bluuebunny/crossref_metadata_2025 huggingface dataset:
BEAPS
Authors:   , Kumar Abishek Sampath , Rank Stefan
Published: February 2023

Video games have become highly detailed not only visually but also in terms of interactivity: Advanced agent control architectures enable immersive performances of game characters, autonomously adapting behavior based on skeletal animations to the narrative context; Simulation of particle-based soft-body dynamics enable novel expressive interactive behaviors using real-time mesh deformation. Interactive soft-body dynamics are not commonly applied to game characters and are usually only passively applied to environmental objects as special effects without involvement in game play or reactive mechanics. Integrating controllers of soft-body dynamics with agent control architectures in a tractable way would allow for a wide range of new dynamic effects for interactive characters and reactive environmental objects. I demonstrate the feasibility of incorporating soft-body simulations in an agent prototyping pipeline. The BEAPS system (Behaviors for Expressive and Adaptive Particle Systems) allows for interactive soft-body effects as actions usable in agent behaviors and suitable for coordinating expressive interactivity in a narrative context. Skeletal animation is combined with a soft-body simulation which adds physically based effects. Users of the system can deform and customize the mesh as well as adjust soft-body parameters to adapt these effects and integrate them into a behavior library. In order to demonstrate the value of coordinating behaviors for poses and the mesh effects in a narrative setting, controllers that act as an intermediary between the modules for altering soft body dynamics and a central agent coordinator have been built. A modular hierarchical framework is most suitable for extending behaviors that allow for interactive customization and runtime parameterization. Example scenarios and effects are created in the KADAPT agent prototyping library to demonstrate the value of interactive modules for soft dynamics when coordinated with behavior control. The system's capabilities are evaluated with respect to traditional and data-driven approaches to character animation. BEAPS is a step towards improving the visual and interactive appeal of autonomous virtual agents and their actions. The ability of the designer to alter or customize the mesh via dynamic effects that arise as result of interactive soft-body simulation allows for more diverse and expressive mechanics for humanoid and non-humanoid agents in games.
La importancia de establecer estrategias de marketing de relaciones en las agencias de viaje españolas
Authors: Rodríguez-Pallas Ángel
Published: February 2023

El modo de concebir y aplicar el marketing en el ámbito empresarial ha evolucionado y se ha reinterpretado de manera sucesiva, abandonando el planteamiento del marketing transaccional para dar cabida a un enfoque denominado marketing activo o de relaciones, centrado en la figura del consumidor y en satisfacer sus deseos y necesidades; persiguiendo como último objetivo su mejora y el establecimiento de relaciones duraderas con los consumidores. Esta investigación persigue el objetivo principal de analizar la importancia que supone el llevar a cabo estrategias de marketing de relaciones en las agencias de viaje. Tras una revisión de la literatura y en virtud a los aspectos inherentes a este estudio, se optó por la realización de una metodología cualitativa mediante la aplicación de entrevistas en profundidad a agentes de viajes minoristas tanto del ámbito presencial como virtual operando en España. Las conclusiones alcanzadas, corroboran que el marketing de relaciones en las agencias de viajes nacionales se desarrolla de una manera no homogénea; resultando necesario para las agencias tradicionales pequeñas la implantación de estrategias de marketing relacional en el ámbito virtual; y observándose que las estrategias implantadas no implican en todos los casos a toda la organización.
Fabrication and characterization of photosensitive non-isocyanate polyurethane acrylate resin for 3D printing of customized biocompatible orthopedic surgical guides
Authors: Wang Yan , Zheng Zhichao , L. Pathak Janak , Feng Weiwei , Wu Weicong , Yang Chuangang , Wu Lihong , Zheng Huade
Published: February 2023

Three-dimensional (3D)-printed orthopedic surgical guides have the potential to provide personalized precision treatment. Non-isocyanate polyurethane (NIPU) is commonly used in the 3D printing of biomedical materials but its application in the orthopedic surgical guide is limited by poor mechanical properties and biocompatibility. In this study, we fabricated non-isocyanate polyurethane acrylate (NIPUA) photosensitive resin with superior biocompatibility and mechanical properties required for 3D-printed orthopedic surgical guides. NIPU prepolymer was synthesized by a ring-opening reaction and a ring acrylation reaction. NIPUA was further synthesized using polyethylene glycol diacrylate (PEGDA) as a modified material based on sustainable synthesis with reduced synthesis time. NIPUA showed the best tensile and flexural strengths when the PEGDA content reached 12 wt.%. NIPUA exhibited higher thermal stability, hemocompatibility, superior biocompatibility to ME3T3-E1 bone cells and C1C12 muscle cells, and non-immunogenic effect toward macrophages compared with commercial photosensitive resins. Commercial resins triggered a severe inflammatory response during in vivo implantation, but this effect was not observed during NIPUA implantation. Transcriptome analysis showed downregulation of cell death and cell cycle disruption-related genes, such as CDK2, CDKN1a, and GADD45a, and upregulation of autophagy and anti-tumor activity-related genes, such as MYC, PLK1, and BUB1b, in NIPUA-treated MC3T3-E1 cells compared with commercial resin-treated MC3T3-E1 cells. In conclusion, NIPUA resin showed excellent mechanical and thermal properties as well as good biocompatibility toward bone cells, muscle cells, and macrophages, suggesting its possible application in the 3D printing of customized orthopedic surgical guides.
Estrategias en pugna para el control del guano y la cascarilla en Bolivia
Authors: Colàs Pol
Published: February 2023

