bluuebunny/crossref_metadata_2025 huggingface dataset:
Decoding Iran's meme culture and implications in journalism
Authors: Tabatabai Sara , Bulgarova Bella Akhmedovna , Kotecha Ketan , Patil Shruti
Published: April 2024

The study of digital humour and meme culture as a complex phenomenon, given the growing consumption and popularity of memes, especially among digital technology speakers, coupled with the scarcity of scholarly attention and research on this topic in Iran, has become increasingly relevant. This article focuses on the complex interplay between memes, culture and technology. By analysing the integral role of humour in Iranian digital culture, the study aims to explore the nature and functions of Iranian meme culture. The analysis shows that Iranian digital humour and meme culture function as a platform for equal opportunities to laugh, challenge established cultural norms and question prevailing ideologies. The research methodology is based on the reproduction of gender conventions and power hierarchies in Iran through internet memes. The methods applied are: content analysis, distributive and comparative. The study also builds on Bakhtin's concept of "chronotope" in multimodal analysis of memes common among Iranian immigrants. The novelty of the study lies in the fact that it makes a valuable contribution to the field of journalism and media studies, highlighting the importance of understanding the role of humour and memes in shaping public perception and navigating complex ideological landscapes, as well as the ways in which memes can be used to disrupt or alter these dynamics. The results of the analysis of Iranian digital humour and memes show that meme culture functions as a means to combat inequalities in power and status. In addition, the study demonstrated the Iranian population's reinterpretation of the immigrant experience, thereby reaffirming and refining their hybrid identity as transnational Iranians. This process unfolds through the recreation of different spatio-temporal configurations within the meme.
Carrying Capacity of Low Earth Orbit Computed Using Source-Sink Models
Authors: D’Ambrosio Andrea , Linares Richard
Published: April 2024

The low-Earth-orbit (LEO) environment will likely experience an exponential growth of the anthropogenic space object population, also due to the many proposed large constellations, which could negatively affect the sustainability of the space environment if no proper regulatory actions are introduced. This paper introduces a methodology to analyze high-capacity sustainable solutions of the LEO region from 200 to 900 km altitude. Sustainability is assessed through the stable equilibrium points of a source-sink model called MIT Orbital Capacity Assessment Tool 3 (MOCAT-3). Capacity is estimated using an optimization procedure that aims to compute the optimal launch rate that maximizes the number of satellites in LEO, subject to a risk-rate constraint. Results show that the sustainable number of satellites increases with the risk rate constraint. Moreover, the resilience of the proposed solutions is tested against a more accurate time-varying atmospheric density model and perturbations of the initial equilibrium population. The compatibility of the proposed solutions with future traffic launches and a strategy to accommodate future traffic needs are presented. Limitations of the current work are discussed, chiefly the importance of validation of model coefficients and behavior before resulting capacity estimates are used to guide actual decision-making.
Utilizing Artificial Neural Networks for Entry Vehicle Aerodynamic Characterization
Authors: Ernst Zachary J. , Robertson Bradford E. , Mavris Dimitri
Published: April 2024

Determining the dynamic stability of blunt body entry vehicles is a persistent engineering challenge, particularly in the low supersonic to subsonic flight regime where the behavior of the unsteady wake is a primary contributor. Dynamic stability quantities are determined by fitting measurements of a ballistic range campaign or a computational fluid dynamics (CFD) computational experiment to an assumed functional form in order to regress quasi-static stability coefficients. However, this data reduction process has many implicit assumptions that may not hold. This paper explores novel alternatives to the established methods for modeling blunt body aerodynamics. A six-degree-of-freedom CFD-in-the-loop flight model is used to run “virtual ballistic range tests,” fully capturing the relevant flow physics. Feed-forward and time-delay neural network models are fitted to the time-series trajectory and aerodynamic results, which can then be used to predict aerodynamic forces and moments. These models do not have a prescribed functional form and do not assume linearized aerodynamics. The models are evaluated for goodness-of-fit in their aerodynamic and trajectory prediction. The feed-forward neural network model resulted in a better prediction of the virtual ballistic range tests than a traditional database. The time-delay network had good open-loop performance but suffered from closed-loop instability.
Uncertainty Quantification of Artemis I Space Launch System Integrated Aerodynamics Databases
Authors: Lee Michael W. , Shea Patrick R. , Pinier Jeremy T. , Chan David T.
Published: April 2024

