bluuebunny/crossref_metadata_2025 huggingface dataset:
Posterior Calot’s triangle approach would be a better choice for chronic atrophic cholecystitis: a retrospective controlled study
Authors: Zhong Hua , Li Shaoyin , Wu Xiaojian , Luo Fang
Published: April 2023

ObjectiveCompare the clinical efficacy of anterior and posterior Calot’s triangle approach in laparoscopic cholecystectomy (LC) for chronic atrophic cholecystitis, to find out which approach is much safer and more reliable.MethodsFrom June 2020 to June 2022, 102 patients with chronic atrophic cholecystitis underwent LC in our hospital. They were divided into anterior Calot’s triangle approach group and posterior Calot’s triangle approach group. And their clinical data, intraoperative conditions, surgical results, and postoperative recovery were analyzed.ResultsLC was performed in 41 females and 28 males by the anterior Calot’s triangle approach, and in 20 females and 13 males by the posterior Calot’s triangle approach. There were no differences in age, gender, and BMI between the two groups (p > 0.05). The probability of rupture of cystic artery between both groups was not significantly different (p = 0.549), and the intraoperative blood loss was more in the anterior group (p = 0.014). The operative time of the posterior approach appeared to be shorter (p = 0.013). Bile duct injury and conversion to open cholecystectomy revealed no significant difference (p > 0.05). The recovery time of gastrointestinal function, wound infection, white blood cell count, liver function and postoperative hospital stay were found to be not significantly different (p > 0.05).ConclusionBy the posterior Calot’s triangle approach, LC is a convenient and feasible surgical procedure for chronic atrophic cholecystitis with less blood loss and can become easier to perform without increasing the risk of surgery.
Evaluation of serum nickel levels in some Syrian industrial workers with prostate cancer
Authors: Brrow Feras , Barguil Sophie
Published: April 2023

Prostate cancer is one of the most common cancers among workers of various industries that depend on nickel extensively, through different mechanisms. Our present study is designed to estimate nickel concentrations in serum samples from patients with prostate cancer compared to the control group of healthy subjects. The study was carried out on 43 patients with prostate cancer at Al-Biruni University Hospital for Cancerous Diseases in Syria compared with 35 healthy controls. All measurements of serum were done with a graphite atomic absorption spectrophotometer equipped with a deuterium lamp. Our results showed that patients with prostate cancer had significantly higher serum levels of Ni than healthy controls (p < 0.0001). These findings suggest that increased nickel serum levels are associated with an increased risk of prostate cancer in industrial workers through one of the carcinogenic mechanisms.
Phosphate Distribution at the Ferric (hydr)oxide-Water Interface: Individual and Simultaneous Effects of Bicarbonate and Calcium Ions
Authors: Sorid Md Aktaruzzaman , Islam Rashedul , Azad Md Takibul , Ganguli Sumon , Chakraborty Ashok Kumar , Kabir Mahbub , Sabur Md Abdus
Published: April 2023

Concentrations of bicarbonate (HCO3-) are typically high in natural waters and can enhance internal phosphate (PO4) loading from sediment to the overlying water. However, chemical constituents at the sediment-water interface controlling bicarbonate-induced PO4 mobility are poorly understood. This study evaluates the individual and simultaneous effects of HCO3- and calcium (Ca2+) ions on the mobility of PO4 at the ferric (hydr)oxides-water interface by conducting PO4 adsorption pH envelope and desorption experiments. Results from the individual PO4 adsorption pH envelope experiments show that HCO3- competes with PO4 for the surface binding sites and decreases PO4 adsorption to ferric (hydr)oxides. In contrast, Ca2+ exerts the opposite effect to HCO3- and enhances PO4 adsorption and these effects of HCO3- and Ca2+ are highly pH dependent and intensified under alkaline conditions. For instance, PO4 adsorption decreased by 30% and increased by 32% at pH 8 in the presence of 0.25 mM HCO3- and Ca2+, respectively, compared to the adsorption in 10 mM NaCl, which are 39 and 67% at pH 9. The PO4 desorption pH envelope experiments display a similar pattern as of adsorption pH envelope. However, the amount of adsorbed-PO4 desorbed at a given pH is lower than the amount expected from adsorption studies. This partial release of adsorbed-PO4 implies the immobilization of PO4 at the solid surface, potentially via the formation of stronger surface complexes. Therefore, the high concentrations of HCO3- may increase PO4 mobility in the aqueous phase by restricting the re-adsorption of sediment released-PO4 rather than by PO4 description from sediment mineral surfaces. However, this competitive effect of HCO3- may be minor in the system buffered by calcite dissolution.
High-sensitive and Background-free Coherent Anti-Stokes Raman Scattering Microscopy Using Delay Modulation
Authors: wang pu , Wu Fan , Li Shangyu , Chen Xun , Yue Shuhua , Hong Weili
Published: April 2023

