process or theyhighlight the abnormal status including in osteoporosis in addition to other biomolecules evaluation such as hormones, inflammatory markers, myokines and adipokines. In this narrative review, we aimed to highlight several aspects regarding osteoporosis-related rehabilitation amid mitigating the role of physical exercise as bone formation booster. Bone turnover markers assays, by capturing the essence of the bone remodelling, registered a great progress during latest years, thus show-ing an enhanced index of applicability in daily practice (despite being known and studied for more than three decades). Irisin, a novel player in the muscle-bone-metabolism cross-talk, represents a muscle-derivate hormone that is expected to highlight the interplay between physical exercise and bone formation. Other concurrent signal transduction pathways include recently described biomarkers such as preptin or the spectrum associated with serotonin-LRP5-Wnt/beta catenin canonical and non-canonical loops. Current pitfalls of the topic include the personalized recommendation of physical activity due to severe co-morbidities, the lack of homogenous studies to measure the intervention and the consecutive bone health and great variations of using the bone turnover markers amid daily practice in different centers. To conclude, part of the monitoring protocol in osteoporotic patients under specific medication against osteoporosis or during bisphosphonates drug holiday, bone turnover markers assays stands for a practical insight in every day practice. The contributing role of physical exercise to boost bone formation as reflected by these biomolecules is well understood across a multitude of signal transduction pathways. However, a current gap in practical use and surveillance of the prescription of physical activity, mechanical load and rehabilitation programs in these patients is confirmed so far.

Keywords: osteoporosis, bone, fracture, rehabilitation, physical exercise, bone turnover markers, osteocalcin.
Prognostic value of physical activity, gender, and age versus
ECG in localizing the idiopathic ventricular outflow tract
arrhythmias
Authors: Sirbu Prisecaru Raluca Vasilica , Sirbu Alexandru Dan , Abagiu Madalina , Purcar Oana Elena , Manitiu Ioan
Published: August 2024

Background: The idiopathic ventricular outflow tract arrhythmias may arise either from the right ventricular outflow tract or the left ventricular outflow tract. It is paramount to establish the precise location, based on the 12 lead ECG, to recommend the proper treatment for the patients. Methods: Based on the 12 lead ECG evaluation, the origin of the arrhythmias was established to be either in the RVOT or LVOT. The level of physical activity, gender, and sex were noted for each patient. Further, we evaluated the accuracy of the arrhythmia’s location based on ECG versus the patient characteristics described earlier. Results: The clinical score based on these parameters presented a 71% sensitivity level and, 69% specificity level. The overall accuracy of predicting the right versus left outflow tract origin of arrhythmias based on the QRS morphology in lead V1 and the subsequent R wave transition in the precordial leads was 96.72%, with a 100% sensitivity and 88.89% specificity. Conclusion: Our clinical score, encompassing older age, sedentarism, and hypertension for the prediction of OT origin presents a lower sensitivity and specificity when compared to the ECG for differentiating the right versus left OT arrhythmias.

Keywords: age, sedentarism, arterial hypertension, idiopathic ventricular outflow tract, ventricular arrhythmias, ECG, radiofrequency ablation, QRS morphology.
Adherence to physical exercise program in patients with hypertension
Authors: Neamtu Andrei Caius , Amaricai Elena , Olariu Teodora , Iurciuc Stela
Published: August 2024

The study aims to assess adherence to a physical exercise program in patients with hyper-tension. 120 hypertensive patients were included in a 3-month physical exercise program (first 2 weeks, 10 daily sessions, under the supervision of a physical therapist in a rehabili-tation center, continued at home, 5 sessions per week). After the 3-month exercise program 108 patients completed an adherence questionnaire. All patients considered the physical exercise program important for their physical health; 82% of them also considered the program important for their mental health. 94% of patients admitted as necessary to con-tinue the physical exercise program after the end of the study. The lowest percentages of patients (47%) admitted the fitting of the physical exercise sessions performed in a rehabil-itation center with their daily program. Adherence to a 3-month physical exercise was beneficial for physical and mental health status of patients with hypertension. The pro-moting factors for a good adherence to rehabilitation were involvement and availability of patients, living in the city or nearby villages, free of charge exercise sessions and quality of physical therapy. The assessment of adherence by an easy-to-use tool can provide im-portant data for adapting the rehabilitation program to patients’ need and expectations.

