bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving follow-up care for people after minor stroke using early personalised care: A protocol for a randomised, mixed-methods, feasibility study.
Authors: Crow Jennifer , Watt Hilary , Wells Mary , Malhotra Paresh
Published: November 2024

Background Of the 150 000 people per year in the UK who have strokes, third to half will experience a so-called ‘minor stroke’. Although appearing benign these strokes put a person at increased risk of further strokes and survivors are usually considered ‘too good’ for referral onto community stroke services. When back at home the hidden effects of stroke like fatigue and changes in mood and cognition become apparent and impact return to work, relationships and everyday activities. Alongside this, managing the risk of recurrence, highest early after an initial stroke, is a priority. People with stroke report feeling abandoned after discharge with unmet information and support needs. Methods To address this issue, we reviewed the literature, met with people with stroke and other stakeholders to develop an early, personalised follow-up programme of care for those who currently only receive routine medical follow-up appointments. This complex intervention is underpinned by self-determination theory, which forms a framework for delivery of the intervention. We will be conducting a randomised, mixed methods, single-centre feasibility study to explore the acceptability and feasibility of the intervention. Sixty participants will be recruited from a Hyperacute Stroke Unit and Rapid Assessment Clinic and randomised to the intervention or control group. The intervention group will receive personalised follow-up appointments at two- and six-weeks post-discharge. All participants will have outcome measures taken at baseline and twelve-weeks post-stroke. Patient reported outcomes will be reviewed to assess their suitability for a later definitive trial. Qualitative interviews will be conducted to gain a deeper understanding of life after stroke from those who did and did not receive the intervention. Conclusions Study findings will be used to further refine the intervention, methods and outcome measurements used. These refinements will inform a future multicentre randomised controlled trial.
Experiencias de estudiantes de enfermería de último curso durante las prácticas de salud mental. Análisis cualitativo
Authors: Gil Mateu Elsa , Barceló Prats Josep , Albacar Riobóo Núria , Reverté Villarroya Silvia
Published: November 2024

Objetivo:   explorar los sentimientos, percepciones y vivencias de estudiantes de enfermería en unidades de salud mental durante sus prácticas clínicas. Método: Estudio cualitativo. Demostración intencional de 81 estudiantes de enfermería matriculados en tareas de práctica clínica en Unidades de Atención a Salud Mental. Durante estos se incorporó un foro de animado debate. Los foros se analizarán mediante análisis de contenido. Resultados: Se realizaron 6 foros con un total de 604 participantes, con un promedio de 100. Surgieron seis categorías: comprensión de la enfermedad mental, intervenciones de enfermería, estigma, relación terapéutica, convivencia con la enfermedad mental, aprendizaje. Conclusión: Los estereotipos negativos, la vergüenza y el estigma impuestos por la sociedad son obstáculos que los estudiantes deben superar. Una metodología que los acompaña durante la práctica los conduce a un proceso de reflexión, integrando las creencias y valores de las personas, aplicando conocimientos y juicio clínico.
Unveiling The Hidden Threat: Acute Myocardial Infarction In A Young Female
Authors: Rahman Aparna , Bhuiyan Mahmud Al Amin , Akhi Syeda , Goswami Chayan , Raqeebuzzaman  , Chowdhury Redwanur Nabi
Published: November 2024

Myocardial infarction often manifests with unusual signs and symptoms in younger people, and the associated factors of risk vary from those in older individuals. Identifying the factors which are preventable and taking preventive measures can help avert myocardial infarction (MI) in these patients. However, inadequate number of studies and guidelines for evaluating and managing those suffering MI at younger age makes it harder for them to receive precise medical attention, despite this age group exhibiting the increasing incidence of MI. Traditional risk factors like raised blood cholesterol levels, raised blood pressure, smoking, male gender, obesity, and early cardiovascular disease history within the family are known contributors to early myocardial infarction. Additionally, risk factors that are untraditional include abuse of substance, thrombophilic disorder, coronary anomalies, autoimmune diseases, psychological stress ,and allergic reactions play a significant role in the younger individuals’ risk profile. Among thrombophilic disorders, inherited protein C and/or protein S deficiency is a rare cause. Protein S and Protein C are anticoagulant proteins that depend on vitamin K and are necessary for inhibiting activated clotting factors V and VIII. When someone inherits thrombophilia, a deficiency in these proteins result in a hypercoagulable state, which raises the risk of development of venous thromboembolism (TE) and rarely arterial thromboembolism .Top of Form Bottom of Form We present a case of a young female with protein S deficiency who experienced an acute MI. Prompt and effective management was crucial in treating her condition, ultimately preventing severe complications and ensuring a positive outcome.
J Med Coll Women Hosp.2024; 20(1): 68-75
Применение методов анализа рисков HAZOP/HAZID в системе управления пожарной и промышленной безопасностью
Authors: Закрута Максим Сергеевич
Published: November 2024