En este trabajo, trato de analizar las diferentes estrategias que adoptaron tanto la administración de José Ballivián (1841-1847) como los grupos dirigentes locales frente al auge económico del guano y la cascarilla en Bolivia de forma comparativa. Para eso, expongo el corpus legal creado por el Estado central en consecuencia, las contratas firmadas por este con empresas extranjeras para la exportación de sendos recursos y las respuestas articuladas por la localidad, siendo el contrabando la más destacada. Considero que la firma de las contratas monopolísticas fue rechazada por parte de la población local, que a través de la ilegalidad propuso otro modelo político y económico para el trato con el guano y la cascarilla y, en definitiva, expuso la existencia de otras vías de construcción del Estado en el siglo XIX latinoamericano.
“Una lacra social y un peligro”: vagancia y malvivencia en la ciudad de México, 1931-1937
Authors: Rojas Sosa Odette María
Published: February 2023

El presente trabajo analiza, por un lado, cómo influyó el concepto de “peligrosidad”, acuñado por la criminología, en la construcción del tipo penal de “vagancia-malvivencia”, el cual se consignó en el artículo 255 del Código Penal de 1931. Por otro lado, a partir de la revisión de expedientes judiciales, se examina la persecución contra vagos-malvivientes en la ciudad de México entre 1931, año en que se promulga el Código Penal, y 1937, año en que inicia una campaña de las autoridades para reprimir dicho delito. El artículo muestra que en ese periodo la persecución y sanción de la vagancia y malvivencia transitó de una cuestión policiaca y administrativa a una actividad judicializada que respondía a las políticas de profilaxis social del cardenismo. El tema ha sido escasamente estudiado, por lo que este texto pretende ser una aportación para la historiografía de la criminalidad y la transgresión en el México posrevolucionario.
Retinal arterial macroaneurysm in a patient with arterial hypertension
Authors: Masten Matejka , Hudovernik Mojca , Pahor Dušica
Published: February 2023

Purpose: To present a case of retinal arterial macroaneurysm in a 48–year–old male patient with systemic arterial hypertension.

Case report: A 48–year–old male was admitted to our department because of progressive deterioration of visual acuity in his right eye. He reported diplopia and blurred central field vision. The patient was treated for systemic arterial hypertension and had no other known medical problems. Medical treatment, examination results, and therapy were presented in this case report.

Conclusions: In the treatment of patients with retinal arterial macroaneurysm a holistic approach is important. In an attempt to optimize the final outcome of the patient's treatment, both the ocular symptoms and systemic risk factors should be treated. Therapeutic interventions for eyes with retinal arterial macroaneurysm include laser photocoagulation, pneumatic displacement of haemorrhage, vitreoretinal surgical techniques, the use of neodymium–doped yttrium aluminium garnet or argon laser, and intravitreal injections of anti–vascular endothelial growth factor drugs. Their precise roles should be evaluated in further studies.
Giant symptomatic hydatid cyst requiring pneumonectomy
Authors: Crnjac Anton , Hojski Aljaž , Greif Boris , Petek Tadej , Vidovič Damjan
Published: February 2023

Purpose: This paper discusses the diagnostic approach, treatment and certain complications in the treatment of patients with hydatid lung disease. The objective of surgical treatment is removal of the cyst and preservation of the healthy lung parenchyma. In cases of overgrowth of the pulmonary artery, which are rare, it is sometimes necessary to remove the lung;this is linked with the possibility of serious postoperative complications.

Case report: We present the case of a 27–year–old patient with a hydatid cyst overgrowing the pulmonary artery and requiring removal of the left lung. After the surgery, acute respiratory distress syndrome (ARDS) developed in the remaining right lung. Extracorporeal membrane oxidation (ECMO) was required. Despite a serious complication of the extensive surgical resection, the patient left the hospital after four weeks without major health problems.

Conclusion: In patients with giant pulmonary hydatidcysts it is possible to perform surgery, preserve the lung and continue treatment with the addition of albendazole therapy. The removal of the lung, on account of overgrowth of the pulmonary artery, can significantly affect the course of postoperative treatment. When planning the surgical procedure, a precise image of the pulmonary hilar structures is essential.
Mechanisms and Prevention of Open Globe Eye Injuries
Authors: Kuhta Katja , Pahor Dušica
Published: February 2023

Purpose: Open globe injuries are a frequent cause of unilateral vision loss. The purpose of our study was to determine the epidemiological data of open globe injuries during a 15-year period in Central East Slovenia.

Methods: A retrospective analysis of 219 patients (219 eyes) with open globe injuries admitted to the Department of Ophthalmology in the University Clinical Centre Maribor, Slovenia, from January 1999 to January 2014 was performed. We analyzed the following parameters: sex, age, month of injury, place of injury, type of injury, and mechanism of injury, grouped according to sex.

Results: The majority of patients were male (186 patients, 85%). The mean age of male patients was 38 years with almost 45% of injuries occurring in the age interval between 30 and 50 years. Most injuries occurred during the colder part of the year from October to January. The most common place of injuries was the home (126 eyes, 66.5%). The most common open globe injuries were penetrating injuries (126 eyes, 57.6%) and rupture of the globe (49 eyes, 22.4%). Males most frequently experienced open globe injuries as a result of sharp objects (86 eyes, 46%), while in females, the most common causes of injuries were falls (10 eyes, 31%) and blunt objects (10 eyes, 31%).