Keywords: hypertension; physical exercise; adherence.
The muscle strength of the hip joint can be used as a criterion of quality rehabilitation patients after total hip arthroplasty
Authors: Mihajlov Marjan , Dragomir Marian , Bausic Alexandra , Xhardo Kristo , Onu Ilie , Talaghir Laurențiu Gabriel , Coja Daniel Mădălin , Iordan Daniel Andrei , Musat Carmina Liana , Voicu Bogdan
Published: August 2024

The primary aim of this study is to evaluate the efficacy of rehabilitation following total hip arthroplasty (THA) through the assessment of hip joint mobility parameters, namely abduction, extension, and flexion, at 2, 4, and 6 weeks post-surgery. These evaluations coincide with the implementation of rehabilitation exercises recommended by the physiotherapist. The study intends to analyze the progression of hip mobility during these specific time intervals in conjunction with the prescribed rehabilitation program. By examining the relationship between the performed exercises and the observed improvements in hip mobility, the research aims to provide valuable insights into the effectiveness of the rehabilitation protocol in facilitating post-THA rehabilitation. Material and method: The evaluation of hip joint mobility encompassed measurements of abduction, extension, and flexion utilizing a "Active Force 2" digital dynamometer. In tandem, the functional assessment of patients' health status was conducted through the utilization of the WOMAC index (Western Ontario and McMaster Universities Osteoarthritis Index). Results: The experimental data acquired in the measurement joint mobility during abduction, extension and flexion at 2, 4 and 6 weeks of exercises performed after THA are presented. Pain: mean score decreased from 3.08 to 1.18 (38.31% improvement); physical difficulties: mean score decreased from 3.10 to 1.01 (32.25% improvement) and joint stiffness: mean score decreased from 3.41 to 0.65 (19.06% improvement). These findings highlight the effectiveness of the recovery exercises in reducing pain, improving physical function, and decreasing joint stiffness post-THA. Conclusions: Our research emphasizes the essential contri-bution of physiotherapists to achieving positive outcomes for patients post-THA surgery. Through a personalized physiotherapy regimen administered during follow-up appointments, patients undergoing THA exhibited notable functional improvements. The study's results high-light the efficacy of this approach in alleviating discomfort, expediting recovery, and enhancing patients' overall quality of life, enabling a smoother transition back to normal daily activities.

Keywords: total hip arthroplasty, physiotherapy, rehabilitation, hip joint mobility, muscle strenght
Biological Evaluation of Balneotherapeutic Mud and Sulfurous Mineral Waters: Insights from In Vivo and In Vitro Studies
Authors: Munteanu Constantin , Popescu Cristina , Munteanu Diana , Hoteteu Mihail , Iliescu Madălina Gabriela , Ionescu Elena Valentina , Stanciu Liliana , Oprea Doinița , Minea Mihaela , Oprea Carmen , Luca Andreea , Calin Mihaela Antonina , Onose Gelu
Published: August 2024

Balneotherapy, treating diseases by bathing in mineral-rich waters and mud, has a long historical application across various cultures. Despite its widespread use, comprehensive studies on its biological impacts are scant, particularly in quantifying effects at the cellular and systemic levels. This study aims to rigorously investigate the biological effects of therapeutic mud and mineral waters, providing a scientific basis for their clinical application. We focused on elucidating the mechanisms behind the observed therapeutic effects and determining these natural resources' safety profiles. Employing a dual approach, we conducted both in vitro and in vivo studies. For the in vitro experiments, human fibroblast cells were treated with different concentrations of mud extracts to assess cytotoxicity, proliferation, and apoptosis pathways. For the in vivo assessments, Wistar rats were exposed to mud and mineral water treatments, with subsequent evaluations of biochemical markers in blood and urine indicative of systemic physiological changes. Our findings reveal that mud extracts exert a dose-dependent influence on cell viability, with low concentrations promoting cellular proliferation while higher concentrations induce apoptosis. In vivo treatments demonstrated significant modulation of inflammatory markers and oxidative stress parameters without evident systemic toxicity. The therapeutic mud and mineral waters demonstrate pronounced biological effects, enhancing cellular health and modulating systemic physiological responses without adverse side effects.