Цель. Обзор методов анализа рисков HAZOP/HAZID для выявления возможности их применения к элементам пожарной безопасности на промышленных объектах.
Методы. Анализ рисков в системе управления безопасностью промышленных объектов. Системный подход к выявлению потенциальных опасностей и эксплуатационных проблем производственного объекта.
Результаты. Проведен анализ методов HAZOP и HAZID. Рассмотрены преимущества и недостатки этих методов, а также способы их использования в оценке рисков и управлении рисками на промышленных объектах.
Область применения исследований. Анализ последствий внедрения опасных факторов на ранних этапах разработки проектной документации. Разработка реестра типичных опасных факторов и последствий. Детальный анализ опасных факторов и рисков на всех этапах жизненного цикла производственного объекта.
ANALISIS RASIO KEUANGAN DALAM MENILAI KINERJA KEUANGAN UMKM JAYA PONSEL
Authors: Sidik Dena Purnama , Halimah Diniar , Andriyani Desi , Suharniati Suharniati , Kamilah Nurul
Published: November 2024

Micro, Small, and Medium Enterprises (UMKM) play a crucial role in Indonesia's economy, particularly in providing employment opportunities and supporting local economic growth. Jaya Ponsel, an MSME operating in the mobile phone sales and repair sector, requires a financial performance evaluation to maintain business stability and growth. This study aims to assess Jaya Ponsel's financial performance through financial ratio analysis, covering liquidity, solvency, activity, and profitability, and to present the income statement and balance sheet for 2022 and 2023. The method used is a quantitative descriptive approach, with data sourced from the company's internal financial reports. The analysis results indicate that although there was a decline in some liquidity and activity ratios, Jaya Ponsel managed to improve its profitability. The current ratio decreased from 2.50 in 2022 to 2.20 in 2023, while the quick ratio dropped from 2.00 to 1.80. The increase in the debt-to-asset ratio and debt-to-equity ratio suggests greater reliance on debt. On the other hand, the profit margin on sales rose from 20% to 22%, ROI increased from 6.67% to 7.50%, and ROE improved from 11.11% to 12.63%. In conclusion, despite challenges in liquidity management and operational efficiency, Jaya Ponsel successfully maintained and enhanced its profitability. These findings provide valuable insights for management to optimize financial and operational strategies moving forward.
DAMPAK KUALITAS PELAYANAN TERHADAP KEPUASAN PELANGGAN DI RICHEESE CABANG GRAND DEPOK CITY
Authors: Hira Rosa Janatul , Jullistia Vriska Naya , Inayatuzzahra Syifa , Cipta Ramdhina , Fadillah Nanda Nur , Susilowati Isnurrini Hidayat
Published: November 2024

The fast-food industry, particularly Richeese Factory, plays a significant role in the global culinary landscape. This study aims to evaluate the impact of service quality on customer satisfaction at Richeese Factory GDC using a combination of library and field research methods. The study employs a cross-sectional design, with data collected through questionnaires from 99 randomly selected respondents. Service quality was assessed based on aspects such as speed, order accuracy, staff friendliness, and restaurant cleanliness. Linear regression methods were applied, including instrument tests for validity, reliability, and classical assumptions such as normality, heteroscedasticity, and multicollinearity. The validity and reliability tests showed that the questionnaire was reliable and valid. The classical assumption tests indicated that the data distribution was not normal; however, the regression model did not show heteroscedasticity or multicollinearity. Correlation analysis demonstrated a strong and positive relationship between the two variables. The coefficient of determination revealed that 29.2% of customer satisfaction variability was influenced by service quality, with the regression equation Y = 24.180 + 0.449X, indicating a positive effect. The T-test also showed a positive and significant effect of service quality on customer satisfaction, with a t-value of 6.322, which is greater than the t-table value of 1.988. These findings highlight the importance of improving service quality to achieve optimal customer satisfaction in the fast-food industry.
«П’ЯТЬ ТЮДОРІВСЬКИХ ПОРТРЕТІВ» РАЛЬФА ВОАНА ВІЛЬЯМСА: ОСОБЛИВОСТІ ВТІЛЕННЯ СМІХОВОГО НАЧАЛА
Authors: УСТЮЖАНІНА НАДІЯ
Published: November 2024

Розглянуто хорову сюїту «П’ять тюдорівських портретів»англійського композитора ХХ століття Ральфа Воана Вільямса, написануна слова поета-сатирика доби Відродження Джона Скелтона. Висвітленоісторію створення і виконання сюїти, проаналізовано її вербальнускладову. Аналіз «Тюдорівських портретів» здійснено з урахуванням концепції сміхового музичного світу Ольги Соломонової. У результатірозгляду виявлено способи втілення та форми функціонування сміховогоначала в «Тюдорівських портретах».
William Hunter's library at the University of Glasgow: use and borrowing in the early nineteenth century
Authors: Craig Michelle H.
Published: November 2024

This article considers the borrowing patterns found within the Hunterian Museum Library after its donation to the University of Glasgow by its creator, Dr William Hunter, in 1807. It considers its move from a private collection to an institutional one and starts to unpack the role it was playing within the university and wider community at Glasgow. It considers who was able to borrow from the Hunterian Library at Glasgow and suggests that ‘borrowing’ was perhaps only part of a larger picture of ‘use’ of the library. It also examines trends in what was borrowed from the library to gain a picture of how it was being used, showing that it was largely for borrowing of books not found in the main university library (particularly rare imprints, manuscripts, and illustrated books). It concludes that the borrowers’ register, and the contextual evidence around it, suggests that the library struggled to find a solid footing in the university in its first decades and as it transitioned from a private to an institutional collection.
Matematica e letteratura
Authors: Lolli Gabriele
Published: November 2024