Conclusions: The vast majority of eye injuries are preventable. Studying the causes of injuries for a determined region is important to provide for preventable measures, like the use of eye protection, and to provide health education, to prevent severe vision loss or blindness.
Preparing patients to undergo surgery
Authors: Rakovec Felser Zlatka , Planinc Špela , Matvoz Marjanca , Vidovič Lea
Published: February 2023

Purpose: This study aimed to evaluate patient anxiety levels and ways of coping, while they are waiting in the hospital to undergo surgery.

Methods: One hundred fifty-four patients were included from four different surgical departments (62 females and 92 males), 24–86 years of age (mean age [M] = 58.8 years). The following instruments were applied: a semi-structured interview; the State-Trait Inventory for Cognitive and Somatic Anxiety; and The Brief Cope Inventory.

Results: One-half of the patients (50%) expressed a fear to undergo surgery; 28 % of the patients said that they were afraid of anaesthesia, regarderless of the type of anaesthesia, and 54% of patients expressed a fear and worry about the outcome of surgery. Women (Mas ± SDas =32.58±8.01; Mat ± SDat =35.16±8.97; in general, Ma ± SDa =67.74±15.44) had state and trait anxiety significantly more often than men (Mas ± SDas =28.11±6.21; Mat ± SDat =30.29±7.48; in general Ma ± SDa=58.40±12.74). Elderly males fall due to the received weak social support into the risk group of patients. They less often/less directly express their needs and emotions, and are less active in searching for information or advice in the social environment. In stressful situations, elderly males also frequently give up the attempt to obtain the goals with which the stressor is interfering.

Conclusion: Patients who wait to undergo surgery should not suffer anxiety needlessly because it is known that anxiety has a negative impact on the course and outcome of surgical procedures. The pre-operative management of a patient’s anxiety is therefore important and a well-educated medical care team should be familiar with the appearance of anxiety, communication skills, and relaxation treatment.
A Comparison of Incidence of Patient Aggression in the University Psychiatric Clinic Ljubljana and at the Department of Psychiatry of the University Medical Centre Maribor
Authors: Žgavec Nace , Kores Plesničar Blanka
Published: February 2023

Purpose: Management of aggressive behaviour in patients with psychiatric diagnoses presents a challenge and burden for health staff. The present study compared two psychiatric institutions (the Department of Psychiatry of the University Medical Centre Maribor and the University Psychiatric Clinic Ljubljana) in terms of frequency and consequences of patient aggression. We compared frequencies of aggression between male and female patients, patients diagnosed with schizophrenia and other diagnoses, previously aggressive patients and patients who were aggressive for the first time. We also compared the use of special protective measures in both institutions.

Methods: This study was retrospective and included the analysis of documentation of patients who were hospitalised at both institutions from 1 January 2012 to 31 June 2012. We identified patients with aggressive behaviour and acquired their sociodemographic data, diagnosis, number of hospitalisations, presence of alcohol or psychoactive substances and presence of aggressive behaviour. For assessment of aggressive behaviour, the Overt aggression scale was used. 

Results: One-hundred and forty-seven patients met the criteria for aggressive behaviour. There was no statistically significant difference in the frequency of aggression between genders or diagnoses. However, there was a statistically significant difference (p ≤ 0.01) in the frequency of aggression in patients who had previously been aggressive compared to those patients who had not exhibited such behaviour. There was no statistically significant difference in the use of special protective measures between the two institutions.

Conclusions: Two hypotheses were confirmed: patients who had exhibited previous aggression were more frequently aggressive than those with no previous aggressive behaviour while the use of special protective measures between the two institutions was similar.
Beliefs and viewpoints of family medicine physicians on approaches to identify and treat medically unexplained symptoms
Authors: Ivetić Vojislav , Poplas Susič Tonka , Pašić Klemen , Selič Polona
Published: February 2023

Purpose: The purpose of our study was to identify the beliefs and viewpoints of family medicine physicians (FMPs) on the approaches to identify and treat medically unexplained symptoms (MUS).

Methods: We used qualitative and quantitative research methods, and prepare a purposive sample for the implementation of five focus groups (three in Maribor and two in Ljubljana) between July and September 2011. The findings were used as questions in the quantitative part of the study applying random sampling (n = 90). FMPs were invited throughout Slovenia to participate in our study (January – March 2012). Analysis of qualitative material was performed using ATLAS.ti 7 software, and quantitative data were statistically processed using SPSS 21.0.

Results: In the process of coding, we created 64 codes, which were categorized into 8 categories. In the quantitative part, we received responses from 63 (70%) of the invited FMPs, 84.1% (n = 53) and 77.8% (n = 49) of whom stressed the importance of MUS prevention and treatment, and the importance of good communication, respectively. Of the 63 FMPs, 93.7% (n = 59) were of the opinion that patients with MUS leave feeling exhausted. As potential reasons for MUS, FMPs described problems in patients’ interactions with their surroundings (100%, n = 63), past and current stressful events (96.8%, n=61), and occult psychiatric diseases (68.3%, n = 43). The quality of MUS patient care would improve with more education in the field of basic psychotherapeutic techniques, difficult patient approaches (95.2%, n = 60), and communication skills (95.2%, n = 60).