Keywords: Balneotherapy, Mud, Mineral Waters, Inflammatory Markers, Oxidative Stress
Zoledronic acid: challenges and pitfalls amid rehabilitation in primary osteoporosis and beyond
Authors: Florescu Alexandru Florin , Sima Oana-Claudia , Costăchescu Mihai , Stanciu Mihaela , Popa Ligia Florina , Nistor Claudiu , Iliescu Mădălina Gabriela , Ciobica Mihai-Lucian , Carsote Mara
Published: August 2024

Zoledronate (or zoledronic acid) represents a standard (guideline-based) approach in the area of anti-resorptive medication (namely, an annual 15-minute perfusion of 5 mg for os-teoporosis treatment), while the same drug (with doses/regimes variations) is used for other bone metabolic conditions such as Paget’s disease of the bone or skeleton metastasis originating from different cancers. The objective of this narrative review was to highlight the most recent published data with respect to zoledronic acid use as part of the complex clinical management amid primary osteoporosis in addition to other osteo-metabolic clin-ical entities. This was a research based on exploring PubMed database with respect to the search words “zoledronic acid” and “primary osteoporosis”. We included highly relevant (from the clinical perspective), English-published, full-length articles that have been re-cently published (between January 2023 and March 2024). From 249 results, 31 articles met the inclusion timeline criteria across the 15-month analysis and the final results were based on data provided from 16 articles. Important insights concern not only the zoledronic acid administration, the efficacy and the safety profile, but, also, an extension on daily indications with concern to diabetic bone disease, liver osteodystrophy, osteogen-esis imperfecta or Paget’s disease of the bone.

Keywords: osteoporosis, rehabilitation, zoledronic acid, DXA, hypercalcemia, bone, surgery, prosthesis, Paget’s disease of the bone, liver osteodystrophy
Assessment of knowledge about the doping in the rehabilitation assistance of performance and recreational athletes
Authors: Tăbîrță Alisa , Chihai Victoria , Cebanu Serghei , Pogonea Ina , Timercan Tatiana , Jucov Artiom , Ștefaneț Gheorghe
Published: August 2024

Background: During the activity of performance and recreational athletes can arise critical situations that imply medical rehabilitation treatments. In the process of functional recovery, the applied methods can be sometimes aggressive and intense. The lack of knowledge of forbidden substances may pose a threat for the athlete’s health and performance. It is of utmost importance that the medical personnel that care for athletes take into consideration the risks and effects of doping substances.
Methods: A group of 53 physicians - specialists in the field of physical medicine and sports medicine participated in the written study. The investigation was carried out according to the Questionnaire for the evaluation of anti-doping knowledge. By means of 14 categories of simple introductory questions, the questionnaire allowed the collection of data on the doctor's seniority and job, age, gender and general knowledge about substances and methods of interest in sports. The data of the participants in the questionnaires were collected and entered into a Microsoft Excel database and were analyzed in the MEDCALC statistical software program version 12.7.0. The data were analyzed using the SPSS program, version 21. Descriptive analysis was performed using the means and standard deviations of PEAS Instrument variables and mean difference tests were performed on two-response variables along with analysis of variance (ANOVA).
Results: The majority of doctors (40/75.48%) do not have information about test procedures for inert substances and almost half of them (25/47.17%) do not know the anti-doping rules and standards developed within World Anti-Doping Agency (WADA). Of the people surveyed all (53/100%) positively noted the effectiveness of anti-doping programs, but 18 (33.96%) of the respondents distinguished exaggerated actions in the mass media regarding the issue of doping and 35 (66.04%) of the respondents did not have accusations against mediating the issue of doping. Of all the people investigated, the majority (49/92.45%) are ready to report on cases of doping in the anti-doping organization or the sports federation. 24 (45.28%) marked agreement in these actions and total agreement - 25 (47.17%) physicians.
Conclusion: In the evaluation of the knowledge of specialist doctors involved in the assistance of people who practice performance and recreational sports, a discrepancy in the knowledge about doping was determined. The development of strategies and policies by informing doctors from medical rehabilitation and sports medicine in the field of sports doping will offer athletes access to quality medical services and safe professional activity.

