bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful treatment of peripartum cardiomyopathy: a case report
Authors: Korneeva N. V. , Mislimova N. N.
Published: August 2024

Peripartum cardiomyopathy is a rare disease that occurs in late pregnancy and early postpartum, manifesting as rapidly progressive heart failure. To save the mother’s life, quick diagnosis, correct routing and pathogenetic treatment is required. The demonstrated case shows a detailed childbirth situation, which could provoke peripartum cardiomyopathy in a 36-year-old woman with subclinical hypothyroidism, rapid recognition of the clinical situation with the correct treatment tactics, which helped not only to stabilize the patient’s condition, but also to completely restore the left ventricular contractile function. Practitioners are interested in following the tactics of drug treatment in the intensive care unit and further at the outpatient stage using a specific clinical example.
Hydro-mechanical behaviour of reinforced concrete linings in hydraulic tunnels: steady state
Authors: Stucchi Riccardo
Published: August 2024

Existing literature covers the behaviour of reinforced concrete (RC) tunnel linings in hydraulic tunnels during filling and steady-state conditions. However, certain aspects remain insufficiently addressed, risking the under-dimensioning of structures, particularly concerning transient behaviour. This paper introduces a comprehensive analytical framework for the design of RC linings in hydraulic tunnels, clarifying conditions that lead to a water-filled gap between the lining and rock mass, significantly impacting system behaviour. The presence or absence of this gap notably affects the number of cracks in the lining, with a substantial increase in cracks when the gap is absent. Contrary to prior assumptions, the paper highlights that the cracking process of the lining is progressive and can stabilize before reaching a fully cracked state, resulting in fewer cracks. Understanding these phases is crucial for setting realistic initial conditions for transient events, particularly concerning lining stiffness. Accurate stiffness determination is essential for evaluating the lining’s response during transients and its fatigue performance. This becomes increasingly significant with the rise of pumped storage schemes for grid stabilization, posing challenges in resistance and fatigue verification of hydraulic tunnel RC linings.
Lymphatic and blood vessels in parathyroid tumors: Immunohistochemical study with LYVE-1 and von Willebrand factor
Authors: Tomita Tatsuo
Published: August 2024

Parathyroid tumors exhibit distinct histopathological features that differentiate benign from malignant lesions. This study aimed to study characteristic distribution of lymphatic and blood vessels in normal parathyroid gland and parathyroid tumors to distinguish cancer from benign tumors. Immunohistochemical staining for lymphatic and blood vessels and parathyroid hormone was performed with parathyroid proliferating lesions including adenoma, multiglandular multiple adenomas, atypical tumor, and carcinoma. Lymphatic vessels were immunostained with lymphatic vessel endothelial receptor 1 (LYVE-1) and blood vessels were immunostained with von Willebrand factor (vWf). Normal parathyroid gland contained several round blood vessels with less linear lymphatic vessels. The less parathormone-immunostained adenomas weighing less than 2 g revealed larger blood vessels with perivascular small linear lymphatic vessels, and the larger adenomas contained proportionally larger blood vessels. Smaller multiglandular multiple adenomas were like smaller adenomas with less parathormone staining and contained larger, round blood vessels with perivascular small linear lymphatic vessels. Larger multiglandular multiple adenomas weighing more than 4 g and one atypical tumor contained nodular pattern consisted of alternating strongly parathormone-positive lobes and negative lobes with numerous, dilated blood vessels and perivascular linear lymphatic vessels. Both primary and metastatic carcinomas were strongly and diffusely positive for parathyroid hormone with numerous lymphatic and blood vessels at the invading margin. Thus, normal parathyroid has rich blood vessels which provide accessibility of minced tissues seeding for auto-transplantation. Immunostaining patterns of parathyroid hormone, lymphatic and blood vessels help to distinguish carcinoma from benign parathyroid proliferating lesions. The negative immunohistochemical staining for parafibromin will detect carriers of hyperparathyroidism-jaw tumor (HPT-JT) syndrome and would help in diagnosing parathyroid cancer in both HPT-JT carriers and sporadic patients.
Relative Feature Classification Method for Diabetic Retinopathy Detection from Scanned Eye Images
Authors:   Assistant Professor, Department of ECE, Sri Eshwar College of Engineering, Coimbatore, Tamil Nadu, India, Dhanasekar J , Sudha V K
Published: August 2024

Objectives: Intense/unattended Diabetic Retinopathy (DR) results in vision loss for diabetic patients for which a precise computer-aided image process is required. This article introduces a Distributive Function-Relative Feature Classification Method (DFRFCM) for identifying precise DR positive rates using scanned eye inputs. Methods: The proposed method performs a linear distributive assessment for the identifying features between the positive and false rate regions. This linear assessment is based on matching features between inputs and training sets for maximum classifications. Findings: The classification of feature relativity is the key factor used for training the neural network across various regions identified. Such a process relies on one-layered neural processing for distinguishing the distribution or closure of the features between consecutive regions. Novelty: The closure pixels are identified as false rates from which DR region detection and intensity are classified. This process improves the detection accuracy with fewer errors and has an accuracy of 91.817% and an error of 7.27% when compared with conventional methods. Keywords: Diabetic Retinopathy, Distributed Function, False Rate, Linear Classification, Neural Network
Certain Applications of New Caristi Contraction Coupled Solution in S𝑏-Metric spaces
Authors:   Research scholar, Department of Mathematics, University College of science, Osmania University, Telangana, 500007, Hyderabad, India, Swapna D , Nagaraju V
Published: August 2024