Coherent anti-Stokes Raman scattering (CARS) microscopy has been demonstrated to be a powerful platform for label-free, non-invasive, and chemically specific imaging of biological samples. Yet, the non-resonant background hinders its sensitive detection of weak Raman bands. Here, we demonstrate an approach to remove the non-resonant background in CARS based on delay modulation (DM), enabled by an acousto-optic modulator and spectral focusing. We show that the DM-CARS reduces the background by 10 times and achieves a detection sensitivity of 3ⅹ105 molecules at a time constant of 7 μs, a 100 fold improvement over normal CARS. We demonstrated the potential clinical applications of DM-CARS in tracking heavy water metabolism in bacteria for antimicrobial susceptibility testing, which is challenging using normal CARS, and a fiber-delivered handheld DM-CARS device for liver tumor tissue imaging.
Lung Aeration Estimated by Chest Electrical Impedance Tomography and Lung Ultrasound during Extubation
Authors: Joussellin Vincent , Bonny Vincent , Spadaro Savino , Clerc Sébastien , Parfait Mélodie , Ferioli Martina , Sieye Antonin , Jalil Yorschua , Janiak Vincent , Pinna Andrea , Dres Martin
Published: April 2023

Background: This study hypothesized that patients with extubation failure exhibit a loss of lung aeration and heterogeneity in air distribution, which could be monitored by chest EIT and lung ultrasound.
Methods:Patients at risk of extubation failure were included after a successful spontaneous breathing trial. Lung ultrasound (with calculation of lung ultrasound score (LUS)) and chest EIT (with calculation of the Global inhomogeneity index, front-back Center of ventilation (CoV), Regional ventilation delay (RVD) and Surface available for ventilation) were performed before extubation during pressure support ventilation (H0) and two hours after extubation during spontaneous breathing (H2). EIT was then repeated six hours (H6) after extubation. EIT derived indices and LUS were compared between patients successfully extubated and patients with extubation failure.
Results: 40 patients were included, of whom 12 (30%) failed extubation. Before extubation, as compared to patients with successful extubation, patients who failed extubation had a higher LUS (19 vs 10, p=0.003) and a smaller Surface available for ventilation (352 vs 406 pixels, p=0.042). After extubation, GI index and LUS were higher in the extubation failure group, whereas Surface available for ventilation was lower. The RVD and the CoV were not different between groups.
Conclusion: Before extubation, a loss of lung aeration was observed in patients who developed extubation failure afterwards. After extubation, this loss of lung aeration persisted and was associated with regional lung ventilation heterogeneity.
Trial registration: Clinical trials, NCT04180410, Registered 27 November 2019 – prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04180410.
Antibiotic and heavy metal resistant endophytes inhabit Armeria maritima hyperaccumulator
Authors: Goryluk-Salmonowicz Agata Diana , Myczka Anna , Popowska Magdalena
Published: April 2023

Background and AimsThe occurrence of heavy metal-resistant bacteria in plants and their role in phytoremediation intensification has been quite well recognized in the last few years. Nevertheless, there is a dearth of information on antibiotic resistance profile of those bacteria. In this study, for the first time endophytic bacteria has been isolated from green parts ofArmeria maritimasp. halleri plant growing on mine-tailing soil in the southern Poland. The resistance profile of bacteria was researched.MethodsBacteria were isolated from internal tissues ofArmeria maritimaplant and characterized: MIC was determined by the plate dilution method using (CH3COO)2Pb and ZnSO4supplemented medium; antibiotic susceptibility test was determined by disk diffusion method according to the EUCAST version 11.0; the whole genome sequencing was performed on MiSeq platform (Illumina). Physicochemical properties of soil were evaluated according to European Standards.ResultsFivePseudomonassp. strains exhibiting high tolerance to heavy metals were resistant to antibiotics, such as aminoglycosides, ß-lactam antibiotics, fosfomycines fluorochinolones, macrolides and glycopeptides. Draft genome sequences analysis estimated genome sizes in a range from 6,182,403bp to 7,401,235bp and a G + C content from 60.0–61.0%. 12 and 11 genes conferring resistance heavy metals and antibiotics were identified, respectively.ConclusionArmeria maritimasubsp. halleri is inhabited by resistant to heavy metals and antibiotic endophytic bacteria identified asPseudomonasspecies. Under the One Health concept the contamination of soil and plants with ARB and ARGs should be monitored and limited and a regulatory framework for safety use of bacterial bioinoculants should be established.
Post-operative anterior diaphragmatic hernias in children with Trisomy 21 after cardiac surgery
Authors: Zugayar Diaa , Berkovits Reuven , Tenenbaum Ariel , Erez Eldad , Arbell Dan , Koplewitz Benjamin
Published: April 2023

Purpose: Morgagni hernias account for less than 5% of congenital diaphragmatic hernias. They are characteristically retrosternal and bilateral, with right-sided predominance. An association between Trisomy 21 and diaphragmatic hernias resembling Morgagni hernia has been reported, but the effect of cardiac surgery on its formation has not been investigated. The purpose of this study was to determine whether there is a higher incidence of anterior diaphragmatic hernias in children with Trisomy 21 after cardiac surgery.
Methods: We compared the prevalence of anterior diaphragmatic hernias in 92 patients with Trisomy 21 who underwent cardiac surgery with its prevalence in two control groups - children without Trisomy 21 who underwent cardiac surgery, and children with Trisomy 21 who did not undergo cardiac surgery, 100 patients in each. All available CXRs of all children underwent revision for the presence of an anterior diaphragmatic hernia by a pediatric radiologist.
Results: Within the study group, four cases of an anterior diaphragmatic hernia were detected, all upon presentation to the emergency room due to breathing difficulties. No cases of an anterior diaphragmatic hernia were found in the two control groups (P = 0.0094)
Conclusions: A high index of suspicion for an anterior diaphragmatic hernia should be maintained in children with Trisomy 21 who have undergone cardiac surgery and present with breathing difficulty. If CXR findings are uncertain, UGI series and\or CT should be performed. In light of our findings, the surgical technique has been modified in patients with DS in our medical center.
Pretreatment anemia and low skeletal muscle index as predictors of poor prognostic in cervical cancer patients
Authors: Resende Leandro Santos Araujo , Amorim Francine Vilela , Conceição Miguel Soares , Jales Rodrigo Menezes , Pereira Patrick Nunes , Sarian Luis Otávio , Baiocchi Glauco , Derchain Sophie , Filho Agnaldo Lopes Silva
Published: April 2023