Keywords: medical rehabilitation of athletes, doping substances, World Anti-Doping Code
A Deep Learning Approach for Classification of Physiotherapy Exercises Using Segmentation of Techniques
Authors: Turnea Marius , Gheorghita Andrei , Rotariu Mariana , Ilea Mihai , Arotaritei Dragos , Duduca Irina , Condurache Iustina
Published: August 2024

: Physiotherapy exercises are necessary to patients to restore their functional abilities in many cases as disabilities, injury, or basic with complementary approach as balneotherapy. Different type of exercised and different template sessions are used depending on the medical diagnostics. The evaluation of effectiveness of these exercises are important for patient’s rehabilitation process as time and level of recovery of locomotor skills. A dataset publicly available (Physical Therapy Exercises) is used for classification of session of repeated exercises that includes movement executed correct (C), fast execution (F) and low-amplitude execution (L). A novel approach is proposed by using segmentation of signal using deep learning neural network followed by a convolutional neural network for classification of sequence of the labeled classes L,C, F, and N (a new class introduced to label the noise of sensor of exercised or incorrect movement of the patient. The signal is extensively analyzed in order to made and corresponding labeling for analyzing using sliding window with a drive user selected length. The accuracy of classification is greater than 96% and sensitivity is greater than 95% but the results can be better if the labelling of N class is more restrictive and the effect of imbalanced dataset is reduced.

Keywords: physiotherapy exercises; segmentation techniques; deep learning neural networks, classification; imbalanced dataset
Comprehensive Approach of the Diagnosis, Treatment, and Medical Rehabilitation of Patients with Spondylolisthesis
Authors: Nedelea Dana-Georgiana , Vulpe Diana , Enyedi Mihaly , Cergan Romica , Scheau Cristian , Baz Radu Octavian , Dragosloveanu Serban
Published: August 2024

: Spondylolisthesis represents the slippage of one vertebra over another, and is widely diagnosed among patients accusing low back pain. Despite most patients being asymptomatic, spondylolisthesis can be the cause of extremely severe, irreversible, and invalidating symptoms. The most frequent types of spondylolisthesis are isthmic, degenerative, dysplastic, traumatic, pathologic, and iatrogenic. While numerous classification systems have been used to describe spondylolisthesis, the descriptive Wiltse classification and the Meyerding classification based on the severity of slippage are the most commonly used in current practice. The clinical evaluation is focused on the degree of pain, the presence of radiculopathy, and other neurological deficits, and is followed by diagnostic imaging, including standing anteroposterior and lateral spine radiographs, computed tomography, and magnetic resonance imaging. Therapeutic options include conserva-tive methods comprising symptomatic medication and physical therapy for lowgrade spondy-lolisthesis with good to excellent results in the long term, as well as surgical treatment with a variety of possible techniques that allow for the reduction of the grade of slippage and obtaining the fusion of the affected level, followed by a well-tailored physical therapy program. The most important role for a patient’s long-term satisfactory result is adequate medical rehabilitation, with consequent and properly designed regimens that the patients will adhere to for the rest of their lives.