Objective: To initiate some new Caristi-type contractions on complete Sb-metric spaces. Methods: Caristi-type contractions of four mappings together with -compatibility in Sb- metric space used to derive some common coupled fixed-point theorems. Findings: We obtained new common coupled fixed-point results in complete Sb- metric spaces by using Caristi-type contractions which generalize some existing results in the literature and validated them with an appropriate example. Novelty: By defining a new Caristi type contraction, we have established a common coupled fixed-point result and have given some applications to integral equations as well as homotopy theory of common coupled fixed point results in Sb- metric spaces. Keywords: Caristi type mappings; Coupled fixed point; Complete Sb-metric spaces; lower semi continuous mappings; compatible mappings
N-Cubic Picture Fuzzy Linear Spaces
Authors:   Department of Mathematics, University College of Science, Osmania University, Hyderabad, 500007, Telangana, India, Soujanya Gundeti , Reddy B Surender
Published: August 2024

Objectives: The major objective of the present work is to apply the concept of N-cubic structure to N-Picture Fuzzy Linear Spaces. It also examines the fundamental operations such as P-union, P-intersection, R-union and R- intersection of N-Cubic Picture Fuzzy Linear Spaces, ENCPFLS and INCPFLS, and discusses in detail both of them with examples. Methods: We define P(R)-union and P(R)- intersection of N- Cubic Picture Fuzzy Linear Spaces and its properties by giving few examples with the motivation of the notion of Cubic Picture Fuzzy Linear Space (CPFLS). Findings: The notion of external and internal N-Cubic Picture Fuzzy Linear Spaces including their properties are derived. Novelty: For the first time, we present the idea of N-Cubic Picture Fuzzy Linear Spaces (NCPFLS), which has been developed on the basis of interval valued N- Picture fuzzy linear spaces (IVNPFLS) and N-Picture fuzzy linear spaces (NPFLS). In addition, we have studied the basic operations which includes P(R)-union and P(R)- intersection on ENCPFLS and INCPFLS. Keywords: N­-picture fuzzy set, N-­cubic set, N-Picture fuzzy linear space, Interval valued N-Picture fuzzy linear spaces, P(R)­ union, P(R)­intersection AMS Subject Classification: 08A72, 03E72
Laceability Partition Dimension of Some Special Graphs
Authors:   Research Scholar, Department of Mathematics, B.N.M.I.T., Bengaluru and Visvesvaraya Technological University, Belagavi, Karnataka, India, M Manjula , Shenoy Leena N , Krishna Sowmya
Published: August 2024

Objectives: Laceability partition dimension of a connected graph is the minimum number of partitions of vertex set such that the subgraph induced by each partition is laceable in the case of a bipartite graph and random Hamiltonian laceable in case of non-bipartite graph . Methods: Mathematical Induction method and tracing Hamiltonian path. Findings: This study presents the laceability partition dimension (lpd) of some special graphs namely the Crown graph, Windmill graph, Dutch windmill graph, Cocktail party graph, shadow graph, and image graph. Novelty: This study discusses the laceability partition dimension of the graphs through which we discover a Hamiltonian path within a smaller structure whenever Hamiltonian laceability doesn't exist in large networks which has significance in communication networking that strives for optimal message routing efficiency. Keywords: Hamiltonian path, Bipartite graph, Laceability, Perfect matching, Shadow distance graph
Unveiling Key Gene Biomarkers and Clinical Factors in Breast Cancer Subtypes Using Machine Learning and Cox Regression
Authors:   Research Scholar, Department of Statistics, Assam University, Silchar, Assam, India, Pradhani Gitanjali , Gogoi Jonali
Published: August 2024

Objective: Breast cancer is the most frequent malignancy among women, and understanding its genetic subtypes is crucial for improving patient outcomes. Using clinical and gene expression data, this study attempts to uncover important gene biomarkers and clinical factors for various subtypes of breast cancer. Methods: Ten machine learning techniques were initially employed to classify breast cancer subtypes, with the most accurate method serving as the base classifier. Eight feature selection techniques were then used to pinpoint important genes, which were combined with clinical characteristics and subjected to Cox regression analysis to determine their impact on overall survival. Optimal cut-points were identified for each significant gene to stratify data into high and low-expression groups, followed by Kaplan-Meier survival analysis. The selected genes underwent biological validation through Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, Gene Ontology (GO) enrichment analysis, and a protein-protein interaction (PPI) network. Findings: Age was found to be significantly associated with the hazard as well as survival of all breast cancer subtypes. The genes FOXP1, BRCA1, SETDB1, CHEK2, BRCA1, and MAP2K4 were most strongly associated with the survival time of Basal-Like, HER2, Claudin-Low, Luminal A, Luminal B, and Normal-Like subtypes, respectively. The PPI network identified CDKN2A as the hub protein with the highest node degree. KEGG pathway analysis revealed significant pathways, including the PI3K-Akt, FoxO and ErbB signalling pathways that are closely related to breast cancer. GO analysis identified numerous breast cancer-related biological processes, molecular functions, and cellular components. Novelty: This paper proposes a novel way to find important gene biomarkers and clinical factors by combining advanced feature selection methods with Cox regression. The results' robustness is further increased by applying KEGG Pathway and Gene Ontology analysis for biological validation. Keywords: Breast cancer, Gene expression, Feature Selection, Machine Learning, Survival Analysis
Soham Transform in Fractional Differential Equations
Authors:   L.V.H., Arts, Science and Commerce College, Nashik, 422009, Maharashtra, India, Khakale Savita Santu , Ahire Kailas Sahadu , Patil Dinkar Pitambar
Published: August 2024