Background Locally advanced cervical cancer (CC) is mostly treated with concurrent chemoradiotherapy (CCRT). The amount of local extension of the disease and lymph-node invasion are the most important factors related to a worse progression-free survival (PFS) and overall survival (OS). Moreover, recently, anemia and skeletal muscle index (SMI) appears as important predictors of clinical outcomes in patients with cancer, demonstrating the association of low haemoglobin level and SMI with worse PFS and OS. However, there is no consensus about the clinical impact of pretreatment anemia and low SMI in women with CC.Objective To evaluate pretreatment level of haemoglobin and SMI as a prognostic factors in women diagnosed with CC that CCRT.Methods 151 women diagnosed with CC were included in this cohort study with retrospective data collection. Pretreatment computerized tomography (CT) images were analysed to assess SMI. Hazard ratios (HR) and multivariate Cox proportional HR with (95%CI) were used to analyse the association between low SMI, age, menstrual state, body mass index (BMI), haemoglobin levels, neutrophil and platelet count, histological type, and FIGO stage with PFS and OS. The Kaplan-Meier method was used to analyse the survival of patients with or without low SMI according to stages.Results Among the 151 patients included, 53 (35.1%) presented pretreatment low SMI. Linear regression models showed that despite showing no association with age, neutrophil or platelet counts, low SMI was associated with low pretreatment haemoglobin levels (p = 0.01). After a multivariate analysis, only haemoglobin and complete CCRT remained associated with DFS (p < 0.001) and OS (p < 0.001). Low SMI was significantly associated with worse PFS and OS in FIGO stage I/II.Conclusion Pretreatment low level of haemoglobin was significantly associated with low SMI. However, only anemia and incomplete CCRT were independently associated with poor prognosis in women with CC. Pretreatment low SMI was a predictor of poor prognostic in early stages.
Secure and manipulation-proof TLS communication with Plug and Charge
Authors: Kilic Ahmet
Published: April 2023

PnC according to ISO 15118 enables most secure charging session and highest comfort for user and secure and manipulation-proof communication between electric vehicle and charging station. This secure communication is ensured by encrypted communication channel and asymmetric cryptographic algorithms using PKI. The encrypted communication channel between EV and EVSE must be ensured by using Transport Layer Security (TLS) according to ISO 15118. To realize V2G communication between EV and EVSE, first line certificates between EV and EVSE must be validated and verified. Due to new standard for TLS and due to new PKIs the requirements for TLS are significantly changed. With this work all requirements for TLS are collected, evaluated and solution concepts for secure realization of TLS function are derived. Here new concepts and solutions for secure TLS are developed, which are based on Cross Certificate Sign and on use of the network solutions within the PnC Ecosystem. These solutions are validated and verified in a testbench, and it is ensured that secure TLS function is also possible without Interoperable PKIs. So, a user can establish a secure TLS function at the charging station.
Is robotic-assisted surgery a better choice in vaginectomy of complicated vaginal high-grade squamous intraepithelial lesions than conventional laparoscopic surgery?
Authors: Liu Yana , Mao Meng , Bai Jing , Cai Mingbo , Wang Qian , Fu Hanlin , Zhao Mengling , Wang Chunfang , Si Lulu , Guo Ruixia
Published: April 2023

The aim of this study was to evaluate the operative outcomes of robotic-assisted laparoscopic vaginectomy (RALV) and conventional laparoscopic vaginectomy (CLV) for patients with complicated vaginal high-grade squamous intraepithelial lesions (HSIL). Therefore, an analysis of one hundred and nine patients with complicated vaginal HSIL (32 patients in the RALV group and 77 patients in the CLV group) who underwent minimally invasive vaginectomy was conducted retrospectively. Compared with the CLV group, patients in the RALV group demonstrated less estimated blood loss, a lower rate of intraoperative complications and shorter durations of paralytic ileus time, urinary catheter indwelling time and postoperative hospitalization time (all P < 0.05). However, the RALV group had significantly higher hospital costs than the CLV group (P < 0.05). The total operative time, postoperative complications, positive surgical margins, pathology upgrading or treatment outcomes did not significantly differ between the two groups (all P > 0.05). Our results demonstrated that both RALV and CLV can achieve satisfactory treatment outcomes, while RALV has the advantages of less intraoperative blood loss, fewer intraoperative complications and faster postoperative recovery. RALV has the potential to become a better choice for vaginectomy without regard to the burden of hospital costs.
Inhibition of sexual maturation inhibition using exemestane and tamoxifen in female olive flounder (Paralichthys olivaceous)
Authors: Kim Ki-hyuk , Moon Hye-na , Yeo In-kyu
Published: April 2023