Consapevoli dei drammatici compiti che attendono le nuove generazioni, è necessario che, se si vuole conservare una cultura che permetta di essere partecipi e non sudditi, l’insegnamento della matematica sia proposto a un livello superiore. Il principio che deve guidare i docenti deve essere quello di una continua disposizione creativa appoggiandosi agli esempi storici, ma anche, per fortuna, alla stessa attenzione mostrata da intellettuali umanisti. Abbiamo un esempio convincente che non solo la matematica è narrazione, ma la narrazione deve seguire i percorsi aperti dalla matematica.
Insegnare matematica come narrazione
Authors: Zazkis Rina , Liljedahl Peter
Published: November 2024

In questo articolo viene presentata una selezione di tre capitoli del libro Teaching Mathematics as Storytelling, di Rina Zazkis e Peter Liljedahl (2009), nei quali si mette in evidenza che l’avvicinamento a concetti ardui della matematica con la mediazione delle storie consente un coinvolgimento attivo degli studenti nella costruzione di significati matematici e ne favorisce la comprensione profonda. Gli autori forniscono anche interessanti e molteplici esempi di come rimodulare storie già note, facendo sì che semplici problemi testuali presenti sui libri scolastici, diventino accattivanti spunti di narrazione e attività d’aula. Questo abstract, l’introduzione ai tre capitoli e la loro traduzione sono a cura di Angela Donatiello.
Intervención arqueológica en la villa romana de Gárgoles de Arriba (Cifuentes, Guadalajara)
Authors: Alcón García Israel Jacobo
Published: November 2024

Este artículo es el resultado de la intervención arqueológica llevada a cabo durante año y medio en los restos arqueológicos de la villa romana del municipio pedáneo de Gárgoles de Arriba (Cifuentes, Guadalajara). Estos trabajos formaron parte de un proyecto más amplio, que tuvo como objetivo la intervención arqueológica y de restauración en varios Bienes del Patrimonio Cultural del término municipal de Cifuentes (Guadalajara), bajo el amparo de su Ayuntamiento: el castillo y parte de las murallas del albacar, lo que vino a denominarse como Entorno 1 - Fortificaciones Medievales; y la villa romana del municipio pedáneo de Gárgoles de Arriba, lo que se designó como Entorno 2 - Villa Romana.
Este artículo se centra en los trabajos desarrollados en el Entorno 2 - Villa Romana. Éstos consistieron en el acondicionamiento de los restos arqueológicos ya conocidos, en la excavación arqueológica de un sondeo estratigráfico, en la valoración del estado de conservación de las estructuras, y, por último, en la instalación de un panel informativo con los datos más relevantes del yacimiento. Estos cometidos se desarrollaron con una metodología sistemática y minuciosa, que dieron como resultado una provechosa información arqueológica que suma, si cabe, a los datos ya obtenidos de las anteriores investigaciones.
El asentamiento de tejada. Floruit y Lapsus de un enclave campiñés a la luz de las fuentes textuales y cartográficas
Authors: Vidal Teruel Nuria
Published: November 2024

El poblamiento de las comarcas campiñesas del suroeste peninsular ibérico se caracteriza por una larga diacronía sustentada en dos factores principales, la bonanza climática y la alta capacidad agrológica de los suelos. Buen ejemplo de ello es el asentamiento de Tejada, situado en la actual provincia de Huelva, y ocupado desde momentos protohistóricos hasta inicios de la edad moderna. Su importancia durante la época romana e islámica, evidenciada por su carácter urbano, contrastan con un paulatino declive que, tras un último momento de florecimiento después de la conquista y la posterior repoblación cristianas, cristalizará en su abandono a comienzos del siglo XVI, en favor de otras poblaciones circundantes, tal y como revelan las fuentes textuales, cartográficas y arqueológicas. Su secuencia ocupacional puede servir de modelo para valorar el tipo de poblamiento de carácter urbano y rural entre la margen derecha del río Guadalquivir y la costa de Huelva en un típico paisaje andaluz de campiña.
L’Arco di Santa Maria a Portus. Analisi preliminare del monumento
Authors: Frumenti Ilaria
Published: November 2024

Il presente lavoro propone lo studio analitico della cosiddetta Porta o Arco di Santa Maria, ovvero uno degli antichi accessi al Porto di Roma.
La Porta, avente pianta quadrata, nasce in concomitanza con la costruzione delle “Contromura interne” dello scalo portuale, nell’ultimo quarto del V secolo per consentirne l’accesso lungo il settore S-E.
Oltre ad essere l’unico ingresso monumentale tuttora conservato lungo il circuito murario, è probabile che la porta di Santa Maria possa essere stata una delle porte principali, consentendo l’accesso alla città a chi giungeva da Roma tramite la via Portuense.
La struttura mostra una straordinaria testimonianza di continuità della vita all’interno della città di Porto che va ben oltre il VI secolo d.C., attestato anche dalla rilevazione di una serie di restauri che, in periodi naturalmente differenti, coprono un arco temporale che va praticamente dalla sua realizzazione nel V secolo d.C. fino agli interventi del XV secolo d.C.
Una nueva inscripción romana en el castillo de Aroche: el yacimiento de Arucci y el aprovechamiento de materiales arquitectónicos, decorativos y epigráficos.
Authors: Medina Rosales Nieves , González Fernández Julián , Bermejo Meléndez Javier
Published: November 2024