Objectives: Soham transforms is one of the appropriate tools for solving fractional differential equations that are flexible enough to adapt to different purposes. Methods: Integral transform methods help to simplify fractional differential equations into algebraic equations. Enable the use of classical methods to solve fractional differential equations. Findings: In this paper, the Soham transform can solve linear homogeneous and non-homogeneous Fractional Differential Equations with constant coefficients. Finally, we use this integral transform to obtain the analytical solution of non-homogeneous fractional differential equations. Novelty: The Soham transform method is a suitable and very effective tool for obtaining analytical solutions of fractional differential equations with constant coefficients. Soham Transform is more multipurpose as the Laplace transform is limited to fractional differential equations. Soham Transform is in the development stage. Keywords: Soham Transform, Fractional Differential Equations, Integral transforms, Reimann­ Liouville Fractional Integral, Caputo Fractional Derivative
Examination of Cloud Simulation Platforms and Implementation of Load Balancing in CloudAnalyst
Authors:   Assitant Professor, PG Department of Information Technology and BCA, Dwaraka Doss Goverdhan Doss Vaishnav College, University of Madras,, Chennai, Tamilnadu, India, Shanmugapriya S , Priya N
Published: August 2024

Objectives: In light of the growing number of open-source simulation tools for load balancing in cloud computing, the objective of this research is to assess some of the most significant tools before selecting the best one depending on the requirements and goals of the research and also implementing the load balancing approach in the CloudAnalyst tool for dynamic workload (HTTP request) allocation and virtual machine selection in the Infrastructure as a Service (IaaS) heterogeneous cloud environment, with the aim of minimizing the searching time, improving the response time and datacenter processing time and also adds a new performance metrics such as makespan. Methods: We conducted a comparative examination of a few cloud simulators using a variety of criteria, including their core components, working models, scalability, performance metrics, simulation technique, and structural design, it incorporated and experimented with the load balancing approach with significant performance metrics such as searching time, response time, datacenter processing time and makespan in CloudAnalyst simulation tool. Findings: This research finding shows that, after reviewing, examining, and comparing some of the significant cloud simulation tools and their features in the Infrastructure as a Service cloud computing environment, the CloudAnalyst tool was best suited for implementing and experimenting with the load balancing strategies in a cloud environment with respect to significant performance metrics such as response time, datacenter processing time, cost, searching time and, throughput. Moreover, it evaluates the performance of the load balancing approach by implementing it in the CloudAnalyst tool and proves that there is an improvement in average response time of 270.91milliseconds, Datacenter processing time by 212.74 milliseconds and there is a reduction in searching time of 127.21 milliseconds and makespan value of 192.89 compared to existing approaches in a heterogeneous IaaS cloud environment. Novelty: The novelty of this research provides recommendations for researchers that the CloudAnalyst simulation tool is the ideal tool for the implementation of the load balancing approach and also incorporates the new metrics termed makespan in a dynamic IaaS cloud environment. Keywords: Cloud Computing, Load Balancing, Simulation Platforms, Virtual Machine, Infrastructure as a Service, Datacenter
A Stratification of Integer Solutions to the Triple Equations 𝑥 + 𝑦 = 𝑧𝟐, 𝟐𝑥 + 𝑦 = 𝟐𝑧𝟐 + 𝑤𝟐, 𝑥 + 𝟐𝑦 = 𝟏𝟎𝑝𝟑
Authors:   Assistant Professor, Department of Mathematics, School of Engineering and Technology, Dhanalakshmi Srinivasan University, Samayapuram, Trichy, 621 112, Tamil Nadu, India, Thiruniraiselvi N , Gopalan M A
Published: August 2024

Objectives: The purpose of this research article is to find non-zero distinct integer solutions to the system of triple equations with five unknowns represented by . Different sets of distinct integer solutions are presented. Methods: Various substitution strategies and factorization techniques are employed for finding non-zero distinct integer solutions. Findings: Four different choices of substitutions are utilized to determine many non-zero distinct integer solutions to the given system of triple equations with five unknowns. Novelty: In this analysis, the given system of triple equations with five unknowns is reduced to a single non-homogeneous cubic equation for which solutions can be found elegantly. Keywords: System of triple equations, Triple equations with five unknowns, Non-homogeneous cubic Equation, Ternary cubic equation, Integer solutions
Optimizing infection trajectories: Innovation in Controllability of Nonlinear SIR Model
Authors:   Hassan II University of Casablanca, Zakary Omar , Bidah Sara ,   Hassan II University of Casablanca, Rachik Mostafa ,   Hassan II University of Casablanca
Published: August 2024