Sex determination in some reptiles, amphibians, and fishes is influenced by environmental factors.
Exemestane acts as an estrogen agonist non-steroid hormone. Olive flounder (Paralichthys olivaceous) is easily affected by water temperature or sex steroid hormone treatment during sex determination.
Tamoxifen is a steroid hormone, which is widely used as a drug in human cancer therapy as an anti-estrogen agent (estrogen receptor antagonist). In this study, we intraperitoneally injected exemestane and tamoxifen, a pre-maturation sex hormone inhibitor, into the bodies of female olive flounder. The expression of estrogen receptor mRNA and vitellogenin mRNA in the liver were almost the same in both cases. For exemestane injection, the histological observation of intersex was confirmed at day-5. Although these results suggest the possibility of the synthesis of estrogen by tamoxifen, the underlying mechanism has not yet been fully investigated. Hence, examinations are needed to confirm the direct involvement of tamoxifen.
WITHDRAWN: Efficacy of Autologous Platelet Rich Plasma on Morphea: A Comparative Clinical and Ultrasonographic Follow-up Study
Authors: Makki Mahmoud Abdel Sabour , Moshrif Abdelhfeez , Mansour Mofreh , Elnaquip Esraa
Published: April 2023

Despite different modalities for morphea therapy used; it still has a great challenge. This study aimed to evaluate the efficacy and safety of intralesional Autologous Platelet Rich Plasma injection once weekly for 12 sessions to restore skin disfigurement (dyspigmentation, skin atrophy, and adnexal destruction) in nine patients (21 lesions) with a mean duration of 5.96 ± 2.4 years. The disease severity and damage were evaluated by the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) score; the skin layer thickness and Echogenicity were evaluated by musculoskeletal ultrasound at baseline, 3- month, and 6 months intervals. The LoSCAT score showed a significant improvement with the mean reduction from 13 ± 7.3 to 7.33 ± 6.8 at the end of 3rd month and to 6.44 ± 7.1 at the end of 6th month (p = 0.008 and 0.014) respectively, additionally, the ultrasound showed an increase in the thickness of skin layers from baseline to be nearly equal to normal control (p < 0.001), with transient adverse effects. The present study indicates that PRP is a good tool for the improvement of morphea lesions with a great aesthetic outcome.
Linking farmers' tree species priority with planting niche accelerates scaling up of homestead agroforestry in semi- arid Ethiopia
Authors: Gebretsadik Wondwossen
Published: April 2023

Agroforestry improves food security and smallholder livelihoods through provision of multiple products from limited land while ensuring sustainable land use system. Locally adaptable agroforestry practices and technologies identified by farmer- led approaches are key for wide spread adoption of agroforestry as a sustainable land use at a landscape level. Studies disclosed that farmers in the rift valley regions of Ethiopia require far more tree diversity on their lands than they already have. This is an indication that there is a need for systematic testing through participatory homestead trials, of a wide range of tree species preferred by farmers across a range of contexts to promote tree diversity and bring large scale impacts in adoption of agroforestry technologies. This paper presents the study findings on management, survival, and growth of farmer managed fruit tree seedlings at homesteads. Participatory trials were established at farmers' homesteads with fruit trees that were prioritized by farmers in the semi-arid Ethiopia. The trial sites were farmers’ homesteads in East shoa zone (Adamitulu woreda -Ziway, Dugda bora woreda-Meki and Lome woreda- Mojo). Higher survival of improved Papaya -Carica papaya seedlings was found at Lome as compared- to that of Dugda and Adamitulu at seven months after planting. The survival of Avocado- Persea americana was the highest at Lome site. Beating up was carried out at the end of first year and analysis of data two years later revealed significant differences (a=0.05) in survivals of fruit trees across study sites. Height growth and crown width of farmer managed fruit trees also revealed significant differences (a=0.05) across study sites at two years. Watering frequencies of seedlings were found to vary greatly across study sites. On average farmers in different sites watered their seedlings bi-weekly. At Dugda site 77% of participant farmers watered their seedlings daily and provided a comparatively better care to seedlings resulting in a remarkable performance of Avocado. Though factors constraining seedling growth and survival at homesteads in the semi arid are diverse, it is highly recommended to link species priority and local knowledge with planting niches to win the willingness of farmers to plant trees and contribute to the success of homestead agroforestry.
Bereavement counsellors’ experiences supporting the families of deceased children within a German bereavement network and their perceptions of the network organisation – A qualitative interview study
Authors: Betke Merle , Stiel Stephanie , Schwabe Sven
Published: April 2023