Accurate prediction of integrated aerodynamic forces and moments is a necessary part of aerospace vehicle development. This accuracy can be quantified in the form of an uncertainty model, which makes the prediction more useful within an integrated vehicle design effort. Aerodynamic force and moment databases were constructed for the Artemis I mission of the Space Launch System vehicle. These databases reconcile data from multiple sources to yield unified predictions of how NASA’s most advanced launch vehicle interacts with Earth’s atmosphere as it ascends into orbit. This paper outlines how the uncertainty quantification was performed for these databases to ensure comprehensive and tractable uncertainty source coverage.
Fluid–Structure Coupled Analysis of Maneuver Load Alleviation on a Large Transport Aircraft
Authors: Breitenstein Christian , Müller Jens , Hillebrand Marco , Woidt Malte , Haupt Matthias , Radespiel Rolf
Published: April 2024

Fluid–structure coupled simulations are performed for quasi-steady pitching maneuvers of a large transport aircraft with a load alleviation system consisting of trailing edge flaps and droop noses at the leading edge. For the fluid part of the simulation, a RANS approach is used, whereas the structural simulation is based on a linear modal model. The selected maneuvers are located on the lift boundary of the maneuver envelope at maximum load factor, as not only are the structural loads high here, but also redistributing lift for load alleviation is especially challenging as the wing is close to stall. For a target value of 33% reduction in wing bending loads, which is derived from the CS-25, the effects of applying load alleviation on wing loads, deformations, and aircraft maneuverability are investigated. It is found that the desired reduction of wing bending loads can be achieved for all maneuvers considered, while controlling the torsional moment turns out to be more difficult. A loss of maneuverability due to load alleviation is observed for only one of the maneuvers, while for the other maneuvers, maneuverability could even be increased. To assess the influence of the elasticity of the wing, additional simulations of the rigid wing are carried out and compared with the elastic results. Finally, other potential applications of the considered flap system are also explored. Here, for example, a cruise drag reduction of up to 1.8% is possible by adjusting the spanwise lift distribution.
Positioning Error Estimation Method for Short-Arc Angles-Only Initial Orbit Determination
Authors: Feng Zhao , Yan Changxiang , Wu Congjun , Qiao Yanfeng
Published: April 2024

The development of space surveillance capabilities has received increased emphasis with time. Suitable evaluation parameters are investigated to analyze the effects of multiple factors on short-arc angles-only initial orbit determination. This investigation is crucial for designing surveillance system parameters. In this paper, the orbit determination equations where the target state is linear were derived by assuming that Lagrangian coefficients are constant and taking the minimum residual sum as the optimization objective. From this paper’s analysis, it was demonstrated that because the position uncertainty distribution primarily lies in the line-of-sight vector, the upper limit of relative positioning error (RPE) can be used as the evaluation parameter of the determination accuracy in scenarios where a high-orbit target is observed by a low-orbit sensor observes. An empirical relationship was also found, indicating that the upper limit of RPE is proportional to the observation error, −2.5 power of the observation arc length, and the 0.5 power of the observation interval.
Sensitivity Analysis of Ionization in Two-Temperature Models of Hypersonic Air Flows
Authors: Aiken Timothy T. , Boyd Iain. D.
Published: April 2024

Plasma generation in hypersonic flows is analyzed using a two-temperature model of nonequilibrium air. The uncertainties in electron number density predictions are assessed for flow scenarios that correspond to both strongly shocked and strongly expanded flows, and the dependencies of the calculated uncertainties on individual input parameters are quantified. Ionization levels behind 5 and 7 km/s normal shocks are found to be most sensitive to the associative ionization reactions producing [Formula: see text] and [Formula: see text] in the region of peak electron number density, with nitric oxide kinetics dominating the uncertainty downstream. The higher levels of ionization behind a 9 km/s shock are found to strongly depend on the electron impact ionization of atomic nitrogen as well as the charge exchange between [Formula: see text] and N. Recombining flow scenarios depend on many of the same processes that influence the shocked flows, with the notable addition of the reassociation reaction [Formula: see text], which is responsible for large uncertainties in electron number density in net recombining flows. The results provide valuable insight into the typical magnitude of uncertainty associated with plasma formation predictions in hypersonic flows and identify the parameters that should be targeted in efforts to reduce those uncertainties.
Which Portion of Physiotherapy Treatments’ Effect Is Not Attributable to the Specific Effects in People With Musculoskeletal Pain? A Meta-Analysis of Randomized Placebo-Controlled Trials
Authors: Ezzatvar Yasmin , Dueñas Lirios , Balasch-Bernat Mercè , Lluch-Girbés Enrique , Rossettini Giacomo
Published: April 2024