Se presenta en este trabajo una nueva inscripción romana procedente, probablemente, del entorno del yacimiento de Arucci (San Mamés, Aroche, Huelva). Dicha inscripción se ha localizado en el contexto del castillo reutilizada como material de acarreo en las fases de remodelación de la fortaleza a inicios del s. XIX, momento al que pertenece una de sus últimas fases constructivas a gran escala producto de la construcción de la plaza de toros. El hallazgo de esta pieza supone un testimonio epigráfico más del rico ambiente aruccitano así como del proceso que históricamente ha sufrido el yacimiento, convertido en cantera de materiales tras su desaparición en la Antigüedad Tardía hasta prácticamente el periodo contemporáneo.
Kualitas Pelayanan Kefarmasian di Puskesmas Tampa Padang
Authors: Sahrianti S Nini , Fajriansyah Arif , Nasrullah Nasrullah
Published: November 2024

Pharmaceutical services are a form of pharmaceutical care that aims to maintain the quality of pharmaceutical preparations and support the success of therapy undergone by patients in treatment. The level of patient satisfaction is one way to measure the quality of pharmaceutical services. The purpose of this study was to determine the level of patient satisfaction with pharmaceutical services at the Tampapadang Health Center. This study was a descriptive study using a measuring instrument in the form of a questionnaire containing a list of questions containing 5 dimensions of quality, namely reliability, responsiveness, empathy, tangible, and assurance of service quality. The sample size in this study was 67 respondents determined using accidental sampling. The results of the study showed that the level of satisfaction per dimension was: reliability = the majority was satisfied (100%), responsiveness = the majority was satisfied (97%), empathy = the majority was satisfied (100%), tangible = the majority was satisfied (99%), assurance = the majority was satisfied (96%). Overall, the majority of respondents stated that they were satisfied (99%). Based on the results of the study, it was concluded that patients were satisfied with the pharmaceutical services at the Tampa Padang Health Center.

Keywords: pharmaceutical services; health center; satisfaction; patient

 

ABSTRAK

 

Pelayanan kefarmasian adalah wujud dari asuhan kefarmasian yang bertujuan untuk menjaga mutu sediaan farmasi dan menunjang keberhasilan terapi yang dijalani oleh pasien dalam pengobatan. Tingkat kepuasan pasien merupakan salah satu cara ukur untuk mengetahui kualitas pelayanan kefarmasian. Tujuan penelitian ini adalah untuk mengetahui tingkat kepuasan pasien terhadap pelayanan kefarmasian di Puskesmas Tampapadang. Penelitian ini adalah penelitian deskriptif dengan menggunakan alat ukur berupa kuesioner yang berisi daftar pertanyaan yang memuat 5 dimensi kualitas yaitu reliability, responsiveness, emphaty, tangible, dan assurance kualitas pelayanan. Ukuran sampel dalam penelitian ini adalah 67 responden yang ditentukan dengan menggunakan accidental sampling. Hasil penelitian menunjukkan bahwa tingkat kepuasan per dimensi adalah: reliability = mayoritas adalah puas (100%), responsiveness = mayoritas adalah puas (97%), empathy = mayoritas adalah puas (100%), tangible = mayoritas adalah puas (99%), assurance = mayoritas adalah puas (96%). Secara keseluruhan mayoritas responden menyatakan puas (99%). Berdasarkan hasil penelitian disimpulkan bahwa para pasien merasa puas terhadap pelayanan kefarmasian di Puskesmas Tampa Padang.

Keyword: pelayanan kefarmasian; puskesmas; kepuasan; pasien
Diagnostic value of transnasal fibrolaryngoscopy with a Muller test in the choice of treatment techniques in a patient with moderate ronchopathy and obstructive sleep apnea syndrome: A clinical case
Authors: Ryabova Marina A. , Kralina Darya O.
Published: November 2024

Despite the wide variety of conservative and surgical methods of treatment of obstructive sleep apnea syndrome, choosing therapeutic techniques in affected patients remains relevant. Diagnosis of the level and degree of obstruction of the upper respiratory tract can be carried out by endoscopic examination in both the waking state and during drug-induced sleep. Considering that most patients with obstructive sleep apnea syndrome are older people with a burdened somatic history, with high anesthesiological risk, thorough examination is necessary for the selection of optimal treatment techniques. The article presents in detail the choice and justification of therapeutic techniques in a patient with moderate snoring and obstructive sleep apnea syndrome.
A marker of proliferative activity Ki-67 in assessing the regeneration of the ciliated epithelium after a nasal injury in an experiment
Authors: Berest Iryna Yе.
Published: November 2024

BACKGROUND: Nasal mucosa inflammation in response to surgical trauma is characterized by the development of alternative–dystrophic, vascular–exudative, and proliferative reactions. Immunohistochemical detection of Ki-67 protein expression is one of the most widely used methods for quantifying proliferative activity.
AIM: This study aimed to quantify the proliferative activity of epithelial cells after nasal cavity injury in an experiment under regenerative therapy.
MATERIALS AND METHODS: A preclinical randomized experimental study was conducted on 480 white male rats after experimental rhinitis modeling. The animals were divided into six groups depending on the prescribed regenerative therapy (0.25% solution of sodium deoxyribonucleate, dexpanthenol, and sodium hyaluronate).
RESULTS: After trauma induction, the specific weight of the proliferating epithelial cells in the mucous membrane of the nasal cavity increased from days 10 to 30 of observation. In groups that received reparants, the proliferative activity of cells increased from day 5 and persisted until days 42–60, the number of proliferating cells did not increase, and no carcinogenic effect was observed. Sodium deoxyribonucleate and dexpanthenol had a more pronounced proliferative effect.
CONCLUSIONS: The immunohistochemical determination of the proliferation marker of the nonhistone protein Ki-67, expressed in all cells during preparation and mitosis, appears relevant and allows its use as a universal marker of proliferating cells. Quantitative assessment of the changes in the proliferative activity of epithelial cells is relevant because it allows for the evaluation of the effectiveness and safety of regenerative therapy.
Structure of morbidity in first-year humanities and technical students
Authors: Tsartsidis Ekaterina A. , Karpishchenko Sergey A. , Klyukovkin Konstantin S.
Published: November 2024