Background When children are diagnosed with a life-limiting illness, commit suicide or die in an accident, their families often experience severe grief. Since January 2021, the “Bereavement Network Lower Saxony” (BNLS) project has provided professional bereavement support from trained bereavement counsellors to families grieving either a child who has been diagnosed with a life-limiting illness or a child who has died. The present study aimed at exploring the experiences of BNLS bereavement counsellors in providing bereavement support to affected families and their perceptions of the BNLS organisation.Methods Within the context of the BNLS evaluation, 12 semi-structured qualitative interviews were conducted with bereavement counsellors between June and August 2022. Interviews were recorded, transcribed and analysed using qualitative content analysis, according to Mayring.Results Bereavement counsellors perceived that grief could be experienced very differently, and thus bereavement support must always be based on the individual needs and resources of bereaved family members. They also noted that professional support may prevent family members from developing (mental) illness. Most counsellors considered their emotional detachment from the topics and experiences discussed within meetings an important component of their professional support and a point of differentiation from voluntary support. They appreciated exchange with other counsellors and supervision within the BNLS to cope with emotional stress. They believed that BNLS's public outreach should improve.Conclusions Bereavement counsellors perceived professional bereavement support as a core component of the care they provided to family members grieving for deceased children, and a preventive factor for the development of (mental) illness among these family members. Bereavement support within a network structure may improve the accessibility of individual support and enable exchange between counsellors, thus ensuring better bereavement support. Public outreach and strategic partnerships with clinics may amplify the positive impact of this support service.
Investigation of Physical, Mechanical, Tribological and Biodegradable Properties of Hybrid Natural Fiber Reinforced Polymer Composite
Authors: Ravi Pravesh , Balaji MA Sai , Katiyar Jitendra Kumar
Published: April 2023

This study has investigated the effect of natural fibres such as kenaf, coconut, and jute and their combination as reinforced in an epoxy polymer matrix (NFRP) on mechanical properties (impact, flexural, tensile strength, and hardness), thermal stability, tribological properties, and biodegradability. The raw fibres were chemically treated with 3% NaOH for 24 hrs, and 10 wt.% was blended in the epoxy matrix. Further, a composite surface Morphology and fibre dispersion were analysed using a scanning electron microscope. An improvement of 30.39%, 1157.7%, and 30.98% in impact strength, hardness and tensile strength, respectively, compared to pure epoxy composite. Further, the tribological study has shown a lesser frictional coefficient (~ 0.275) in hybrid NFRP than in other composites. Moreover, the mixed NFRP has demonstrated excellent biodegradable properties compared to other NFRP and pure composites.
PLS Regression Trees for Multivariate Response Data with Multi-collinear Predictors
Authors: Yu WenXing , Lee ShinJae , Cho HyungJun
Published: April 2023

Some problems arise in analyzing massive complex data consisting of multivariate response variables and a large number of multi-collinear predictor variables, especially when the sample sizes compared to the number of predictors are small. Rather than ordinary linear regression modeling approaches, latent variable regression modeling approaches such as partial least squares regression can be used to capture the relationship between the response and predictor variables for such cases. However, for complex nonlinear relationships between the predictor and the response variable, the performance of inference and prediction using regression modeling approaches can be deflated. Regression trees can capture such complex relationships. Thus, we develop a partial least squares tree modeling algorithm that detects complex relationships and makes precise predictions by integrating the merits of partial least squares and regression trees. It is shown that it has better predictive performance than other methods through simulation and it is demonstrated that it generates interpretable predictive models with real data.
A comparison between the VGG16, VGG19 and ResNet50 architecture frameworks for classification of normal and CLAHE processed medical images
Authors: Kamal Kamal , EZ-ZAHRAOUY Hamid
Published: April 2023

In this paper, we chose to focus our study on finding the right convex neural network model specifically for the binary classification task for normal contrast medical image type and enhanced by CLAHE technique. We made a comparison of the architectures of VGG16, VGG19 and Resnet50 in terms of their accuracy, F1 score and Recall for a set of selected brain images of normal and CLAHE enhanced contrast cases. After running 10 experiments in two modes: with and without Data augmentation while keeping the same parameters of the simulations, we came to the conclusion that VGG16 obviously presents the best architecture for medical image classification, the results in the light of Data augmentation mode, the use case the normal contrast images, the three models provided the accuracies 0.78, 0.66 and 0.69 respectively for VGG16, VGG19 and Resnet50, and for the use case the contrast images enhanced by the CLAHE technique, the accuracies being 0,78, 0.76 and 0.72 respectively for VGG16, VGG19 and Resnet50. For the no Data augmentation mode, the use case normal contrast images, the three models provided the accuracies 0.88, 0.79 and 0.75 respectively for VGG16, VGG19 and Resnet50, and for the use case CLAHE-enhanced contrast images, the accuracies being 0.86, 0.87 et 0.65 respectively for VGG16, VGG19 and Resnet50.
Evaluation of patient preferences for treatments to prevent preterm births in singleton and twin pregnancies with a short cervix.
Authors: Perrusi Sabrina de Andrade Fernandes Collier , Brizot Maria de Lourdes , Garavazzo Sckarlet Ernandes Biancolin , Pucci Camila Luiza Meira , Gomez Ursula Trovato , Peres Stela Verzinhasse , Marinelli Juliana Valente Codato , Francisco Rossana Pulcineli Vieira , de Carvalho Mario Henrique Burlacchini
Published: April 2023