OBJECTIVE: We aimed to quantify the proportion not attributable to the specific effects (PCE) of physical therapy interventions for musculoskeletal pain.

DESIGN: Intervention systematic review with meta-analysis.

LITERATURE SEARCH: We searched Ovid, MEDLINE, EMBASE, CINAHL, Scopus, PEDro, Cochrane Controlled Trials Registry, and SPORTDiscus databases from inception to April 2023.

STUDY SELECTION CRITERIA: Randomized placebo-controlled trials evaluating the effect of physical therapy interventions on musculoskeletal pain.

DATA SYNTHESIS: Risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB 2). The proportion of physical therapy interventions effect that was not explained by the specific effect of the intervention was calculated, using the proportion not attributable to the specific effects (PCE) metric, and a quantitative summary of the data from the studies was conducted using the random-effects inverse-variance model (Hartung-Knapp-Sidik-Jonkman method).

RESULTS: Sixty-eight studies were included in the systematic review (participants: n = 5238), and 54 placebo-controlled trials informed our meta-analysis (participants: n = 3793). Physical therapy interventions included soft tissue techniques, mobilization, manipulation, taping, exercise therapy, and dry needling. Placebo interventions included manual, nonmanual interventions, or both. The proportion not attributable to the specific effects of mobilization accounted for 88% of the immediate overall treatment effect for pain intensity (PCE = 0.88, 95% confidence interval [CI]: 0.57, 1.20). In exercise therapy, this proportion accounted for 46% of the overall treatment effect for pain intensity (PCE = 0.46, 95% CI: 0.41, 0.52). The PCE in manipulation excelled in short-term pain relief (PCE = 0.81, 95% CI: 0.62, 1.01) and in mobilization in long-term effects (PCE = 0.86, 95% CI: 0.76, 0.96). In taping, the PCE accounted for 64% of disability improvement (PCE = 0.64, 95% CI: 0.48, 0.80).

CONCLUSION: The outcomes of physical therapy interventions for musculoskeletal pain were significantly influenced by factors not attributable to the specific effects of the interventions. Boosting these factors consciously to enhance therapeutic outcomes represents an ethical opportunity that could benefit patients. J Orthop Sports Phys Ther 2024;54(6):391-399. Epub 11 April 2024. doi:10.2519/jospt.2024.12126
Indonesian orthodontists and laypeople’s perception of the four components of smile analysis in individuals with various vertical skeletal patterns
Authors: Subono Mutiara , Soegiharto Benny M. , Anggani Haru Setyo
Published: April 2024

Objectives:

The objective of this study was to analyze the difference towards orthodontists’ and laypeople’s perceptions of four smile analysis components in individuals with various vertical skeletal patterns.

Material and Methods:

Each of the 100 orthodontists, and laypeople aged 26–65 years old were asked to complete an online questionnaire about four smile analysis components in individuals with various vertical skeletal patterns. The questionnaire consists of 36 modified photos according to various smile curves, buccal corridors, gingival displays, and incisor displays in normal, hypodivergent, and hyperdivergent skeletal patterns. Perceptions were assessed using a visual analog scale.