BACKGROUND: Low levels of public health awareness are observed in many countries, regardless of development status. Promotion of health- conscious thinking should be a key strategy of modern government, ideally cultivated during the period of growth and maintained throughout life, adapting as external and internal environmental factors change. Older age groups exhibit a wider range of disease combinations, though the basis for these conditions begins to form during the body’s development, continues throughout life, and directly depends on the health consciousness.
AIM: The aim of the study was to evaluate the causes of disease development in first-year humanities and technical students based on a comprehensive medical examination.
MATERIALS AND METHODS: The study included 1,100 humanities and technical students (550 humanities students and 550 technical students). Results of comprehensive medical examination were analyzed to assess the health status of first-year students, identify major medical conditions, and categorize students by health group considering their conditions.
RESULTS: The structure of the main groups of diseases was as follows: diseases of the eye and adnexa in 35.5% of humanities student and 31.5% of technical students; musculoskeletal and connective tissue disorders in 23.3% of humanities students and 28.7% of technical students; ear, nose and throat diseases in 23.1% of humanities students and 19.5% of technical students; circulatory system diseases in 17.5% of humanities students and 22.9% of technical students. The distribution of students by health groups was as follows: health group 1 included 15.3% ± 1.5% of humanities students and 11.1% ± 1.3% of technical students; health group 2 included 58.8% ± 2.2% of humanitarian students and 48.3% ± 3.1% of technical students; health group 3 included 23.1% ± 1.8% of humanities students and 34.2% ± 2.0% of technical students; health group 4 included 2.9% ± 0.7% of humanities students and 6.4% ± 1.0% of technical students, respectively.
CONCLUSIONS: The data obtained confirmed the high prevalence of various groups of disorders among the younger generation, with ear, nose and throat diseases being one of the most common groups. This underscores the need for regular health monitoring of the younger generation, along with preventive and rehabilitative measures, to mitigate the development and spread of various groups of diseases.
Haller’s cells in the practice of an otorhinolaryngologist
Authors: Lavrenova Galina V. , Oganyan Kristina A.
Published: November 2024

Haller’s cells are infraorbital ethmoidal cells located along the inferior wall of the orbit. They were first described by Albrecht von Haller in 1743 and were subsequently named after him. The reported prevalence of these cells varies significantly from 2.7% to 45.1%. They are a variant of the normal anatomical structure of the paranasal sinuses. These cells are often incidental findings on computed tomography (CT) of the nasal cavity and paranasal sinuses. Haller’s cells may predispose patients to maxillary sinusitis and may complicate maxillary sinus surgery. In addition, isolated inflammation of these cells with a mucocele formation is possible. A case of cholesterol granuloma of Haller’s cell was also described in the literature. Notably, a relationship exists between the presence of infraorbital ethmoidal cells and the descending course of the infraorbital canal and the presence of dehiscence of the lower orbital wall. However, resecting these cells is at risk of orbital damage. Haller’s cells are identified using CT; on coronal sections, they appear as clearly defined round, oval, or teardrop-shaped formations with clear smooth boundaries, located medial to the infraorbital foramen. Large cells blocking the ethmoidal infundibulum and predisposing to the development of maxillary sinusitis and Haller cell inflammation require surgical treatment. In these cases, endoscopic resection is the method of choice. Rhinosurgeons should be aware of the possible risks involved in the removal of Haller’s cells and manipulations in this area. Preoperatively, CT scans must be reviewed to identify features of the paranasal sinus structure and carefully plan the surgery.
Features of the microbiota of adults and older people under normal and chronic rhinosinusitis conditions
Authors: Tarasova Natalia V. , Stepanenko Irina S. , Belan Eleonora B. , Sokolova Maria V. , Kosov Vyacheslav A.
Published: November 2024