Managing infections within populations poses significant challenges, particularly in achieving controllability over nonlinear models within epidemiological systems. In this study, the challenge is addressed by introducing a novel control function tailored to enhance the management of infections. The approach revolves around leveraging a nonlinear SIR epidemiological model, enabling the derivation of explicit solutions and fine-tuning of control parameters to align with predefined objectives. Specifically, the focus lies on guiding the number of infected individuals towards a predetermined threshold at a specified time for all initial values. Through rigorous numerical simulations, the effectiveness of the proposed control strategy in achieving greater controllability and regulating the spread of infection over time is depicted, For example, our simulations show that starting with an initial infected population of 150 individuals in a population of 25,150, the control strategy can reduce the number of infected individuals to below 40 within 30 days. The quantitative results presented underscore the efficacy of the approach, highlighting its potential to significantly impact disease management strategies.
Refractive index adjusted imaging medium: Iohexol (RI ~ 1.4) - Yeast v1
Authors: Hammer Mathias , Rossouw Ammeret
Published: August 2024

This protocol describes the steps to prepare imaging medium for Saccharomyces cerevisiae with adjusted refractive index. This medium is optimized for fluorescence imaging by the reduction of auto-fluorescence through an abundance of Adenine [1] and the repression of of the Met-promoted pp7- CP expression [2].
Refractive index adjusted imaging medium: Iodixanol (RI ~ 1.41 and 1.42) - Yeast v1
Authors: Hammer Mathias , Rossouw Ammeret , Lari Azra , Montpetit Ben , Grunwald David
Published: August 2024

This protocol describes the steps to prepare imaging medium for Saccharomyces cerevisiae with adjusted refractive index. This medium is optimized for fluorescence imaging by the reduction of auto-fluorescence through an abundance of Adenine [1] and the repression of of the Met-promoted pp7- CP expression [2].
Refractive index adjusted imaging medium: Iodixanol (RI ~ 1.4) - Yeast v1
Authors: Hammer Mathias , Rossouw Ammeret , Lari Azra , Montpetit Ben , Grunwald David
Published: August 2024

This protocol describes the steps to prepare imaging medium for Saccharomyces cerevisiae with adjusted refractive index. This medium is optimized for fluorescence imaging by the reduction of auto-fluorescence through an abundance of Adenine [1] and the repression of of the Met-promoted pp7- CP expression [2].
PADA MATERI LISTRIK DINAMIS UNTUK MEMFASILITASI KOMPETENSI LITERASI SAINTIFIK
Authors: Dahniar Diana , Santoso Aman , Setyawati Endang
Published: August 2024

Perkembangan abad ke-21 berdampak signifikan pada pendidikan, khususnya dalam meningkatkan literasi saintifik, yang masih menjadi tantangan bagi siswa di Indonesia, dengan peringkat ke-71 dari 78 negara menurut PISA 2018. Untuk mengatasi ini, pendekatan Socio Scientific Issues (SSI) dan model Process Oriented Guided Inquiry Learning (POGIL) direkomendasikan, karena metode konvensional seperti ceramah masih dominan. Penelitian ini bertujuan mendeskripsikan pengembangan, kelayakan, dan kepraktisan produk dengan model POGIL berbasis SSI menggunakan model ADDIE dan metode Research and Development (RnD). Data dikumpulkan melalui wawancara dengan guru, angket siswa, dan uji kelayakan oleh dosen ahli dan satu guru IPA. Hasil uji kelayakan menunjukkan persentase sangat layak: materi 91%, kebenaran konsep 93,3%, E-Modul 96,1%, Edukit 94,1%, dan soal 81,7%. Uji validitas dan reliabilitas soal menunjukkan 22 pertanyaan valid dengan koefisien reliabilitas 0,869. Kepraktisan guru dan siswa masing-masing mencapai 96,1% dan 84,6%. Produk yang dikembangkan, berupa E-Modul listrik dinamis melalui aplikasi Heyzine dan media Edukit untuk praktikum, menunjukkan bahwa model POGIL berbasis SSI dan bahan ajar sangat layak dan praktis untuk meningkatkan literasi saintifik pada materi listrik dinamis.
ANALISIS KOLABORASI ANTAR MATA PELAJARAN DALAM MODEL SISTEM BLOK SEBAGAI IMPLEMENTASI KURIKULUM MERDEKA DI SMKN 10 MALANG
Authors: Elifianita Susanti Nur , Iva Swastika Aprilia , Musthofa Abid , Irawan Fendi , Wahyu Puji Utami Indah
Published: August 2024

Penelitian ini bertujuan untuk menganalisis kolaborasi antar mata pelajaran pada Sistem Blok sebagai bagian dari Implementasi Kurikulum Merdeka (IKM) di SMKN 10 Malang. Model sistem blok diadopsi untuk meningkatkan keterpaduan antar mata pelajaran dan memperkuat relevansi pembelajaran dengan dunia nyata. Penelitian ini menggunakan pendekatan kualitatif dengan teknik pengumpulan data melalui observasi, wawancara, dan analisis dokumen. Hasil analisis menunjukkan bahwa kolaborasi antar mata pelajaran dalam model sistem blok berhasil meningkatkan pemahaman peserta didik terhadap hubungan antar mata pelajaran serta relevansi pembelajaran dengan dunia industri. Temuan ini mengindikasikan bahwa implementasi model sistem blok dapat menjadi alternatif yang efektif dalam menerapkan Kurikulum Merdeka di sekolah menengah kejuruan.
CYTOMEGALOVIRUS AND HUMAN IMMUNODEFICIENCY VIRUS IN SEMEN TESTED DURING THE COVID19 EMERGENCY ERA
Authors: Hauser Alexander , Antonellis Matthew , Oun Typhonie , Kiessling Ryan , Hartley Mark , Sullivan Matthew , Kiessling Ann
Published: August 2024