Results:

Significant differences were found in straight and parallel smile curve, maximum buccal corridor, and gingival display 4 mm components in all vertical skeletal patterns. Additionally, differences were also found in the medium buccal corridor in hypodivergent skeletal pattern, gingival display 2 mm in normal and hypodivergent skeletal patterns. Moreover, significant differences were also observed in the 100% incisor display in normal vertical skeletal pattern, and 50% incisor display in hyperdivergent skeletal pattern

Conclusion:

Orthodontists and laypeople have similar perceptions toward the most esthetic components (parallel smile curve, minimum buccal corridor, gingival display 0 mm, and incisor display 75%) in all vertical skeletal patterns.
Human Anti-Rabies Treatment in the Mucuri Valley, Brazil, 2017 – 2019
Authors:   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Júnior Dilceu Silveira Tolentino , Cavalcante Kellyn Kessiene ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Amaral Ananda Caldeira Tolentino ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Silva Heberson Teixeira da ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Nogueira Manuella Botelho Laure ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Martins Gustavo Teixeira ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Assis Eliseu Miranda de ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Oliveira Roberto Carlos de ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil, Alencar Carlos Henrique ,   Faculty of Medicine, Federal University of the Jequitinhonha and Mucuri Valleys, Teófilo Otoni, Minas Gerais, Brazil
Published: April 2024

Background: We aimed to describe the profile of people involved in accidents with potentially rabid-transmitting animals, and characterize the spatial distribution and temporal trend of post-exposure human anti-rabies treatments. Methods: We carried out a descriptive cross-sectional study including all post-exposure human anti-rabies care and the respective prophylactic conducts reported in the Notifiable Diseases Information System of the Brazilian Ministry of Health that took place in the 23 municipalities of Mucuri Valley, Minas Gerais State, Brazil, in the period from 2017 to 2019. Results: 3,691 notifications of human anti-rabies care were registered, with an average of 102.5 per month. Canine and feline species were the main aggressors. There was a progressive increase of the notifications in the period, and a heterogeneous spatial distribution of incidence with a greater concentration of care in the municipalities located in the north of the region. Conclusions: Our data show a higher incidence of cases when compared to other regions of Brazil. In addition, they can serve as a parameter to stimulate new research in the area and support the decision-making of public health managers in the region, aiming at the timely prevention and control of these neglected conditions.
Prevalence and Seasonal Variation of Different Respiratory Pathogens in Post-Weaned Pigs with Signs of Clinical Respiratory Disease Using a Tracheobronchial Swab Sampling Technique: An Update from Belgium and the Netherlands
Authors:   BU Swine & Ruminants, Elanco Animal Health, Plantijn en Moretuslei 1A, Antwerpen 2018, Belgium, FACJ Vangroenweghe
Published: April 2024

Besides Mycoplasma hyopneumoniae (M. hyopneumoniae), many other viruses and bacteria can concurrently be present in pigs. These pathogens can provoke clinical signs, known as porcine respiratory disease complex (PRDC). A sampling technique on live animals, namely tracheobronchial swab (TBS) sampling, was applied to detect the major PRDC pathogens in pigs using PCR. The objective was to determine prevalence of different PRDC pathogens and their seasonal variations in Belgium and the Netherlands. A total of 600 pig farms and 9,000 post-weaned piglets were sampled using TBS over a 4-year period. TBS samples were analyzed using mPCR and results were categorized and analyzed according to the season of sampling. In Belgium, 53.8% of the sampled farms were PRRSV-positive, followed by M. hyopneumoniae (48.8%) and IAV-S (40.3%), whereas only 20.6% of the farms were detected PCV-2- positive. In the Netherlands, a similar percentage of farms were detected positive for PRRSV (51.4%) and IAV-S (49.1%), whereas a lower percentage of farms was M. hyopneumoniae-positive (32.4%) and only 8.0% was detected PCV-2-positive. Combined infections consisted of M. hyopneumoniae - PRRSV, PRRSV - IAV-S, and M. hyopneumoniae - PRRSV - IAV-S in both countries. In Belgium, the combination of M. hyopneumoniae - PRRSV - PCV-2 also had a relevant prevalence. For all analyzed PRDC pathogens, clear variations among different seasons could be detected. In conclusion, the present study showed that many respiratory pathogens are present during the post-weaning period, which may complicate the clinical picture of respiratory diseases, and their prevalence may vary among seasons.
Bronchial Asthma: Etiology, Pathophysiology, Diagnosis and Management
Authors:   Department of Pharmacy, Negelle Health Science College, Guji, Ethiopia, G Bereda
Published: April 2024