Conclusion: We found that Slovenian FMPs place a strong emphasis on prevention and treatment of patients with MUS, and these patients generally leave them feeling tired and frustrated.
Progressive muscle weakness due to lumbar disc herniation in pregnancy: A case report
Authors: Rečnik Gregor
Published: February 2023

Purpose: Low back pain with radiculopathy caused by lumbar disc herniation is a rare presentation in pregnancy. Appropriate management is based on helping the gravida, while protecting her unborn offspring.

Case report: A case of a 35–year–old pregnant woman in the 15th week of pregnancy with disabling pain and progressive motor weakness due to L4–L5 disc herniation is presented. Surgical decompression was performed with an aim to alleviate disabling pain and improve muscle strength.

Conclusions: Treatment of disc herniation in pregnancy is conservative in the majority of cases. In the rare likelihood of permanent neurologic sequelae, surgical decompression is indicated, taking into account the specific physiologic condition of pregnancy.
From the editorial to the Book of Portraits on its Way / Iz uvodnika Knjigi portretov na pot
Authors: Kranjc Ivan
Published: February 2023

(The book will come out in the publishing house Faculty of Medicine University of Maribor)

In 2014, on the tenth anniversary of operations of the University of Maribor Faculty of Medicine, we published the monograph "Ten Years of the Faculty of Medicine of the University of Maribor". In the monograph, we provided a description of the creation and operation of the second Slovenian medical faculty. Much has happened since the first decade and we have already advanced into the second. An attentive observer would not have missed the important milestones of our development from the establishment of the Bologna Reform to our greatest achievement—building an urgently needed faculty on the right riverbank of the Drava River. Following the ideas of the Architecture Professor Boris Podrecca, the faculty is attached to the city and the university. All along, especially since September 2013, we have monitored the development of our medical studies, introduced new features to the program, and developed or renewed basic research studies. Novel appropriate premises and stateof- the-art medical equipment have been the basis for the formation of numerous innovations and changes.
Infracochlear approach to the petrous apex: a report of two cases
Authors: Rebolj Janez , Milojković Vojin , Cvetić Goran
Published: February 2023

Purpose: Presentation of the infracochlear approach to the petrous apex of the temporal bone, based on two clinical cases.

Case report: Infracochlear approach to the petrous apex of the temporal bone was performed on two patients with cholesterol granuloma and plasmocytoma. The procedure was performed through the external auditory meatus, the tympanomeatal flap was raised, and the triangular/rectangular window bounded by the internal carotid artery, jugular vein, and round window of the cochlea was drilled out to the petrous apex.

Conclusion: Infracochlear approach to petrous apex is a safe operating procedure that preserves the normal external auditory canal and middle ear conductive mechanism. It is the most direct and least invasive of all procedures to reach the petrous apex, and it is suitable for both drainage procedures and biopsy of lesions in the petrous apex of the temporal bone.
Fast repetitive response as a useful predictor of long-term success of radiofrequency ablation of right ventricular outflow tract ventricular tachycardia
Authors: Vokac Damijan , Nedog Viljemka , Kanic Vojko , Naji Franjo
Published: February 2023

Purpuse: Idiopathic right ventricular outflow tract ventricular tachycardia (RVOT-VT) is the most frequent type of ventricular arrhythmia in patients without structural heart disease and is frequently treated using radiofrequency ablation (RFA). Fast non-sustained ventricular arrhythmia showing the same morphology as initial arrhythmia, the so-called fast repetitive response (FRR), is sometimes observed during ablation of the desired region. In this study, we evaluated the prognostic impact of FRR in patients after successful RFA of RVOT- VT.

Methods: A prospective observational case-control design was selected for the study. We included patients with successful RFA of previously registered RVOT- VT. Patients with provoked FRR during RFA were assigned to the FRR group and 33 patients displaying no FRR to the control group. Overall, 33 patients in both groups were monitored for the subsequent 24 months. Parameters of the procedure, such as duration, energy application as well as long-term success, were compared between the two groups.

Results: We observed significantly shorter duration of procedure performance (120±29 min vs. 70±16 min; P<0.001) with a markedly smaller number of applied lesions [Please note that I am unsure what the author means by 'applied lesions' here.] (21.6±15.6 vs. 13.4±12.5; P=0.02) in the FRR group. After 24 months, the adjusted odds ratio of relapse for patients from the FRR group vs. control group was 0.19 (95% CI 0.05–0.83; P=0.03).

Conclusion: In patients with induced FRR during RFA of RVOT-VT, the procedure tended to be drastically shorter and more successful in the long-term.
Mutations of the CYP21A2 gene: Association of p.V281L mutation with polycystic ovarian syndrome (PCOS)
Authors: Stangler Herodež Špela , Fijavž Lusien , Zagradišnik Boris , Došen Marko , Takač Iztok , Kokalj-Vokač Nadja
Published: February 2023

Purpose: The CYP21A2 gene encodes the enzyme 21–hydroxilase, which is responsible for the production of steroids. These hormones are key mediators of sexual development and conception. Patients with 21–hydroxilase deficiency tend to be affected in different stages of life. The purpose of this study was to compare the genetic profiles of women with unexplained infertility problems with the genetic profiles of healthy controls. Furthermore, were analyzed associations between mutations of the CYP21A2 gene and various clinical and laboratory parameters.