Men seeking surrogacy in the United States must undergo Food and Drug Administration (FDA)-mandated infectious disease screening within seven days of the sperm collected for fertility treatments. Travel bans imposed during the COVID19 pandemic (April 1, 2020 to March 7, 2022) did not deter 156 men from 12 countries from pursuing fatherhood by traveling to facilities to cryopreserve and screen semen specimens for virus, along with paired FDA serology and urine tests. Heterosexual couples not needing FDA serology testing collected specimens remotely and shipped them overnight for cryopreservation and testing. A total of 464 semen specimens were evaluated for viable sperm, 453 of which were RT-PCR tested for HIV and cytomegalovirus (CMV). More specimens tested positive for CMV (136, 30%) than for HIV (52, 11%). Fifty two men (33%) had at least one CMV-positive specimen, 38 men (24%) had at least one HIV-positive specimen, and 16 men (11%) had at least one specimen test positive for both HIV and CMV. Results were similar for the 32 international clients as for domestic clients and for gay clients as for heterosexual clients. No correlations between virus-positivity and CD4+ blood cell counts, leukocytospermia, anti-HIV medications, nor age were noted. During the same time frame, 43 babies were born to gestational carriers and wives, 82 gestational carriers and wives underwent embryo transfer without consequent infection, and 32 pregnancies from nine fertility clinics were reported. Virus shedding into semen is in urgent need of better understanding to avoid the risks associated with new infections early in pregnancy.
Breastfeeding: Benefits, challenges and the solutions
Authors: Sumangala BR , Kudari Ananda
Published: August 2024

Breast milk is widely accepted as the benchmark for nourishing new-born babies. Breast milk is a continually fluctuating fluid that signifies the principal source of nutrition for new-borns. Breast milk contains all the necessary nutrients for new-born babies. There are numerous benefits to the baby and mother when mother breast feed her baby. Time to time feeding breast to the baby reduces the babies’ risk of infectious disease like respiratory tract infections, middle ear infection, Gastro intestinal infections and more. It helps in growth and development of body organ, aids in intellectual ability of the baby, enhance normal bacterial flora. It may be advantages to the mother also such as reduction of uterine and ovarian cancer, bleeding uterus, loosing body weight, emotional stability and bonding. Breast feeding also act like natural contraceptive which will postpone the subsequent pregnancies. There are many challenges faced by the mothers while feeding breast to the baby. Cracked nipple, breast engorgement, lack of milk production, over flow of milk, retracted nipple, sore nipple, sleeping deprivation, day time sleeping and many more. Because of this issues the mother may not feed the baby perfectly which may lead to under development and mal nourishment of the baby health. Nursing mother must have the knowledge about the issues of breast feeding and their solutions.
Historias conectadas mediante GECEM Project Database: circulación de bienes globales e integración de mercados en el sur de China, América y Europa, 1680-1796
Authors: Pérez García Manuel
Published: August 2024

Este artículo presenta un nuevo caso de estudio que conecta el eje comercial Cantón-Macao-Manila con el eje Marsella-Sevilla-Cádiz, cuyo objetivo es renovar las líneas de investigación de historia global y revisar el debate de la gran divergencia a escala microanalítica enfatizando el rol de regiones de la América colonial, China y Europa. El análisis de redes de comercio y circulación de productos globales nos permite identificar cambios en el consumo, regulación de mercados, e intensificación de vínculos económicos en regiones del Pacífico, Atlántico y Mediterráneo. Para implementar metodológicamente este caso de estudio se ha diseñado la GECEM Project Database, cruzando fuentes chinas y occidentales, lo que posibilita establecer tipologías de bienes globales, circulación de plata y conexiones en estos mercados. La introducción de plata americana en regiones de China muestra la formación de nuevas elites locales y comercio no reglado que el estado Qing era incapaz de controlar.
Local Treatment of Ischemic Skin Wounds Using a Unique Drug Mixture in Combination with Magnetic Therapy
Authors: Terekhov Alexey Gennadievich , Pankrusheva Tatyana Alexandrovna , Chekmareva Marina Semyonovna , Mishina Ekaterina Sergeevna , Grigoryan Arsen Yurievich , Klueva Elena Gennadievna , Zaitseva Lyudmila  Yuryevna
Published: August 2024