Bronchial asthma is a disorder of the airways causing swelling and narrowing; which leads to wheezing, shortness of breath, chest tightness, and coughing. The impact of asthma in children depends on complex interaction between disease severity, reaction of children towards disease, treatment efficiency, social roles, and social environment. Most common asthma triggers of bronchial asthma are dust, animal dander, weather changes, pollution, mold, pollen, respiratory infections, stress, and tobacco smoke. The main pathophysiological characteristics of asthma are inflammation and airway remodeling, which include goblet cell hyperplasia, subepithelial fibrosis, collagen deposition, mucosal gland, hyperplasia, smooth muscle hypertrophy, and changes in the extracellular matrix. Spirometry (test lung function when diagnosing asthma), pulse oximetry (monitors oxygen saturation which used to measure amount of arterial hemoglobin that is combined with oxygen) used for diagnosis bronchial asthma. The goal of asthma treatment is to achieve normal respiratory function, with an absence of symptoms, exacerbations, or adverse effects. The beta 2 agonists are sympathomimetic drugs that produce “selective” activation of beta 2 adrenergic receptors, promote bronchodilation, and thereby relieve bronchospasm. The use of short actin beta 2 agonists as a reliever five or more times daily indicates controller agents need to be increased. Prednisone and prednisolone are preferred glucocorticoids for oral therapy of asthma. Methylxanthines are widely used in the treatment of asthma due its ability to inhibit phosphodiesterase causing bronchodilatation. The adverse effects of theophylline include gastrointestinal symptoms such as nausea and vomiting at initial oral administration. In addition, toxic symptoms may progress to tachycardia and arrhythmia.
Pharyngeal Electrical Stimulation Treatment of Critically Ill Intensive Care Tracheostomized Patients Presenting with Severe Neurogenic Dysphagia: A Case Series
Authors:   Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Austria, MT Traugott , W Hoepler ,   Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Austria, H Kelani ,   Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Austria, M Schatzl ,   Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Austria, E Friese ,   Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Austria, S Neuhold ,   Department with Infectious Diseases and Tropical Medicine, Klinik Favoriten, Austria
Published: April 2024

Purpose: To assess the benefits of Pharyngeal Electrical Stimulation (PES) in critically ill tracheostomized patients with severe neurogenic dysphagia. Methods: A retrospective outcome analysis of tracheostomized patients weaned from mechanical ventilation and treated with PES in a medical ICU. Results: Nineteen patients (mean age: 64 years), admitted to the ICU mainly because of severe acute infections, were treated with PES whilst still tracheostomized (mean duration of intubation prior to tracheostomy: 12 days). Following the start of PES, 15/19 patients were successfully decannulated during their hospital stay (mean time to decannulation: 13 days); 11 of the 15 surviving patients experienced a complete restoration of swallowing function. Among patients with available data, the mean time to improved feeding status from “nil by mouth” was three days with thickened fluids and ten days with thin oral fluid. The mean length of stay was eleven days in the ICU and 56 days in the hospital. PES treated tracheostomized patients had a shorter mean LOS in the ICU (47 vs 58 days) and in the hospital (109 vs 125 days) compared to non- PES treated ones. No serious adverse events related to PES treatment were observed, and no patients required recannulation. Conclusions: In this mixed population, PES led to improved swallowing function resulting in successful decannulation of 15/19 patients and return to normal oral intake at hospital discharge in 11/15 patients with severe neurogenic swallowing disorders and tracheostomy.
Flexing frontiers: Pioneering advances in biosensors for instant health insights
Authors: Ushaa Eswaran , Vivek Eswaran , Keerthna Murali , Vishal Eswaran
Published: April 2024