BACKGROUND: Aging is naturally associated with morphofunctional rearrangement.
AIM: This study aimed to examine and compare the microbiota of adult patients with chronic rhinosinusitis aged 60–95 and 45–59 years.
MATERIALS AND METHODS: The study was performed in Volgograd Regional Clinical Hospital No. 1 in an otorhinolaryngological adult department. Laboratory studies and microorganism identification were performed in the bacteriological department of the clinical diagnostic laboratory of Clinic No. 1 of Volgograd State Medical University. All patients underwent endoscopic examination of the nasal cavity with a smear from the middle nasal passage. After sampling, the material was delivered to the laboratory for all bacteriological examinations and microorganism identification.
RESULTS: During the bacteriological study, 6 genera and 12 species of microorganisms were isolated (relative frequency of isolation %), and Staphylococcus spp. (78.45%) and Enterococcus spp. (16.45%) were the main representatives of the microbiota in the nasal cavity of patients aged 45–95 years. Staphylococcus spp. represent the basis of the microbiotype in the sinonasal microbiome and the predominant genus in patients regardless of the pathologies of the nose and paranasal sinuses. Staphylococcus aureus (45.48%), Staphylococcus haemolyticus (19.57%), and Enterococcus faecalis (9.99%) were the three dominant types in all age groups. However, in patients aged 60–95 years with chronic rhinosinusitis, in addition to Staphylococcus spp. (66.67%) and Enterococcus spp. (10.67%), representatives of Pseudomonadales (6.01%) and Candidiales (6.0%) were also observed. In patients aged 60–95 years with chronic rhinosinusitis, the microbial landscape of the nasal mucosa was represented by various strains of Staphylococcus spp.
CONCLUSIONS: The microbiota in patients aged 60–95 years with chronic rhinosinusitis is very diverse compared with those in younger individuals and patients without inflammatory diseases of the nose and paranasal sinuses.
Use of split cellulose for ear packing: comparative experimental evaluation based on postoperative clinical and microbiological observations
Authors: Khorov Oleg H. , Sak Victor N. , Chernova Natalya N. , Yanovich Regina V.
Published: November 2024

BACKGROUND: Postoperative packing of the external auditory canal is still controversial. The shape of a wick, its material, the time of its presence in the ear canal and in the postoperative cavity, and the type of packing depending on the type of surgery are still under discussion. There are many different packing techniques, but there is no single standardized one.
AIM: The aim of the study was to evaluate characteristics of split cellulose compared to other materials for ear canal packing after ear surgery in an animal experiment based on postoperative clinical and microbiological observations.
MATERIALS AND METHODS: For the experiment, 36 chinchilla rabbits were used. The animals were divided into three groups according to the material of the ear canal wick: cellulose, microporous sponge of hydrolyzed polyvinyl acetate; medical gauze. The condition of the postoperative wound, the condition of the wicks for the presence of ear discharge, and the inflammatory response of the ear canal tissues were assessed. A microbiological study involved isolation and identification of pure bacterial cultures. Microbial growth was assessed based on the count of colony forming units (CFU).
RESULTS: The study showed that the presence and degree of clinical response did not correlate with the type of packing material in the ear canal. The ear canal packing with split cellulose, microporous hydrolyzed polyvinyl acetate sponge, medical gauze did not cause the growth of pathogenic microflora during the experimental period up to 21 days, and the absence of significant local reaction of the tympanic membrane and ear canal in rabbits suggests that split cellulose can be used as one of the promising import-substituting packing materials for ear canal and trepanation cavities after middle ear surgeries.
A modern understanding of IgA nephropathy and hemorrhagic vasculitis as tonsillogenic diseases and effects of tonsillectomy on their progression
Authors: Zaitseva Tatiana S. , Nesterova Anna  A. , Nesterova Klimentina I. , Mirakyan Ruben G. , Lesnykh Anastasia A. , Eremchenko Vladislav O. , Volosnikova Anastasia R. , Ermolaeva Maria V. , Terre Valeria V.
Published: November 2024

IgA nephropathy and hemorrhagic vasculitis are IgA-mediated meta-tonsillar diseases. The literature on their pathogenesis, association with chronic tonsillitis, and effects of tonsillectomy on their progression was reviewed. In patients with IgA nephropathy, tonsillectomy is associated with higher rates of clinical remission, suppressing progression of renal failure as a result of decreased mucosal production of abnormally galactosylated IgA1 molecules. This finding is supported by high-quality studies in Asian populations and isolated comparative studies in Caucasians. For this reason, Asian guidelines, especially Japanese, include tonsillectomy as a treatment option for this group of patients.
In hemorrhagic vasculitis, tonsillectomy is only effective in clinical forms with renal impairment. For other forms, symptomatic treatment is preferred, and tonsillectomy is indicated when there is a proven association between attacks of chronic tonsillitis and deterioration of kidney function. Further research is needed in this area with a larger population of patients with IgA-mediated diseases and with the ability to evaluate the impact of genetic characteristics on treatment outcome.
Decannulation of tracheostomized infants after choanoplasty
Authors: Breeva Olga A. , Polunin Mihail M. , Asmanov Alan Ismailovich
Published: November 2024

BACKGROUND: The paper outlines stages of decannulation in tracheostomized infants with congenital choanal atresia following a stentless surgery using upper septal flaps fixed with fibrin glue.
AIM: The aim of the study was to optimize preparation, timing, and prognostic factors for successful decannulation in infants after choanoplasty.
MATERIALS AND METHODS: The study included 11 tracheostomized children under 1 year of age with congenital choanal atresia. The treatment group included tracheostomized children who undergone standard choanoplasty with stents (n = 5). The comparison group included tracheostomized children admitted for primary surgery (n = 6). Endoscopic examination and tracheobronchoscopy were performed to evaluate treatment outcomes, and saturation was measured with a closed tracheostomy.
RESULTS: In group 1, endoscopic examination of the nasal cavity and nasopharynx revealed that neochoanae were too small (less than 50% of the norm) for decannulation; revision surgery was required using a stentless technique. In group 2, patients after the stentless choanoplasty showed no signs of re-stenosis during the follow-up period (3–6 months). They underwent successful decannulation at different time points after surgery. Over the one-year follow-up, no re-stenosis was observed in either group. In 9 patients, successful decannulation was performed at various time points after surgery. In 2 patients, decannulation was delayed.
CONCLUSIONS: Long-term mechanical ventilation is unsuitable in patients with bilateral choanal atresia, and tracheostomy is a common solution for respiratory failure. However, tracheostomy can have many early and late postoperative complications, so decannulation should be performed as soon as possible after nasal breathing is restored. The proposed endoscopic approach using a vascularized mucosal flap and fibrin glue appears to be the method of choice for choanoplasty in tracheostomized children. The process of decannulation in children, even with the restoration of nasal breathing after choanaplasty, is extremely complex and is associated with many risks.
In memory of Valentina P. Bykova (1935–2024)
Authors: Karpishchenko Sergey A.
Published: November 2024