Background Prematurity is the primary cause of neonatal morbidity and mortality. Despite some treatment methods, the preferences and concerns of women regarding the prevention of premature births have not yet been elucidated. Thus, this study analyzed singleton and twin pregnancies with an increased risk of prematurity to evaluate patient preferences for treatment and the factors that may influence such preferences.Methods Self-administered questionnaires in Portuguese were administered to pregnant women to collect data about their knowledge and concerns regarding prematurity and treatment methods( pessary, progesterone ovules and combination of a pessary and progesterone )as well as their preferred methods. Questionnaires were also used to assess the anxiety and quality of life of the participants. The chi-square, Fisher’s Exact, and Linear-by-Linear association tests were used to compare qualitative independent variables and qualitative outcomes. The Student’s t-test and ANOVA were used to compare the quantitative independent variables and qualitative outcomes. The Mann–Whitney or Kruskal–Wallis tests were used for non-parametric data.Results The study included 123 pregnant women with a short cervix (twin pregnancies, n = 61; singleton pregnancies, n = 62) from May 2009 to January 2022. As for their preferences, women with singleton pregnancies preferred to use a pessary (53.2%), but with no significant difference (P = 0.703) compared to progesterone (46.8%). Women with twin pregnancies preferred the combination of a pessary and progesterone (P + P) (60.7%), followed by ovules (26.2%) and a pessary (8%), with a significant difference in this choice (P < 0.001). Previous knowledge of the pessary by pregnant women with twins resulted in a significantly higher preference for the use of the pessary alone compared to P + P (37.5% vs. 5.7%; P = 0.04), and no patients chose ovules.Conclusion The higher risk of prematurity in twin pregnancies and the lack of studies showing effective treatments for twin pregnancies may have contributed to the higher preference for the combined use of P + P. Women with singleton pregnancies showed no preference between the methods. This may be due to the fact that use of pessary and progesterone have already been proven to be effective in singleton pregnancies.
Converting Tall Spindle Apple Trees to Narrow Walls with Summer and Dormant Hedging Plus Root Pruning
Authors: Campbell Thiago , Schupp James R. , Marini Richard P.
Published: April 2023

Recently, some commercial apple growers have been adopting hedging as an alternative or supplement to hand-pruning. With increasing labor costs across the United States, alternatives to hand-pruning and current training systems are being considered. One management strategy involves transitioning tall spindle trees to a narrow tree wall and simplifying labor-intensive activities of apple production, such as pruning, harvesting, and fruit thinning. The objective is to form the orchard system into a “fruiting wall” that makes fruit more visible and accessible, thus facilitating harvesting. Four management practices (tall spindle; narrow tree wall with manual pruning; narrow tree wall with dormant and summer hedging; and narrow tree wall with dormant hedging, summer hedging, and root pruning) were used to convert 12-year-old ‘Brak Fuji’ apple trees from the tall spindle training system to a narrow tree wall. Photosynthetically active radiation (PAR) and ultraviolet light levels within the canopies were improved by summer hedging, but they were still low for all treatments. Light within the canopy was improved most when root pruning was included. Specific leaf weight was not significantly impacted by hedging or root pruning. Detailed spur sampling showed that treatments had no effect on vegetative or reproductive growth on 2- to 3-year-old wood. Although dormant plus summer hedging alone did not affect shoot length, the combination of hedging and root pruning caused a significant reduction in terminal shoot length. Red fruit color was only improved with dormant hedging plus summer hedging plus root pruning. Compared with dormant plus summer hedging, dormant plus summer hedging plus root pruning improved fruit set and yield, but it reduced fruit size. Without root pruning, hedging had little effect on light, specific leaf weight, flower initiation, fruit set, and fruit quality. Conversion to narrow tree walls by manual pruning resulted in more poorly colored fruit and less highly colored fruit compared with maintaining the trees as tall spindles with manual pruning.
Mycophenolate mofetil in therapy of primary nephrotic syndrome in children
Authors: Morozov S. L. , Kursova T. S. , Petrosyan E. K. , Piruzieva O. R. , Dlin V. V.
Published: April 2023

Idiopathic nephrotic syndrome is the most common glomerular disease in children, with a prevalence of 1.15–16.9 cases per 100,000 children per year worldwide. In some cases, nephrotic syndrome has a frequently relapsing course or dependence on steroid therapy is formed, which leads to the appointment of immunosuppressive therapy. So far, in clinical practice, there is no unambiguous approach among physicians to the management of patients with nephrotic syndrome, especially when it comes to the further choice of immunosuppressive therapy. Because of the serious side effects of long-term corticosteroid use, doctors prescribe steroid adjuvants to maintain remission and limit the cumulative effect of glucocorticosteroids. Among adjuvants, mycophenolate mofetil, with mycophenolic acid as the active ingredient, is believed to be the most preferred option due to fewer adverse events, acceptable tolerability and, at the same time, high efficacy. This article describes the advantages and features of the use of mycophenolic acid in clinical practice, provides data on pharmacodynamics and drug monitoring, and discusses issues of personalized medicine.
Molecular and genetic basis of variability in clinical manifestations of Marfan syndrome
Authors: Gritsevskaya D. Yu. , Smirnova A. V. , Voinova V. Yu.
Published: April 2023

Marfan syndrome is an inherited connective tissue disease with autosomal dominant inheritance and pronounced phenotypic variability, which is highly likely to be caused by genetic modifiers. This review presents the molecular characterization of fibrillin-1, the protein product of the disease-associated FBN1 gene, the genotype-phenotype correlations studied to date, and the results of the search for possible genetic modifiers.
Clinical and pathogenetic significance of immunity factors in congenital generalized infection caused by the herpes simplex virus
Authors: Levkovich M. A. , Kravchenko L. V. , Кrukier I. I. , Ermolova N. V. , Avrutskaya V. V. , Kaushanskaya L. V. , Levkovich A. Yu.
Published: April 2023

Intrauterine infections are serious diseases that largely determine the level of infant mortality. Newborns who have had intrauterine infections often have long-term consequences, leading to disability. One of the intrauterine infections is a congenital infection caused by the herpes simplex virus (neonatal herpes). Neonatal herpes occurs less frequently (1:2000 live births) than cytomegalovirus fection, but the clinical symptoms in this disease are characterized by multiorgan damage.