Keywords: spondylolisthesis; diagnosis; treatment; orthopedics; medical rehabilitation; radiology; magnetic resonance imaging
The impact of comorbidities on the physical and psychological dimension in heart failure patients
Authors: Iovanovici Diana Carina , Bungau Simona Gabriela , Purza Anamaria Lavinia , Țiț Delia Mirela , Antal Ioan Andrei , Nistor – Cseppento Carmen Delia , Toma Mirela Marioara , Dogaru Bombonica Gabriela
Published: August 2024

Assessing patients' quality of life is frequently used in medical research. Patients di-agnosed with heart failure (HF) have reduced exercise tolerance and reduced quality of life due to reduced heart pump function. The objectives of the study are (i) to assess quality of life and comorbidities in HF patients; (ii) to compare quality of life in the physical and psychological do-mains according to drug treatment followed and (iii) to identify predictors of the two domains as-sessed. Methods. A cross-sectional study was conducted between February 2023 and May 2024. A total of 169 patients with HF were included and were distributed into two groups: the HF -S/V group (N=64) who received treatment with sacubitril/valsartan and the HF -CT group (N=105) received treatment with conventional therapy. Two questionnaires were used to assess patients: the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF) questionnaire and the Charlson Comorbidity Index (CCI). Results: The values determined for physical and psy-chological health were significantly lower for Group HF - S/V (51.391 ± 22.232 vs. 61.79 ± 20.04, p=0.002, respectively 59.203 ± 16.871 vs. 64.933 ± 17.448, p=0.038). Approximately 25% of all re-cruited patients distributed in the 2nd CCI category (CCI score 3-4) have an overall poor and moderately poor perception of quality of life vs. 35.5% of patients distributed in the 3rd CCI cate-gory (CCI ≤ 5); 55% of them belong to the HF - S/V group. A good perception of health status is held by 29 (17.16% of the HF group) of the patients distributed in the 2nd CCI category and 28 (16.56%) have a low and moderate perception. Conclusions: The values for the Physical health domain are moderately low, while the values obtained for the psychological domain show that this domain is less affected. Predictors identified for physical health and psychological well-being are patient age, weight, CCI.

Keywords: heart failure; comorbidities; quality of life; physical dimension; psychological dimension
The connections between meteorological conditions and the health status of the population of Suceava municipality. A case study on respiratory afflictions throughout the years 2019-2020 in Suceava
Authors: Țiculeanu (Ciurlică) Mihaela , Mihăilă Dumitru , Bistricean Petruț-Ionel , Sfîcă Lucian , Lazurca (Andrei) Liliana Gina Lazurca (Andrei) , Mihalache Andrei , Silișteanu Călina-Sânziana
Published: August 2024

Background: The present study addresses the real necessity of covering the gaps related to the actual understanding of the relationships established between weather patterns and the health status of the population. The urban area of Suceava is representative of medium-sized cities in Romania.
Methods: Respiratory pathologies manifest with a temporal offset when compared to intervals with severe weather conditions. The consultation program is one that does not take into account the severity of weather conditions. Through statistical and graphical correlations, strong direct or inverse proportional relationships were identified between meteorological elements, the multitude of meteorological elements represented by bioclimatic indices, and the number of consultations provided to patients with respiratory afflictions.
Results: In the winter season when t°C, THI, and TPr have minimum values and Pr has maximum values, the number of consultations for respiratory conditions is at an all-time high. The value of the coefficient of determination R2 between the monthly values of t°C and THI, respectively, the number of consultations for respiratory conditions exceeds the threshold of 0.7, and between the monthly values of Pr and the number of consultations for respiratory afflictions was 0.66. On days when t°C was ≤ 0°C, the average number of consultations for respiratory conditions was 6.1, decreasing to 3 on days when t°C was > 23°C.
Conclusions: Respiratory diseases have the most favorable temporal framework for occurrence in the months of the cold season. In winter in Suceava, respiratory conditions affect twice as many people as in summer.