Methods: We enrolled 300 women, diagnosed with unexplained infertility problems, into this retrospective study. For each subject, we recorded important clinical and laboratory parameters during different phases of the menstrual cycle. In the control group, we enrolled 100 samples. Each subject provided a blood sample, which was used to isolate DNA for subsequent polymerase chain reaction (PCR).

Results: In total, 11.6% of the test subjects exhibited significant hormonal deviations (HD) (estrogens and/ or progestins and/or total testosterone) and 5.3% were diagnosed with polycystic ovarian syndrome (PCOS). We identified a significant association between the p.V281L mutation and the frequency of test subjects with significant HD (x2=6.99, p=0.01). A similar association was also observed between p.V281L mutation and the frequency of test subjects with PCOS (x2=16.78, p=0.00). However, we did not establish any associations between the frequency of mutations in test subjects when compared with controls. In addition, we did not find any significance in the frequency of CYP21A2 gene mutations and any of the laboratory parameters tested.

Conclusion: Our results identify a significant association of the p.V281L mutation in the CYP21A2 gene with the frequencies of both PCOS and significant HD.
Ethical responsibility of journal editors and authors when publishing scientific publications / Etična odgovornost pri objavljanju znanstvene publikacije urednikov revij in avtorjev
Authors: Pahor Dušica
Published: February 2023

Ethics has been and always will be an important part of scientific research. Guidelines are not always followed, however, and we must, on the basis of experience, take care to ensure that science remains ethical. Indeed, ethics is a consideration that pertains to all areas of research. Unethical practices in the pursuit of success, fame, or personal benefit must be strictly controlled to prevent the possibility of misusing science. This is the wish and the mission of our editorship.
Preoperative renal dysfunction is a predictor of postoperative atrial fibrillation in coronary artery bypass patients
Authors: Antonič Miha
Published: February 2023

Purpose: Atrial fibrillation is the most common arrhythmia following cardiac surgery. An association between preoperative kidney dysfunction and postoperative atrial fibrillation has been previously reported; however, no study has so far investigated the impact of kidney function during cardiopulmonary bypass on the incidence of atrial fibrillation. The aim of this study was to investigate the value of preoperative renal function and urine output during cardiopulmonary bypass as predictors of postoperative atrial fibrillation in patients undergoing elective coronary artery bypass.

Methods: This observational retrospective study included 409 patients who underwent elective coronary artery bypass surgery. According to whether or not atrial fibrillation developed postoperatively, the patients were divided into a sinus rhythm group (n = 340) and a new-onset atrial fibrillation group (n = 69). The impact of preoperative (serum creatinine and estimated glomerular filtration rate) and intraoperative (urine output during cardiopulmonary bypass) kidney function on the incidence of new-onset postoperative atrial fibrillation was assessed using univariable and multivariable analyses.

Results:Patients with atrial fibrillation were older, and had higher EuroSCORE II and higher preoperative B-type natriuretic peptide levels than patients with sinus rhythm. Preoperative renal function was worse (higher serum creatinine level and lower estimated glomerular filtration rate) in the atrial fibrillation group than in the sinus rhythm group. However, there were no differences between the groups in urine output during cardiopulmonary bypass. Multivariable analysis identified older age, left ventricular ejection fraction ≤30%, and lower preoperative estimated glomerular filtration rate as independent risk factors for new-onset postoperative atrial fibrillation.

Conclusion: Preoperative renal function—but not urine output during cardiopulmonary bypass—is a predictor of new-onset postoperative atrial fibrillation in patients undergoing elective coronary artery bypass surgery.
The effects of gabapentin and ethanol on the regulated cell death of astrocytes in primary culture
Authors: Hutyrová Paulína , Stangelj Jan , Lipnik-Stangelj Metoda
Published: February 2023

Purpose: In this study, the effect of gabapentin on the regulated cell death of astrocytes in primary culture was examined. Because astrocytes are relatively resistant to decay by apoptotic pathways, the effect of different concentrations of gabapentin on apoptosis in necroptosis was tested as another form of regulatedcell death. In addition, the impact of gabapentin on the death of astrocytes that were exposed to ethanol was also examined.

Methods: Primary cultures of astrocytes that were obtained from the brain cortex of newborn rats were used as the experimental model. Cells were exposed to different concentrations of gabapentin only, ethanol only or to a combination of ethanol and gabapentin. Using flow cytometry, the proportions of viable, early apoptotic, necroptotic, and secondary dead cells were determined.

Results: The effect of gabapentin on early astrocytic apoptosis and necroptosis was dependent on concentration. In concentrations of up to 10 μg/mL, gabapentin did not affect astrocyte deaths; whereas at higher concentrations, the proportion of necroptotic cells increased. The concomitant exposure of the cells to gabapentin (10 μg/mL) and ethanol (100 mM) for 24 hours did not significantly affect cell death caused by ethanol. For cells that are exposed to 50 mM ethanol for 7 days, gabapentin slightly reduced the proportion of necrotic cells.