Biosensors that incorporate a biological recognition element with a transducer offer a rapid, simple approach for selective detection of analytes. However, conventional rigid biosensors have limited capabilities for continuous on-body monitoring applications. The emergence of flexible electronics has opened new possibilities for developing conformal biosensing platforms that can intimately interface with soft, curvilinear surfaces like skin for non-invasive health tracking. This review covers the fundamentals of biosensor technologies and recent progress in flexible biosensors aimed at pointof- care diagnostics and medical monitoring. Key developments in materials, electrochemical sensing interfaces, microfluidics integration and wireless connectivity are highlighted. Examples of flexible biosensors for metabolites, electrolytes, proteins and nucleic acids are presented along with capabilities and limitations. Current challenges include improving biocompatibility, correlation with standard assays, wireless range, manufacturability, and regulatory requirements. Further research on translating flexible biosensor devices from initial proof-of-concepts to validated medical products is warranted. Overall, flexible biosensors hold immense promise to enable continuous personalized health monitoring.
INFLUENCE OF MULTIVITAMIN COMPLEX ON ZOOTECHNICAL INDICATORS OF HYBRID YOUNG FATTERN RABBIT
Authors:   Timirâzevskaâ selʹskohozâjstvennaâ akademiâ, KULMAKOVA N.I.
Published: April 2024

The problem of increasing the production of highquality, profitable and in-demand livestock products on the market is acute at the present stage of agricultural development. Rabbit breeding today is a promising branch of beef farming, the main product of which is highquality dietary meat. The article presents the results of a study of age dynamics and live weight gain of hybrid young rabbits for fattening when different doses of the multivitamin complex “NutriCel” are included in their diet. From August to October 2023, a scientific and economic experiment was carried out on the territory of the rabbit breeding farm of Russian Rabbit LLC, Kostroma district, Kostroma region. As a result of the scientific experiment, the following data were obtained: the best results were obtained in experimental group No. 2, the animals of which were fed 0.5 ml/animal/day: a significant increase in live weight of young fattening rabbits was 3.06 kg (P≤0.05), which is 0.11 kg (3.59%) more than the control. The absolute increase had an advantage over the analogues of the control and experimental groups No. 1 and No. 3 by 20 g (6.4%; P≤0.01). The average daily gain was higher by 2.64 g (5.77%; P≤0.01) compared with peers in the control group. The relative increase exceeded the control by 0.14% (1.41%). At the same time, the safety of the young animals was 100%. In order to increase live weight gain, we recommend including the multi-vitamin complex “NutriCel” in the diet of rabbits with a dosage of 0.5 ml/bird/day for preventive purposes within 3–5 days from the moment of weaning. It showed a positive effect not only on the zootechnical parameters of young rabbits, but also on immunity in general.
Evaluation of the effectiveness and safety of erector spinae plane block during coronary artery bypass surgery: a randomized clinical trial
Authors: Paromov K. V. , Svirskii D. A. , Kirov M. Yu.
Published: April 2024

The search for a method of perioperative pain control after coronary bypass surgery is relevant both from the point of view of safety and effectiveness of the methods used.

Aim: To evaluate the hemodynamic changes and effectiveness of erector spinae plane block (ESPB) for off-pump coronary artery bypass surgery.

Methodology and research methods. The prospective randomized single-center study included 45 patients equally distributed according to the applied methods of perioperative analgesia into 3 groups: general anesthesia with epidural anesthesia (GA + EA group, n = 15), general anesthesia with ESPB (GA + ESPB group, n = 15) and general anesthesia without any regional anesthesia techniques (GA group, n = 15). Assessment of hemodynamics and severity of pain syndrome was performed during the first postoperative day.

Results. The intraoperative dose of fentanyl was 0.4 (0.4–0.5) mg in the GA + EA group, and 0.4 (0.3–0.4) mg in the GA + ESPB group that is significantly less than in the GA group – 1.1 (1.0–1.1) mg (p < 0.001). Postoperatively, the dose of fentanyl was 0.10±0.04 mg in the GA + EA group and 0.23±0.05 mg in the GA group (p < 0.001), whereas in the ESPB group fentanyl was not used. The pain level assessed by the numeric rating scale (NRS) was 3.0 (2.0–4.0) points at one hour after tracheal extubation and 3.0 (0.5–3.5) points at the end of the first day of the postoperative period without difference between the groups. The systemic and pulmonary hemodynamics, respiratory and vasopressor support did not differ as well.

Conclusion. The use of regional anesthesia (EA and ESPB) provides similar quality of perioperative analgesia like general anesthesia, but leads to reduction in opioid doses. Postoperatively, the use of ESPB does not lead to a deterioration of the hemodynamic status of the patient.
Features of chronic heart failure on the background of thrombocytopenia in persons infected with the human immunodeficiency virus
Authors: Goryacheva O. G.
Published: April 2024

The general context of the study is to review the characteristics of the course of chronic heart failure (CHF) in persons infected with the human immunodeficiency virus (HIV) as a part of a single-stage screening clinical trial.