Purpose. To determine the role of immune factors in the development of congenital generalized HSV infection.

Material and methods. Twenty-two newborns with a severe form of congenital generalized infection caused by the herpes simplex virus infection were examined (group I). The control group consisted of 26 healthy newborns born to women with uncomplicated pregnancy and childbirth. Determination of the population and subpopulation composition of peripheral blood lymphocytes and monocytes, the level of expression of activation markers, T-regulatory cells (Treg) was carried out by laser fl w cytometry using reagents from Immunotex (France), Caltag (USA), HyCultbiotechnology (Netherlands): FITC (fl           escein isothiocyanate) — labeled CD3+, CD4+, CD8+, CD 16+, CD19+, CD282+ and PE (phycoerythrin)-labeled CD95+, CD25+, CD14+. Determination of the number of lymphocytes that have entered apoptosis using a diagnostic kit including Annexin-V, labeled with FITC and propidium iodide (PI), (Caltag, USA). The concentration of IFN-γ, IFN-α, IL-12 in the blood serum of newborns was determined by ELISA using BenderMedsistems test systems.

Results. The development of a congenital generalized infection caused by the herpes simplex virus is associated with a lack of IFN-α, IFN-γ, IL-12 production, a decrease in the number of monocytes expressing TLR-2, a decrease in the relative number of CD8+, CD16+ lymphocytes, CD25+ activation markers, on the surface of NK cells, in combination with an increase in CD16 + CD95 +, AnnexinV + PI +, the number of Tregs.

Conclusion. The results of the work indicate suppression of the early stages of the innate immune response, impaired effector function of immunocompetent cells, apoptosis processes
Understanding the nature of atherogenic disorders in children
Authors: Neudakhin E. V. , Kozhanova Т. V. , Abramov A. A.
Published: April 2023

The article provides information about the nature of atherogenic disorders in children. Much attention is devoted to the problem of the pathogenesis of atherosclerosis, the substantiation of its stress theory, whereas nosological essence is rejected. Atherosclerosis is considered as an evolutionary, genetically determined pathophysiological process that accompanies a person from conception to death, affecting the health quality and life expectancy. Attention is drawn to the issues of susceptibility to atherogenic disorders in children, which explanation allows us to solve the problems of their prevention and prophylaxis.
Natural history of phenotype markers in patients with bronchial asthma (a decade’s observation)
Authors: Kamaev A. V. , Mizernitsky Yu. L. , Shaporova N. L.
Published: April 2023

Volatility of certain bronchial asthma (BA) phenotype markers is not enough investigated during maturation of pediatric patients. Material and methods. One hundred thirty-one patients with non-severe BA were included; by the age on inclusion date subgroups of “Children” (62 patients aged 6 to 11 years) and “Adolescents” (69 patients aged 12–17 years) were allocated. Every 6 months patients were examined, fulfi   d asthma control questionnaires, performed spirometry with salbutamol test, provided hematology results with absolute eosinophil count and height and weight data. Exacerbation and hospitalization numbers, BA severity and controller treatment step were considered. Acquired data were archived; patients’ management was driven by real clinical practice algorithms.

Results. Ninety-three patients included (71%) completed at least decade observation. Adolescents and young adults had body mass index higher than 90th percentile by age more often than younger children; some patients had normalized their body mass during observation. BMI and ACT results had moderate reverse correlation (r=–0.64). Eosinophil counts more than 300 cells per microliter conserved longer in older patients: duration median and [Q1; Q3] for “Adolescents” were 11,7 [9,6; 15,3] months and 9.3 [4.8; 11.1] months for “Children” subgroup, difference was significant (р=0.043). Most lung functional parameters were in age normal range. Rare cases of functional obstruction were not stable and did not differ in duration between “Children” 7.3 [6.2; 8.8] months and “Adolescents” 8.4 [6.5; 10.4] months.

Conclusion. Phenotype markers of future BA exacerbation risk are quite volatile in pediatric patients and young adults. We recommend repeated evaluation of such markers every 12–18 month of observation to decide on asthma controller change. Simultaneous detection of several markers was quite often but did not lead to more severe asthma course in most patients. Longer duration of elevated BMI or peripheral blood eosinophils were typical for patients with more often BA exacerbations.
Gut microbiota in chronic liver diseases in children
Authors: Volynets G. V. , Nikitin A. V. , Skvortsova T. A. , Potapov A. S. , Dudurich V. V. , Danilov L. G.
Published: April 2023

The impact of gut microbiota on the development of various diseases is of great interest to researchers. However, data on the taxonomic diversity of the intestinal microbiota in chronic liver diseases in children are lacking.