Conclusion: Gabapentin did not affect the viability of astrocytes in concentrations up to 10 μg/mL. The concomitant exposure of astrocytes to ethanol and gabapentin for 24 hours did not reduce the toxicity of ethanol. In astrocytes that are chronically exposed to ethanol, gabapentin slightly reduced the effect of ethanol on necroptosis.
Experience involving the implementation and compliance with the ERAS® at a small gynecologic oncology centre
Authors: Pakiž Maja , Lonzarič Nives , Krebs Bojan , Dobnik Sarah , Sobočan Monika , Zadravec Kristina
Published: February 2023

Purpose: We report on the first patient with refractory hypoxemia treated with venovenous extracorporeal membrane oxygenation (VV ECMO) at the Medical Intensive Care Unit of the University Medical Centre Maribor.

Case report: A 52-year-old male was admitted after successful cardiopulmonary resuscitation from out-of-hospital cardiac arrest (first rhythm was ventricular fibrillation, with 40 min to return of spontaneous circulation). The patient underwent primary percutaneous revascularization of the left anterior descendingcoronary artery with insertion of one coronary stent. Hypoxemia was present during patient transportation and the procedure and continued to worsen after admission. Due to refractory hypoxemia caused by aspiration pneumonia, treatment with the VV ECMO was initiated. The ECMO procedure wasperformed without complications and led to improvement in gas exchange and lung mechanics. The patient was then successfully weaned from ECMO, decannulated, and extubated. After extubation, the patient’s course of treatment was complicated by hospital pneumonia and catheter-related blood stream infection.As his state deteriorated, reintubation was necessary. Despite intensive treatment, the patient died on day 30.

Conclusions: Response to the VV ECMO treatment of refractory hypoxemia due to aspiration pneumonia was positive and without complications. In spite of initial improvement, the patient died after several weeks due to recurring infection and septic shock.
Distance learning in medicine / Učenje medicine na daljavo?
Authors: Pahor Dušica
Published: February 2023

In March, an epidemic of coronavirus was announced, and a state of emergency was declared. The introduced measures have, among other things, halted in-person pedagogy in schools and faculties, having been replaced by distance learning. Furthermore, the University Clinical Centre and the Faculty of Medicine of the University of Maribor were closed to medical students ...
In-stent restenosis and stent thrombosis rates after left main coronary artery stenting
Authors: Balevski Igor , Arva Vigor
Published: February 2023

Purpose: The aim of this study was to evaluate the in-stent restenosis (ISR) and stent thrombosis rates along with one-month and one-year survival rates in patients with left main coronary artery disease (LMCAD) with different methods of stenting, lesion characteristics, and clinical disease presentation. Methods: A total of 297 consecutive patients with unprotected LMCAD were treated by percutaneous coronary intervention (PCI) at University Clinical Center Maribor between January 2008 and October 2016. One hundred and thirty-two (50.8%) eligible patients underwent angiographic follow-up. The majority of patients (86.5%) were treated with a single drug-eluting stent (DES). Results: The overall prevalence of angiographic ISR in unprotected LMCA lesions was 33.3% (44 out of 132 patients with angiographic follow-up). The in-stent restenosis rate was 31.7% (39) in the group initially treated with DES (123). Most patients (63.6%) with ISR underwent repeated PCI, 22.7% had coronary artery bypass graft surgery, and 13.6% were treated conservatively. Only hypertension was shown to be statistically significant as a predictor of ISR in the present study. Stent thrombosis rate was 2.0% (six out of 297 patients). The mortality rate was 12.5% one month after the procedure on the left main coronary artery lesion, and 17.2 % after one year. Conclusion: Patients presenting with acute coronary syndrome had worse outcomes. While the numbers in the present study are higher compared to some other studies, they represent a real-world example of patients with different clinical presentations.
Clinicopathologic characteristics of patients with vulvar cancer treated between 1994 and 2017 at the University Medical Centre Maribor
Authors: Gavrič Lovrec Vida , Kozar Nejc , Takač Iztok , Stangler Herodež Špela
Published: February 2023

Purpose: Vulvar cancer is one of the rarest forms of cancer. Vulvar cancer represents 3%–7% of all gynecologic cancers. Eighty percent of patients with vulvar cancer are > 60 years of age. The vulvar cancer, analyze the epidemiology, and describe the clinical characteristics, treatment modalities, and factors that influence the development of vulvar cancer. Methods: This retrospective study included patients treated at the University Medical Centre Maribor for vulvar cancer between 1994 and 2017. Patient demographics, disease characteristics, clinical features, histologic findings, and type of therapy were recorded. Associations among various demographic factors, tumor characteristics, treatments, and risk factors of vulvar cancer were evaluated. Results: We collected data from 124 patients between 22 and 92 years of age. The average age of the patients was 71 years. Six different tumor types were identified, of which the most common histologic type of vulvar cancer was squamous cell carcinoma. Forty-five patients were tested for the presence of HPV types, which was confirmed in 71% (32/45) of the tested patients.Conclusion: Squamous cell carcinoma was the most common form of vulvar cancer in patients treated at the University Medical Centre Maribor. Undoubtedly, one of the risk factors for vulvar cancer is HPV infection. HPV 16 was the most frequently diagnosed HPV type in our patients. For more comprehensive and more representative conclusions, data from other medical centers in Slovenia should be included.
Use of Peripheral Venous Blood Gas Analysis and Oximetry to Assess Respiratory Failure in the Emergency Department
Authors: Golub Jerneja , Gorenjak Mario , Žuran Pilinger Eva , Lešnik Amadeus , Markota Andrej
Published: February 2023