The main cause of ischemic wounds is peripheral arterial disease (PAD). The overall prevalence of PAD varies within 3-10%, increasing to 15-20% among patients over 70 years of age. The PAD prevalence is slightly higher in men than in women. This problem is crucial for healthcare, since such wounds can lead to the need to amputate the lower extremities in case of ulcerative-necrotic processes and gangrene, being one of the common causes of increased disability and mortality in the population.The aim of the study was to investigate features of the wound process when healing ischemic skin wounds with local application of a unique mixture of benzalkonium chloride, dexpanthenol and pentoxifylline in combination with magnetotherapy.Materials and methods. Ischemic skin wounds were simulated on the hind limbs of 90 male Wistar rats (RU Patent for Invention No. 2807383). The animals were divided into three groups based on the features of the treatment performed. In animals of the 1st group, a unique mixture of benzalkonium chloride, dexpanthenol and pentoxifylline was applied to the skin defect; in animals of the 2nd group, magnetotherapy was used; in animals of the 3rd group, the unique medicinal mixture and magnetotherapy were used simultaneously. The analysis of the results included an assessment of the wound area, microcirculation, pH of the wound surface and the local temperature. The results were recorded on the 1st, 3rd, 5th, 8th and 10th days of the study. Microsoft Excel 2014 and Statistica 13.0 programs with the Kruskal-Wallis test were used to process data statistically. Significant differences were considered at p0.05.Results. A combination of benzalkonium chloride, dexpanthenol and pentoxifylline with the simultaneous use of magnetic therapy is effective in the treatment of ischemic wounds. The third group showed the greatest effectiveness, where the area of wounds significantly decreased on the 10th day by 1.9 times compared to group 1 and 9.4 times compared to group 2, respectively. The healing rate was also significantly higher in group 3 compared to group 1 (1.3 times) and group 2 (1.7 times), respectively. The third group also showed the best result during the assessment of microhemocirculation and a shift in pH to the slightly acidic side already on the 3rd day; only on the 8th day there were significant differences of 1.1 times between the 1st and 3rd groups.Conclusions. The use of the specifically developed unique medicinal combination of drugs applied together with magnetic therapy has confirmed its effectiveness if compared with the control treatment groups. This treatment option has a beneficial effect on the healing process of ischemic skin wounds and allows recommending it for further preclinical studies.
Modern Approaches to the Classification of Adhesions and Adhesive Disease of the Abdominal Cavity
Authors: Andreev Alexander Alekseevich , Gluhov Alexander Anatolievich , Chernyh Alexander Vasilyevich , Sundeev Artem  Sergeevich , Laptiyova Anastasia Yurievna , Ostroushko Anton Petrovich
Published: August 2024

Classifications of abdominal adhesive disease developed to date are not universal, which is associated with polyetiology, the versatility of local and systemic manifestations of the disease, high requirements for prognostic value and objectification of the pathological process. Classifications with a large number of variables do not often become popular due to their complicatedness, and too simple assessment systems cannot reflect all the features of the disease. This paper presents an attempt to distribute all known classifications by specific features, with their subsequent analysis, and proposes the authors’ version to classify adhesions and adhesive disease of the abdominal cavity. The presence of a unified system to assess the adhesive process, working both in experimental and clinical conditions, will allow achieving reproducible, standardized results required to implement principles of evidence-based medicine.
Specific Complications after Pancreatoduodenal Resection Depending on the Pancreatic Transection Plane and the Dorsal Pancreatic Artery Origin
Authors: Dvukhzhilov Mikhail Vyacheslavovich , Markov Pavel Viktorovich , Gorin David Semenovich , Shirokov Vadim Sergeevich , Kriger Andrej Germanovich , Struchkov Vladimir Yurievich
Published: August 2024

Pancreaticoduodenectomy (the Whipple procedure) is one of the most complex surgical interventions in abdominal surgery and is associated with a high risk of severe postoperative complications. Studying all aspects of the operation can reduce the incidence of adverse outcomes. One of the ways to reduce the incidence of postoperative complications after pancreaticoduodenectomy is to shift the pancreatic transection line to the left in order to remove the poorly blood-supplied zone between the cephalocervical and corporocaudal segments.The aim of the study was to evaluate the effect of different pancreatic transection planes on the incidence of pancreatic fistula in various anatomical origins of the dorsal pancreatic artery.Material and Methods. The study included 103 patients with the determined origin of the dorsal pancreatic artery. All patients were divided into two groups: with a standard origin of the dorsal pancreatic artery (69 patients) and with a variant origin of the dorsal pancreatic artery (34 patients). In each group, two subgroups were identified depending on the transection plane of the pancreas (at the midpoint of the portal vein and 10-15 mm to the left of its left edge). The short-tern treatment outcomes in subgroups were compared based on the arterial anatomy and transection plane.Results. In cases of a standard origin of the dorsal pancreatic artery, relocation of the transection plane to the left led to a statistically significant reduction in the frequency of specific complications (p=0.04), clinically significant pancreatic fistula (p=0.037), and gastrostasis type B (ISGPS) (p=0.038). In cases of a variant origin of the dorsal pancreatic artery, no statistically significant difference in subgroups with different transection planes was found.Conclusion. In case of a standard origin of the dorsal pancreatic artery, it is advisable to shift the transection line to the left. The algorithm for transecting the pancreas in other variants of the dorsal pancreatic artery origin requires further study.
Evaluation and Analysis of Outcomes Resulting from Internal Jugular Vein Catheterization Using In-Plane and Out-of-Plane Ultrasound-Guided Techniques in Oncology Patients at Shariati Hospital
Authors: Mohammadi Afrakoti Nima , Rokni Mobin Bararpour , Hajimola Rabei Samaneh , Shoeibi Gita , Talebi Kahdouei Mohammadsadegh , Aghaei Fatemeh , Khajehnasiri Alireza
Published: August 2024