Purpose. To study the taxonomic diversity of the fecal microbiota in children with chronic liver diseases in comparison with healthy patients.

Material and methods. A metagenomic analysis of the intestinal microbiota of 24 children with chronic liver diseases (mean age 10.3 ± 4.7 years) was carried out with the isolation of the target fragment of the 16S rRNA gene. The group included 18 children with autoimmune liver diseases and 6 children with non-autoimmune liver diseases. The comparison group consisted of fecal samples of 34 apparently healthy children.

Results. The conducted study revealed 684 types of microorganisms in the studied samples of patients’ feces. An analysis of the conducted studies showed that fecal samples of healthy children and patients with chronic liver diseases differ in bacterial diversity. The dominant taxa in healthy children were Neisseria flavescens, in patients with chronic liver diseases, the dominant taxa were Bifidobacterium longum, Bifidobacterium adolescentis, Blautia massiliensis. At the same time, Bifidobacterium longum, Bifidobacterium adolescentis, Blautia massiliensis in fecal samples of patients with chronic liver diseases was 8 times as high.

Conclusion. Studies have shown differences in the composition of the intestinal microbiota in healthy children and children with chronic liver diseases.
Frequency and risk factors of simple obesity in children with bronchial asthma
Authors: Alimova I. L. , Yacheykina N. A.
Published: April 2023

Currently, it has been established that obesity in children with bronchial asthma leads to a more severe course of the disease, a worse quality of life, and a reduced response to treatment.

Purpose. To study the incidence and risk factors of simple obesity in children with bronchial asthma. The aim of the study was to study the incidence and risk factors of simple obesity in children with bronchial asthma.

Material and methods. The study included 484 patients aged 7 to 14 years: the main group consisted of 237 patients with atopic bronchial asthma, the comparison group consisted of 247 children without a diagnosis of bronchial asthma.

Results. Patients of the main group were obese more often (18.9%) than children of the comparison group (11.3%, p=0.019). During 5 years of bronchial asthma disease, a tendency (p=0.087) was revealed to increase the SDS body mass index indicator in the dynamics of the disease (from 0.32 to 0.45) and the number of patients with III and IV degrees of obesity (from 10.5% to 42.8%, p=0.025). In children of the main group with normal SDS body mass index before the diagnosis of bronchial asthma 5 years after the onset of the disease, in 8.5% of cases there was obesity (p<0.001) and in 23.9% — excess body weight (p<0.001), in children with initial excess body weight, obesity was diagnosed in 28.6% of cases (p=0.048), and among children who were obese at the time of bronchial asthma, 26.3% had an increase in its severity (p=0.023). In patients with bronchial asthma and obesity, according to the bioimpedance analysis findings, a pronounced imbalance between energy intake and its consumption was revealed, and according to the nutrition assessment data — an unbalanced diet, a violation of the diet and a sedentary lifestyle.

Conclusion. Simple obesity occurs in 18.9% of school-age children with atopic bronchial asthma, and over the course of 5 years of the disease, the number of patients with obesity increases and its severity progresses. Therefore training of patients and their parents, correction of nutrition and increasing the volume of physical activity are an important component of treatment.
Iliofemoral thrombosis in a patient with recurrent nephrotic syndrome
Authors: Razdolkina T. I. , Vereshchagina V. S. , Balykova L. A. , Moskovskaya E. F. , Krasnopolskaya A. V. , Gorbatov V. A. , Shulepina A. V. , Ishutkina S. S.
Published: April 2023

Nephrotic syndrome is one of the most common glomerulopathies in children, accompanied by a high risk of thrombosis due to hypoalbuminemia, hypovolemia, hyperlipidemia, hyperfibrinogenemia, and antithrombin III deficiency. The article describes a clinical case of iliofemoral thrombosis in a 16-year-old boy with recurrent nephrotic syndrome and primary thrombophilia (heterozygote F5 — Leiden mutation) was diagnosed. The presented clinical observation indicates the multifactorial origin of thrombotic complications in nephrotic syndrome, caused by a combination of an imbalance between the proand anticoagulant components of the blood coagulation system and individual risk factors (severity of proteinuria, hypoalbuminemia, comorbidity, hereditary thrombophilia), and therefore further study is needed to determine the tactics of prevention and treatment.
Diagnosis and treatment of orphan disease — homocystinuria and megaloblastic anemia, type cblG
Authors: Nikolaeva E. A. , Semyachkina A. N. , Zabrodina A. R. , Berezina M. Yu. , Bochenkov S. V.
Published: April 2023

The term «homocystinuria» combines a number of genetically determined nosological forms caused by defects of the metabolism of sulfur-containing amino acids (methionine, homocysteine), cobalamin and folate. The group of these diseases includes «classical» homocystinuria caused by insufficiency of cystathionine beta-synthase and forms associated with defects in methionine remethylation processes. More information is given about one of these forms — homocystinuria and megaloblastic anemia, type cblG, caused by MTR gene mutations. The results of observation of a child with this disease are presented. The clinical status includes: intellectual disability, autistic behavioral traits, stereotypes, nystagmus, visual impairment, macrocytic anemia, epilepsy in remission. Effective treatment requires the use of medications not registered in the Russian Federation — betaine and hydroxocobalamin.