Purpose: The diagnosis of acute respiratory failure (ARF) is based on arterial blood gas analysis (ABGA), which is associated with patient discomfort and requires an additional vascular puncture. Our aim was to compare ABGA with peripheral venous blood gas analysis (PVBGA) and pulse oximetry in adult patients with dyspnea and/or suspected ARF.Methods: We included 102 patients (56 males) in a prospective study performed in a medical emergency department from March–May 2019. Patients with overt signs of circulatory shock or severe respiratory failure were not included.Results: We showed significant positive correlations between ABGA and PVBGA results (for pH, ρ=0.590; for HCO3, ρ=0.901; and for pCO2, ρ=0.740), and insignificant differences between oxygen saturation based on ABGA and pulse oximetry (95% vs. 94%; p=0.49). When we subtracted 1 kPa from the venous pCO2 and added 4 kPa to the venous pO2 , there were no statistically significant differences between peripheral venous and arterial pCO2 and pO2 (4.8 vs. 4.7 kPa, p=0.26 and 9.5 vs. 8.9 kPa, p=0.21, respectively).Conclusion: The combination of PVBGA and pulse oximetry provided sufficient data to make clinical decisions in a select group of patients with dyspnea and/or ARF.
2D speckle-tracking in assessment of myocardial strain in children with hypertrophic cardiomyopathy
Authors: Chernykh Nadezhda , Tarasova Alla , Groznova Olga
Published: February 2023

Purpose: To assess the myocardial strain in children with hypertrophic cardiomyopathy (HCM).

Methods: A total of 61 patients aged between 7 and 17 years with an asymmetric form of HCM underwent an ultrasound examination of the heart using standard techniques. An assessment of the left ventricular systolic function was performed using the two-dimensional (2D) speckle-tracking mode with analysis parameters that included global and segmental longitudinal, circumferential, and radial myocardial strains. Strain data for the subendocardial and subepicardial layers for each segment of the left ventricle, as well as their total values, were determined.

Results: Global longitudinal strain and longitudinal strain rate were dec reased due to the impaired contractility of hypertrophied myocardial segments in 100% of cases of non-obstructive and obstructive HCM forms. A decrease in global, radial, and circumferential strain parameters and their rates has been observed in all children with an obstructive form of HCM and 39 (86.6%) patients with non-obstructive form. At the same time, there was a statistically significant difference between strains and strain rates in children with a non-obstructive form of HCM in comparison to those with an obstructive form of the disease.

Conclusion: Changes in myocardial strains observed using the 2D speckle-tracking mode in children with HCM indicate early systolic dysfunction of the left ventricle. Longitudinal strain was the most sensitive compared to radial and circumferential types. It was statistically significantly different in children with an obstructive form of HCM compared to those with non-obstructive form of the disease. These results are important for early therapy initiation and, therefore, may improve prognosis in children with HCM.
The clinical relevance of severe thermal artefacts in specimens after LLETZ
Authors: Cokan Andrej , Žebeljan Ivan , Serdinšek Tamara , Pakiž Maja
Published: February 2023

Purpose: Large loop excision of the transformation zone (LLETZ) under local anaesthesia has almost replaced cold knife conisation in the treatment of cervical squamous intraepithelial dysplasia (SIL). Thermal artefacts in specimens after LLETZ may be so severe, that they prevent histopathological interpretation and evaluation of the radicality of the procedure. There are limited data regarding the prevalence of severe thermal artefacts after LLETZ and their clinical relevance regarding the need for reoperation.

Methods: In this retrospective study, we included 314 consecutive patients who were treated with LLETZ or cold knife conisation for cervical SIL in 2016 at our clinic. The primary outcome of the study was to determine the prevalence of severely damaged surgical margins after LLETZ and if these thermal artefacts can predict residual disease or the need for reoperation. The secondary outcome was the prevalence of postoperative and short–term complications.

Results: Three hundred and fourteen women underwent surgery for cervical SIL. In 95.2% of cases, we performed LLETZ, and 89.3% of women had this procedure under local anaesthesia. The reoperation rate was 3.8%. Positive or inconclusive margins were present in 20.4% of specimens. In 10.7% of allLLETZ cases, thermal artefacts were so severe that they interfered with histopathological interpretation. However, only one of these patients needed reoperation. Postoperative vaginal discharge and mild bleeding requiring therapeutic intervention occurred in 4.7% and 6.7% of cases, respectively.

Conclusion: Although approximately 10% of patients had severe thermally damaged margins after LLETZ, only 3% required reoperation. In our experience, severely damaged margins were not associated with higher reoperation rate. On the other hand, a carefully planned follow–up visit with cytology, human papillomavirus (HPV) testing and colposcopy with biopsy after the procedure is of utmost importance in the evaluation of residual disease.
Evaluation of successful treatment of patients with unilateral functional crossbite
Authors: Fekonja Anita , Šijanec Kebrič Jasmina
Published: February 2023

Purpose: Unilateral functional crossbite (UFCB) is one of the most common malocclusions in the deciduous and early mixed dentition stage. It is accompanied by lateral mandibular shift and mandibular midline deviation due to the narrow maxillary dental arch. The aim of this study was to assess the effects of early correction of UFCB with the Fränkel (FR–3) functional regulator.