Aim: To determine the features of the CHF course in HIV-infected patients, depending on the presence of thrombocytopenia (TP).

Material and Methods. In a multidisciplinary hospital, 240 patients with HIV infection were examined for four years, where a cohort of patients with CHF (160 people) was identified, further divided into groups of patients with TP (107 people) and without TP (53 people). Patients underwent the same amount of research, including echocardiography, non-invasive arteriography, and a detailed laboratory examination.

Results. TP in patients with CHF and HIV infection is more common in smokers and people with alcohol dependence and is associated with hemodynamic disorders in the form of higher systolic and diastolic blood pressure, left atrium increase. With TP, the values of NT-proBNP in blood plasma are higher, and in the blood serum – tissue inhibitor of metalloproteinases-1, urea, bilirubin, while the concentration of sodium and potassium ions in the blood serum is lower. Anemia and leukopenia were more common in the group of patients with thrombocytopenia. Patients with TP are more adherent to taking protease inhibitors and non-steroidal anti-inflammatory drugs.

Conclusion. The frequency of CHF detection in patients with HIV infection against the background of TP is almost 2 times higher and is more often accompanied by dilatation of the left atrium, higher blood pressure, an increase in TIMP-1 and a decrease in the concentration of potassium ions in the blood serum. The concentration of NT-proBNP in blood plasma has a close inverse correlation with the number of platelets in patients with CHF and TP, and the presence of severe TP ≤ 30 × 109 cells/l increases the chances of developing CHF with low left ventricular ejection fraction by 10.8 times. Smoking, possible alcohol dependence and adherence to taking protease inhibitors and NSAIDs are significant factors associated with the development of thrombocytopenia in HIV-infected patients with CHF.
Changes in the level of some tryptophan metabolites in the blood of patients with type 2 diabetes mellitus complicated by diabetic retinopathy
Authors: Saklakova О. A. , Maksimenya M. V. , Fefelova E. V. , Tereshkov P. P. , Karavaeva T. M.
Published: April 2024

Aim: To study the content of tryptophan and the intermediate metabolites of kynurenine and serotonin pathways of its metabolism in the blood plasma of patients with type 2 diabetes mellitus (DM) and non-proliferative diabetic retinopathy as candidates for markers of the early stage of the pathological process.

Material and Methods. Three groups of people were analyzed: the first group of 10 patients with type 2 diabetes mellitus and without diabetic retinopathy; the second group of 10 people with type 2 diabetes mellitus and non-proliferative stage of diabetic retinopathy; and the control group of 10 healthy people. The features of the first group were a decrease of macula’s photosensitivity in the fundus and a slight increase in the central thickness of the retina. Patients with diabetic retinopathy tended to have a moderate number of microaneurysms and microhemorrhages, moderately presented intraretinal microvascular anomalies in one quadrant, vein dilatation, clearness of the central retinal vein and its branches. In the macular zone there was an edema with hard exudates in the center and lateral to the fovea centralis. All participants of the study gave blood on an empty stomach in the morning, and after that in we measured the content of tryptophan (TRP), kynurenins ((kynurenine (KYN), 3-hydroxykynurenine (3-HKYN), kynurenic acid (KYNA)) and the level of L-5-hydroxytyrptophan (5HTrp) in blood plasma by HPLC method with fluorimetric and spectrophotometric detection.

Results. The groups of people with type 2 diabetes mellitus showed the increasing of TRP level in blood relatively to healthy individuals: by 15.1% (p = 0.032) and 17.9% (p = 0.030) in the first and second groups, respectively. As for the patients of the first group, the content of their KYN was increased by 57.7% (p = 0.012) and KYNA by 33.6% (p = 0.012) relatively to the control and the concentration of 3-НKYN decreased by 18.1% (p = 0.020) relatively to healthy people. As for the patients in the second group, the changes in their level of kynurenines had the same direction, but were more visible. Thus, the concentration of KYN exceeded the same parameters of healthy individuals by 84.5% (p = 0.001) and the parameters of the first group by 18.0% (p = 0.049); the KYNA level increased by 56.6% (p = 0.001) relatively to the control and by 17.3% (p = 0.049) from that of the first group. There was a decrease in the content of 3-HKYN amounted to 18.6% of the control (p = 0.038) and an increase in the concentration of 5HTrp – 193,9% (p < 0.001).
The effect of physical activity of varying intensity on cardiomyocyte hypertrophy and myocardial polyploidy in rats
Authors: Malyshev I. I. , Alpidovskaya O. V. , Romanova L. P.
Published: April 2024