Valentina P. Bykova, MD, Professor, Full Member of the International Academy of Otorhinolaryngology-Head and Neck Surgery, Board Member of the Moscow Society of Pathologists, passed away on May 19, 2024. Valentina Pavlovna was the head of the pathological anatomy laboratory of the of the National Medical Research Center for Otorhinolaryngology of the Federal Medical and Biological Agency of Russia.
The First Eurasian International School of Young Otorhinolaryngologists: «Pluzhnikov Readings»
Authors: Tulebayev Rais K. , Karpishchenko Sergey A. , Azhenov Talapbek M.
Published: November 2024

The Congress “Pluzhnikov Readings: The First Eurasian International School of Young Otorhinolaryngologists” was held in Astana in the Republic of Kazakhstan. The congress was dedicated to the 60th anniversary of Astana Medical University and the memory of the iconic otorhinolaryngologist Professor Marius Pluzhnikov, who became a mentor for a whole generation of otorhinolaryngologists. This congress for “extraordinary” Pluzhnikov readings was originally conceived by Academician of the National Academy of Sciences Rice Tulebayev and Professor Sergey Karpishchenko. During the congress, a master class on modern endoscopic surgery was held at the otolaryngological clinic of BMC UDP and NCC ENT Center at the first city hospital of Astana. Well-known scientists and experts from different cities and countries spoke to the participants, who shared their rich experiences. Specialists-otorhinolaryngologists, immunologists, radiologists, therapists, and pediatricians had a unique opportunity to get acquainted with the latest international achievements in otorhinolaryngology, ask questions to lecturers, and take part in discussions.
A modern understanding of role of tonsillectomy in tonsillogenic neurological diseases and neuropsychiatric disorders
Authors: Zaitseva Tatiana S. , Nesterova Anna A. , Nesterova Klimentina I. , Mirakyan Ruben G. , Shcherbina Irina A.
Published: November 2024

The association between chronic tonsillitis and neurological and neuropsychiatric disorders is well described in the literature. The role of streptococcal infections is considered obvious, although there is no clear understanding of the pathophysiological mechanism. A cross autoimmune reaction with basal ganglia antigens is thought to play a key role in the development of this group of disorders.
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are the most studied of these groups. Antibacterial therapy is the main treatment option, but there are no reliable recommendations for its use.
No significant changes in the clinical manifestations were observed after tonsillectomy, and the positive results described in some observational studies could have been caused by postoperative treatments.
The paper suggests that chronic tonsillitis may have an effect on the risk of other mental disorders, such as obsessive-compulsive disorder, bipolar disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety disorders, and migraines.
Large randomized trials are needed to make definitive conclusions about the advisability of tonsillectomy in patients with PANDAS and other disorders. One of the most promising areas is to study the microbiota of the palatine tonsils and its contribution to migraine. If confirmed, these data will increase importance of nonsurgical treatment of palatine tonsils by their thorough irrigation.
Development of a graphical interface for medical data standardization for individuals with hearing disorders
Authors: Gavrilov Andrei V. , Kaplun Dmitry I. , Garbaruk Ekaterina S. , Boboshko Maria Yu.
Published: November 2024

BACKGROUND: One of the key tasks in healthcare practice is to collect and process patient data, especially in individuals with hearing impairments, because audiological examination includes a wide range of tests to determine severity and type of hearing loss and damage to the auditory system, to diagnose central auditory processing disorders, and to monitor auditory and speech rehabilitation. Collecting and processing data from such individuals is a complex task that requires precision and a high level of automation, as traditional manual data entry methods may have problems such as high error rates, time inefficiencies, and difficulty standardizing data.
AIM: The aim of the study was to develop a computer program for standardized and automated collection of personal and medical data of individuals with impaired hearing at the stages of diagnosis and auditory and speech rehabilitation.
MATERIALS AND METHODS: A total of 515 individuals with impaired hearing were evaluated? of whom 340 used hearing aids. In this study, a Graphical User Interface (GUI) was developed to standardize personal and medical data for patients with peripheral and central auditory system disorders at the stages of diagnosis and auditory and speech rehabilitation.
RESULTS: The program, developed in Python using the Kivy library, ensures cross-platform compatibility and flexibility. This software is designed to increase the speed and convenience of medical data collection, reducing and minimize errors and typos when entering test results through a simple, user-friendly interface.
CONCLUSIONS: The proposed GUI application improves the accuracy and reliability of the collected data, which is critical for the diagnosis and rehabilitation of patients.
Clinical features of COVID-19 in children with a chronic adenotonsillar disorder
Authors: Afanasev Vladislav V.
Published: November 2024