Keywords: respiratory afflictions, meteorological elements, bioclimatic indices THI, Pr, and TPr
Merging the genus Tomentella with Thelephora (Fungi, Thelephorales)
Authors: Kõljalg Urmas , Saar Irja , Svantesson Sten
Published: August 2024

In this article we merge the genus Tomentella with Thelephora. As a result, 191 new combinations are made and 24 nomina nova are created. In addition, one new combination of Tomentellopsis and Polyozellus species are made, respectively.
Prospects for the use of cell technologies in the treatment of depression
Authors:   Federal State Research Institute of Fundamental and Clinical Immunology, Markova Evgeniya V. , Knyazheva Maria A. ,   Federal State Research Institute of Fundamental and Clinical Immunology
Published: August 2024

The monograph reflects modern ideas about the role of immunocompetent cells and their cytokines in the pathogenesis of depression; presents priority data obtained in the laboratory of neuroimmunology of the Research Institute of Fundamental and Clinical Immunology of the Russian Academy of Sciences, demonstrating the ability of peripheral immunocompetent cells with functional activity modulated outside the body, or a complex of biologically active products of their secretome, by influencing the main pathophysiological mechanisms of depression to have a pronounced positive psychoneuroimmunomodulatory effect, editing depressive-like phenotype of recipients, which is an experimental basis for the development of a fundamentally new approach to immunotherapy of socially significant depressive disorders in humans using cellular technologies. The monograph is intended for researchers, medical specialists in various fields, as well as for undergraduates and students of higher educational institutions in medicine, biology, pharmacology, and psychology.
Comparison of the incidence and causes of injuries in stand-up and ground combat-sport fighters – a narrative review
Authors: Gastoł Bartłomiej , Mikołap Karolina , Staroń Arkadiusz , Kras Marta , Karkos Patrycja , Kuśmierczyk Katarzyna , Jurga Marta
Published: August 2024

Injuries in combat sports can happen to any athlete, regardless of gender, age, training experience or whether he or she is an amateur or a professional. The range of injuries varies from superficial, short-term damage to severe injuries with serious consequences, including death. There are many types of combat sports, each with different rules and specific injuries. Amongst various divisions of combat sports, one of the basic ones is the division into ground and stand-up sports. In the following work, using the available literature, we wanted to present the specifications of several of the most popular combat sports and compare their most common locations of injuries, types of injuries and mechanisms of their formation, paying attention to which of these categories a given sport belongs to. We also discuss differences in the rate of injury for different age, genders, prevalence of injuries during situations of practice and competition. In the end, it is presented what are the possible long-term complications of injuries in combat sports and which actions such as protective gear, bans on certain techniques or behavioural changes might reduce the injury rate to protect the athletes health, well-being and decrease the economic burden on healthcare systems.
The Impact of Nutritional and Dietary Factors on Hashimoto's Thyroiditis: A Comprehensive Review
Authors: Rybka Zuzanna , Kamińska Monika , Moczyróg Katarzyna , Karnas-Bogacka Patrycja , Uchto Adrian , Dąbrowska Natalia , Marszałek-Moc Kaja , Miernik-Skrzypczak Magdalena , Jasiewicz Maria , Palacz Karolina Alicja
Published: August 2024

Introduction. Hashimoto's disease (HD) is the main cause of hypothyroidism in countries where there is no iodine deficiency in the diet. Characteristic antibodies for it are anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) and their level positively correlates with the severity of HD. Whereas its occurrence is related to genetic, environmental and existential factors.
Aim of study. The aim of this study was to analyze dietary factors (protein, fat, vitamin D, iodine, selenium, gluten) and intestinal microbiota on the risk of developing Hashimoto's disease and the influence of each of these factors on its course.
Materials and methods. More than 90 articles addressing these issues were analyzed. They were found using the PubMed search engine, and the time frame of these publications covered the last 10 years.
Results. Excess iodine is the most important environmental factor influencing the development of Hashimoto's disease. Also, selenium deficiency contributes to the development of HD. On the other hand, the concentration of vitamin D is lower in patients with Hashimoto's disease than in the general population. Furthermore, Vitamin D supplementation reduces the concentration of anti-Tg antibodies. In addition, different types of dietary fat affect thyroid hormone levels differently and a deficiency of protein in the diet causes an increase in TSH and a decrease in thyroid hormones. Moreover, changes in the gut microbiome have been observed in people suffering from Hashimoto's disease.
Conclusions. The risk of developing Hashimoto's disease can be increased and decreased by diet and diet allows for the modification of hormone levels in the hypothalamus-pituitary-thyroid axis.
Link Between PTSD and Autoimmune Diseases: A Path to Effective Treatment. Literature review
Authors: Kajka Anna , Antczak Joanna , Wojtczak Karolina , Lipska Julia , Fenrych Urszula , Hamerska Laura , Hamerska Julia , Bocianiak Bogumił , Ruta Damian , Skupińska Olga
Published: August 2024