Background: Central venous catheters (CVCs) are primarily used in oncology to protect peripheral veins and provide effective access to chemotherapy. The authors investigated the results of in-plane ultrasound-guided imaging compared to out-of-plane imaging in patients with oncology-related CVC placement in the oncology department of Shariati Hospital in Tehran.
Methods: This cross-sectional analytical study was conducted on 50 eligible oncology patients over 6 months in 1400 at Shariati Hospital in Tehran. The patients were randomly divided into two groups: in-plane and out-of-plane, and the internal jugular venous catheter was inserted by using one of the methods above by an anesthesiologist. The necessary variables for statistical analysis were collected using predetermined questionnaires.
Results: The mean age of the patients was 73.42 years, with 25 female participants. The catheter insertion was successfully performed in all patients. The mean duration of catheter insertion in the study population was 2.289 seconds, the mean number of skin punctures was 1.7, and catheter placement was successful in 62% of patients on the first attempt. A total of 23 complications occurred, with carotid artery puncture being the most common. The catheterization method, whether in-plane or out-of-plane, did not affect the initial success of catheter insertion.
Conclusions: According to the findings of this study, internal jugular vein catheterization was successfully performed using both in-plane and out-of-plane methods with similar results.
Partial Upper Lip Reconstruction Using Fujimori Flap: A Case Report
Authors: Berjaou Zakia , Cherboub Samir , Moustakbal Ilyass , Hafidi Jawad , Gharib Noureddine , Abbassi Abdallah , Mazzouz Samir
Published: August 2024

The Fujimori gate flap is known and used for the reconstruction of defects resulting from oncologic surgery. This case report describes the use of this flap to reconstruct the upper lip of a patient who had a defect following lip carcinoma, resulting in a loss of 2/3 of the upper lip tissue. The case involves a 34-year-old woman presenting a partial lip defect after upper lip carcinoma. She underwent a unilateral gate flap procedure, which allowed the authors to reconstruct the three levels of skin, muscle, and mucosa. Following surgery, no complications were observed. The patient was followed up at three months and a year later. She was able to speak and chew without any trouble after the flap restored oral competency. The patient’s treatment objectives, which included regaining oral competency and achieving an acceptable aesthetic result, were met thanks to the use of the Fujimori gate flap in this case. Compared to the use of other local, regional, or remote flaps, the flap also provides good color matching. The Fujimori flap ensures the restoration of the oral sphincter, in contrast to the typical flaps used to reconstruct the upper and lower lip, thereby promoting oral competence.
Impact of cigarette smoking on the outcomes of ST-elevation myocardial infarction after primary percutaneous coronary intervention in metropolitan Tehran
Authors: Geraiely Babak , Salarifar Mojtaba , Hadizadeh Aida , Shahmohamadi Elnaz , Jalali Arash , Moghaddasfar Tara , Larti Farnoosh
Published: August 2024

Objective: Although the adverse effects of smoking are well-established, evidence shows a longer survival rate following an acute myocardial infarction (MI) among smokers or the so-called “smoker's paradox”. This study aimed to determine the impact of smoking on the one-year clinical outcomes of ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI) in a large registry of the Iranian population.
Methods: A total of 3087 patients diagnosed with acute STEMI who underwent PPCI between 2013 and 2018 were enrolled in the study. Patients' smoking status was determined based on self-reported history and categorized into two groups: current smokers and non-smokers. Clinical and angiographic data were collected from the Tehran Heart Center (THC) registry. The primary outcome was one-year of major adverse cardiac and cerebrovascular events (MACCE). The effect of smoking on MACCE was evaluated using a Cox model.
Results: From the study population, 1967 (63.7%) were non-smokers, and 1120 (36.3%) were current smokers. Non-smokers had higher rates of prior CABG (5.3%) as well as a higher history of co-morbidities, including a history of diabetes mellitus (46.0%), hypertension (52.7%) and hyperlipidemia (55.4%) than smokers (2.3%, 30.4%, 35.7%, and 49.8% respectively). Smokers had a higher reference vessel diameter than non-smokers (P=0.005). The unadjusted hazard ratios (HRs) for MACCE within one year were significantly lower in smokers than non-smokers (0.73, 95% CI: [0.58,0.92]; P=0.009); however, after adjustment for confounders, the HRs for MACCE in smokers were similar to non-smokers (HR: 1.00,  95% CI: [0.73,1.38]).
Conclusion: The study found that smoking had no significant impact on the one-year clinical outcomes of STEMI patients after PPCI in the Iranian population. This study is the first of its kind to assess the effect of smoking on STEMI patients in Iran and highlights the need for further research in this area.
Simulation training improves resident physicians’ confidence in managing first trimester bleeding in the emergency department
Authors: Leis Maria , Kelly Brendan , Vairavanathan Rajani
Published: August 2024

First trimester bleeding is commonly encountered in pregnancy and can be potentially life-threatening. Simulation training provides an ideal opportunity for resident medical learners to improve clinical knowledge and gain confidence in managing life-threatening causes of first trimester bleeding in a realistic but safe clinical environment. The objective of this study was to assess the effectiveness of simulation in improving family medicine residents’ confidence and knowledge in identifying and managing first trimester bleeding in the emergency department (ED). The intervention was a two-hour educational simulation focusing on management of unstable first trimester bleeding. Twenty-one family medicine residents (67% female) at the University of Toronto participated in the simulation and completed pre- and post-simulation questionnaires assessing their confidence and knowledge in management of first trimester bleeding. This study demonstrates that simulation training improves resident physicians’ confidence in managing first trimester bleeding in the ED. Additionally, it improves their objective history taking skills. Post-graduate medical programs should consider developing structured simulation, particularly for high-yield clinical cases residents may not otherwise have acute exposure to and are required to be competent in managing.
Difficult intubation in critical patient: how can we manage it? a case report
Authors: Ottoveggio Gaetano , Verro Barbara , Nicosia Dario , Saraniti Carmelo
Published: August 2024