BACKGROUND: COVID-19, caused by SARS-CoV-2, is a highly contagious infectious disease associated with a risk of severe complications. In Russia, the COVID-19 incidence has exceeded 24 million, with new strains raising the incidence in children up to 18%. The prevalence of long COVID is rising. In children, the adaptive immune system, including the lymphoepithelial ring of the throat, plays a key role in determining the severity of COVID-19. The lymphoid tissue of the Waldeyer’s ring is one of the first immune barriers against coronaviruses and other respiratory infections. The high incidence of co-infection worsens the course of the disease. A chronic adenotonsillar disease has incidence of 32%–35% in children. However, impact of this disease on the severity of COVID-19 and the incidence of co-infection in children is poorly understood.
AIM: The aim of the study was to evaluate impact of the chronic adenotonsillar disease on COVID-19 progression and the incidence of co-infections in children.
MATERIALS AND METHODS: Conducted in St. Petersburg from January 2022 to March 2023, the study included 493 children (300 with COVID-19 and 144 with chronic adenotonsillar disease). Patients were divided into four groups to evaluate impact of chronic adenotonsillar disease on COVID-19 progression. Non-parametric statistical methods were used to analyze the clinical data.
RESULTS: Children with both COVID-19 and chronic adenotonsillar disease demonstrated a more severe course of disease compared to those without chronic adenotonsillar disease. The first group showed an increased incidence of bronchitis, bacterial co-infections, longer hospitalization and disease duration, longer fever duration, and higher maximum temperature. Laboratory data showed higher white blood cell counts in patients with COVID-19 and chronic adenotonsillar disease compared to those without chronic adenotonsillar disease.
CONCLUSIONS: Chronic adenotonsillar disease significantly complicates the course of COVID-19 in children. Further research is needed to elucidate the pathophysiological mechanisms and optimize treatment strategies for children with chronic adenotonsillar disease.
Blood biomarkers of hepatocellular carcinoma: a critical review
Authors: Zhao Junsheng , Hu Zekai , Zheng Xiaoping , Lin Yajie , Liu Xiao , Zhang Junjie , Peng Jing , Gao Hainv
Published: November 2024

Hepatocellular Carcinoma (HCC) is a malignant tumor with high morbidity and mortality worldwide, which represents a serious threat to human life, health and quality of life. Blood-based detection is essential for HCC screening, early diagnosis, prognosis evaluation, and surveillance. Current non-invasive detection strategy including serum alpha-fetoprotein (AFP), ultrasound, computerized tomography, and magnetic resonance imaging. The limited specificity of an AFP and the dependence on operator experience and diagnostic personnel for ultrasound have constrained their utility in early HCC diagnosis. In recent years, with the development of various detection technologies, there has been an increasing focus on exploring blood-based detection markers for HCC. The types of markers include protein markers, DNA mutation, DNA epigenetic modification, mRNA, miRNA, and so on. However, numerous methodological and biological factors limit the clinical sensitivity and generalization performance of these new biomarkers. In this review, we describe the state-of-the-art technologies for cfDNA analysis, and discuss outstanding biological and technical challenges that, if addressed, would substantially improve HCC diagnostics and patient care.
Developing a participatory research framework through serious games to promote learning for children with autism
Authors: Abd El-Sattar Hussein Karam Hussein , Omar Manal , Mohamady Hoda
Published: November 2024

People with autism, or Autism Spectrum Condition (ASC), is becoming increasingly common worldwide. Since individuals with ASC vary in their skills and methods that work for one may not work for another, many technology designers find it challenging to engage effectively with this population. Serious games (SGs) offer an intelligent learning environment that supports lifelong learning for individuals with ASC. Despite the availability of several frameworks, the question of whether SGs for individuals with ASC can have a dedicated framework remains unresolved. The objective of this study is to create a general framework for the design of serious games that can be applied to a variety of SGs targeting individuals with autism. A new participatory research framework is presented to assist game designers and relevant stakeholders in developing effective SGs for people with ASC. Through participatory sessions and a design thinking process, this framework seeks to involve users and relevant stakeholders as “design partners” in the design process. The framework was employed in the development of a new SG, called SALY (Simulation, Attention, Learn, and PLAY), designed to improve attention span and emotion recognition in individuals with ASC. Three research questions are discussed, and the mixed-methods approach adopted for the investigation. Several usability metrics were used to evaluate the game’s effectiveness, efficiency, and user satisfaction. The results show that the proposed game holds significant potential and will be of interest to educators and learners alike.
School entry detection of struggling readers using gameplay data and machine learning
Authors: Foldnes Njål , Uppstad Per Henning , Grønneberg Steffen , Thomson Jenny M.
Published: November 2024

Introduction

Current methods for reading difficulty risk detection at school entry remain error-prone. We present a novel approach utilizing machine learning analysis of data from GraphoGame, a fun and pedagogical literacy app.

Methods

The app was played in class daily for 10 min by 1,676 Norwegian first graders, over a 5-week period during the first months of schooling, generating rich process data. Models were trained on the process data combined with results from the end-of-year national screening test.

Results

The best machine learning models correctly identified 75% of the students at risk for developing reading difficulties.

Discussion

The present study is among the first to investigate the potential of predicting emerging learning difficulties using machine learning on game process data.