Introduction and Objective:
PTSD is a psychiatric disorder associated with the experience of a traumatic event in the past. Changes in the immune system are presented as one of the mechanisms involved in its pathophysiology. The purpose of this review is to investigate the potential link between PTSD and autoimmune diseases, as well as to highlight the therapeutic implications.
Review methods:
The review is based on scientific publications in PubMed, Science Direct and NCBI databases. After an initial evaluation of the articles, primarily observational studies and meta-analyses on the relationship between PTSD and autoimmune diseases, the underlying pathophysiology, and new potential therapeutic options were selected.
Abbreviated description of the state of knowledge:
PTSD is associated with numerous changes in the immune and neuroendocrine systems. As a result, patients affected by the disorder are susceptible to developing somatic diseases, including autoimmune diseases. Numerous studies indicate a reciprocal effect on the increased risk and aggravation of symptoms for PTSD and autoimmune diseases due to certain similarities in pathophysiology. New treatment options for PTSD targeting the immune system with anti-inflammatory and immunomodulatory drugs are currently being explored.
Summary:
This review article highlights the existing reciprocal relationship between PTSD and autoimmune diseases, which carries important clinical implications. The authors of the review emphasize the importance of better understanding the pathophysiology of PTSD and the early diagnosis and treatment of people with PTSD, as well as the need to develop new effective treatments for PTSD that can help reduce the risk of developing autoimmune diseases in people with the disorder. As suggested, treatment targeting the immune system may be an effective therapeutic option for patients with PTSD.
Robot-assisted partial nephrectomy: Is it the future of kidney surgery? A comparison of nephron-sparing techniques in partial nephrectomy
Authors: Ast Bartłomiej , Piotrowski Igor , Dobrzeniecki Krzysztof
Published: August 2024

Technological advancements are significantly transforming various medical fields, including urology. The increasing adoption of minimally invasive surgical techniques and robotic assistance is particularly impactful. Three partial nephrectomy techniques are investigated: open partial nephrectomy, laparoscopic partial nephrectomy, and robot-assisted partial nephrectomy. Among these, robot-assisted partial nephrectomy is considered to be superior due to shorter warm ischemia time, reduced blood loss, better early renal functional preservation, and shorter hospital stays. The zero-ischemia partial nephrectomy concept aims to improve postoperative kidney function outcomes. The integration of robotic technology and advancements in artificial intelligence and surgical training systems are expected to further enhance surgical techniques. Artificial intelligence, particularly when combined with computer vision algorithms, shows potential for creating precise and automated three-dimensional models for surgical planning in complex robot-assisted partial nephrectomy procedures, potentially leading to better patient outcomes. This review identifies the current capabilities and prospective advancements in the application of robotic technology in partial nephrectomy.
Partnership Diplomacy: China–Algeria’s Comprehensive Strategic Partnership
Authors: Chaziza Mordechai
Published: August 2024

ABSTRACT: This study investigates China’s partnership diplomacy with Algeria as an instrument for realizing its BRI. There are several factors (policy coordination, energy cooperation, trade and investments, connectivity, military ties, and people-to-people bonds) behind the establishment of the China–Algeria comprehensive strategic partnership. The main argument is that Beijing’s comprehensive strategic partnership framework with Algeria is based on shared or mutual complementary interests, given the latter’s geographical location, economic potential, and diplomatic weight. The steady growth of China’s engagement and presence in the Maghreb region through the BRI framework aligns with Algeria’s vision and efforts in the Arab Maghreb Union and African integration.