Difficult airway management represents a challenge. Guidelines recommend choosing the airway technique based on physicians’ skills, equipment, available devices and context.
A man with acute respiratory failure needed an emergent intubation. He was obese with Mallampati score 4, Cormack-Lehane grading 4, macroglossia, reduced mouth opening, stocky and wide neck, and deviated laryngo-tracheal axis due to expanding neck hematoma. After endotracheal intubation failure, the anesthetist placed a second-generation laryngeal mask airway and started ventilation. In the next step, definite airway was provided by an endotracheal tube placed through the mask under flexible fiberscope vision.
Supraglottic airway devices are recommended in cases of unanticipated difficult intubation after endotracheal intubation failure. They are used to ensure satisfactory oxygenation and occasionally to guide the endotracheal tube. Fiberscope is useful to ensure vision of larynx and trachea in these scenarios. This is a unique case of emergency and difficult airway management using this combined approach.
Evaluation of ABCB1 Gene Promoter Methylation in Patients with Ulcerative Colitis
Authors: Moghaddam Hossein Sanjari , Sanati Golshid , Sadr Maryam , Mohebbi Bahareh , Keshavarz-Fathi Mahsa , Salmanroghani Roham , Salmanroghani Hassan , Rezaei Nima
Published: August 2024

Background: The pathogenesis of inflammatory bowel disease may be associated with the disruption in interactions between the immune system and gut flora. Epigenetic mechanisms especially, DNA methylation appear to be significant regarding the interaction between the environment and genome. ABCB1 is the encoding gene for multi-drug resistance protein 1 (MDR1) (P-glycoprotein), which is an important transmembrane protein responsible for the efflux of cellular molecules from the intestinal wall to the lumen
Method: In this study, we compared the methylation status of the promoter of ABCB1 in rectal mucosa of patients with ulcerative colitis (UC) and healthy controls by using the bisulfite conversion system and realtime quantitative multiplex methylation-specific PCR (QM-MSP).
Results: We demonstrated that the mucosal specimen of 26 UC patients had significantly higher levels of promoter methylation in comparison to 26 controls.
Conclusion: As the first investigation of Iranian patients with UC, we showed that patients had higher levels of ABCB1 promoter methylation in their inflammatory rectal mucosa compared to controls. However, this altered state of methylation did not associate with the characteristics of the patients such as age and sex. Our findings are a basis for further studies on concurrent assessment of promoter methylation and expression of ABCB1 in UC.
Study the Relation of Serum Level of IL-33 with Severity of COPD Disease
Authors: Khazaie Hossein Ali , Molaie Nazar Ali , Forughi Forugh , Gowrkian Arewic , Dehghan Javid , Mahmodi Javad
Published: August 2024

Background: Cytokines are important in many pathobiological processes of chronic obstructive pulmonary disease (COPD). This study aimed to determine the relationship between serum levels of interleukin-33 (IL-33) and the severity of COPD disease.
Method:  In this cross-sectional research, the study population consisted of all COPD patients referring to the pulmonary clinic of Imam-Ali Hospital of Zahedan city in 2014. Sixty patients were selected using the available sampling method. Serum IL-33 levels were measured by the quantitative ELISA method.
Results: Of 60 patients, 23 (38.3%) and 37 (61.7%) subjects were male and female, respectively. Analysis shows a significant difference between serum IL-33 of the two groups with regard to the severity of COPD disease. There was a statistically significant negative relationship between the serum level of IL-33 and the severity (decrease of forced expiratory volume in one second (FEV1)) of COPD disease.
Conclusion: : Our results indicate a systemic release of IL-33 correlated with the severity of COPD.
Prevalence and Impact of Thyroid Disorders on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study
Authors: Salimian Mohammad Reza , Injinari Nastaran , Azizi Reyhaneh , Nikkhah Haniyeh , Namiranian Nasim
Published: August 2024

Objective: Diabetes and thyroid disorders (TD) are two prevalent endocrine conditions in adults. While the association between TD and type 1 diabetes is well documented, the relationship between type 2 diabetes mellitus (T2DM) and TD remains unclear due to its complex mechanisms and the involvement of multiple variables. This study aimed to evaluate the prevalence of TD in patients with T2DM referred to Yazd Diabetes Research Center in 2019.
Materials and Methods: This cross-sectional descriptive study included 411 patients with T2DM. Data were collected using a checklist comprising demographic information (age, sex, type of drug used, duration of diabetes) and clinical and laboratory information. Data were analyzed using SPSS version 24 software.
Results: Among the 411 patients with T2DM, 352 (85.6%) had no TD, 38 (9.24%) had hypothyroidism, and 21 (5.10%) had hyperthyroidism. There were no significant differences among groups in terms of gender (P= 0.269), age (P= 0.154), fasting blood sugar (FBS) level (P= 0.196), type of treatment (P= 0.9), and duration of T2DM (P= 0.138). However, a significant relationship was found between TD and the average level of glycosylated hemoglobin (HbA1c) (P= 0.021).
Conclusion: This study highlights a significant prevalence of TD among patients with T2DM, particularly noting the impact on HbA1c levels. Regular screening for TD in patients with T2DM is recommended to improve glycemic control and overall diabetes management. Further research is needed to elucidate the mechanisms linking TD and T2DM and to develop targeted interventions.