Methods: Ninety Caucasian subjects (32 boys and 58 girls) with UFCB in the early mixed dentition stage (mean age, 6 years and 8 months (SD±1.8)) were treated with the FR–3 functional regulator and monitored. The diagnosis was based on anamnestic data, clinical examinations, radiographs, and analyses of study cast models. Dental casts taken before and after treatment were used in the analysis of effects.

Results: Treatment of UFCB involved expansion of the maxillary arch, removal of occlusal interferences, and elimination of the functional shift. The width of the maxilla increased by 2.90 mm (SD±1.63) in the canine region and by 2.78 mm (SD±1.60) in the molar region. Another advantage of early treatment was improvement of maxillary arch length deficiency secondary to maxillary constriction because the permanent incisors were afforded more space before or during eruption than if the crossbite was treated at a later age. At least one abnormal orofacial function was identified in 69 (76,67%) patients with UFCB. Aftertreatment, all crossbites were corrected, functional deviations were eliminated, and no relapses were observed during follow–up at 2 years and 8 months.

Conclusion: The Fränkel functional regulator is a functional orthodontic–orthopedic device that is an effective alternative for the treatment of UFCB. Dental occlusion was significantly improved, and the prognosis for normal craniofacial growth and normal function of the stomatognathic system was enhanced.
Detection of aneuploidy using multiplex ligation–dependent probe amplification in fetal tissues from aborted pregnancies
Authors: Zagradišnik Boris , Stangler Herodež Špela , Erjavec-Škerget Alenka , Zagorac Andreja , Kokalj-Vokač Nadja
Published: February 2023

Purpose: About 10-15% of all pregnancies terminate as spontaneous miscarriages. In the first trimester, ≈50% of spontaneous miscarriages are the result of chromosomal aberrations, mostly chromosomal aneuploidies. Cytogenetic analyses are used to confirm aneuploidy in failed pregnancies. Culture failure or poor-quality chromosomes are often problems in those cases. In such situations, methods that are independent of tissue culture are used, and we employed multiplex ligation-dependent probe amplification (MLPA). We determined if MLPA is an appropriate and compatible method compared with classical cytogenetic analyses on fetal tissues.

Methods: All fetal samples received from spontaneous abortions were cultured, karyotyped (if possible) and genomic DNA extracted. MLPA analyses were undertaken using subtelomeric probe kits. Additionally, comparative genomic hybridization (CGH) was used to confirm aneuploidy detected by MLPA in cases of failed culture growth.

Results: MLPA analyses confirmed an unbalanced chromosome abnormality identified by cytogenetic analyses in all cases in which tissue culture was successful, and provided data in cases of failed culture growth. Several common numeric chromosome aberrations were detected, as well as rare trisomies and other unbalanced chromosome rearrangements.

Conclusions: MLPA analyses can provide information about the karyotype of a DNA sample if cytogenetic analyses are not possible because of a lack of viable cells or if only a small amount of genomic DNA is available. Th
Clostridium difficile toxin B induces morphological changes consistent with autophagy in the human adenocarcinoma cell line (HT-29)
Authors: Zemljič Mateja , Lipovšek Saška
Published: February 2023

Purpose: Toxin B (TcdB) is a product of the bacteria Clostridium difficile, and can trigger apoptosis or necrosis. In the present manuscript, we proposed that TcdBVPI and TcdB8864 would cause morphological changes in cultured cells that are characteristic of autophagy, a constitutive cellular event closely linked with apoptosis or necrosis.

Methods: We examined an in vitro model of cultured HT-29 cells to determine the occurrence of autophagy. The cells were incubated separately with TcdBVPI and TcdB8864 for 2 to 24 hours, and then examined using transmission electron microscopy.

Results: In HT-29 cells, ultrastructural changes were observed following 8 hours of treatment with TcdBVPI and TcdB8864. Upon exposure to both toxins, complex changes occurred that affected the cellular framework, including the dilated regions of the granular endoplasmic reticulum, the Golgi apparatus, as well as electron-lucent and electron-dense autophagosome-like structures. Additionally, lipid droplets were present in the cytoplasm of HT-29 cells.

Conclusion: Our findings indicate that TcdBVPI and TcdB8864 indeed induce ultrastructural changes in HT-29 cells. The presence of these autophagic structures in the cytoplasm of the HT-29 cells suggests that autophagy may be induced during treatment by both toxins. Therefore, this effect could represent an important protective mechanism for cell survival.
Primary leiomyosarcoma of the inferior vena cava necessitating radical resection and reconstruction: case report
Authors: Hansel Jan , Mrdža Božidar , Flis Vojko
Published: February 2023

Primary leiomyosarcoma of the vena cava is a rare tumor. We describe a 63-year-old female in whom a mass was found upon ultrasonographic examination of the abdomen after persistent pain in the right upper quadrant. CT and MRI revealed a malignant intraluminal growth in the inferior vena cava. Radical resec- tion was undertaken to remove the tumor. The inferior vena cava was reconstructed using a PTFE graft. Resection margins were free of tu- mor. Postoperative complications included extended thrombosis below the surgical site and smaller pulmo- nary emboli. A vena-cava filter was inserted to prevent further complica- tions. Twelve months after the first procedure local subcutaneous metas- tases were observed. Metastases were subsequently removed. We discuss our case to deepen our understanding of this extremely rare disease.