Regular exercise improves cognitive function, reduces the risk of premature death from cardiovascular disease, stroke, diabetes and improves quality of life.

Aim: To study the morphological parameters of cardiomyocytes of the left ventricle of the heart and the proliferative activity of rat cardiomyocytes during physical activity of different intensity.

Methodology and Research Methods. Outbred male rats (n = 30) were taken as experimental animals and divided into three series. The first series of rats were given light physical activity – the animals swam in the bath for 15 minutes. The animals of the second series were in the bath for 30 minutes (moderate severity), the third series were in the bath until they began to lose strength and sink (in 55–59 minutes). Animals were taken out of the experiment after 10 sessions of water loading. Some rats (5 animals per series) were slaughtered 30 days after the end of the experiment. After extraction, the heart was stained with hematoxylin and eosin, the amount of DNA in the nuclei of cardiomyocytes was determined, binuclear and Ki-67 positive cells were counted, and the diameter of cardiomyocytes was measured. Statistical analysis was carried out in the program “Statistica 10.0”.

Results. Histological examination revealed changes only in the myocardium of the left ventricle of rats of the third series: pronounced dystrophic changes in cardiomyocytes. There were cells with necrobiosis, focal necrosis of groups of cardiomyocytes. The highest level of cardiomyocyte polyploidy occurred in the second and third series (the ratio of diploid and tetraploid cardiomyocytes in the control corresponded to 91.6 ± 7.4%; 8.2±6.3%). In these series, there was also a change in the number of binuclear cells (in the control – 12.7 ± 1.9‰). In all series of Ki-67 positive nuclei were not detected.

Conclusion. Severe physical activity leads to structural disorders of the myocardium, persistent hypertrophy of cardiomyocytes and is accompanied by a decrease in the proliferative activity of cardiomyocytes.
Experimental models of myocardial ischemia: classical approaches and innovations (review)
Authors: Slatova L. N. , Fedorina T. A. , Shatunova E. P.
Published: April 2024

Myocardial ischemia is the basis for many acute and chronic conditions with great social significance. Therefore, experimental models that describe ischemia development in humans are necessary for a better understanding of the pathophysiology of these conditions and the development of medical and surgical methods of treatment.

Aim: To compare current approaches to experimental modeling of myocardial ischemia considering the pathogenetic features of the simulated processes. The manuscript describes the main experimental models of myocardial ischemia: in vitro cellular models, ex vivo isolated heart models, in vivo animal models, the principal components of the ‘heart-on-chip’ model and the possibilities of in silico modeling. The criteria for choosing a specific model of ischemia by pathophysiological approach, advantages and limitations of the models are considered.
Long-term outcomes in patients with type 1 and type 2 myocardial infarction (data from a single-center register study)
Authors: Kinash V. I. , Kashtalap V. V. , Fedorov D. A. , Vorobiev A. S. , Urvantseva I. A. , Kovalenko L. V.
Published: April 2024

Aim: To study the annual outcomes of patients with a confirmed diagnosis of myocardial infarction (MI), depending on its type.

Material and Methods. Of the 1,325 hospitalized patients, 1,293 (97.5%) were diagnosed with acute coronary syndrome; the rest had extra-cardiac causes of chest pain. Follow-up included examinations of patients in the hospital and interviewing by phone or email in 12 months after discharge. All patients with MI were tested for the presence of personality type D. After 12 months of follow-up, the total number of patients diagnosed with MI was 255 (92.1%) patients [180 (70.5%) patients with MI1, 75 (29.5%) patients with MI2].

Results. After 12 months of follow-up, in the general group of patients complications developed in 53 (20.7%) patients (27 (15.0%) patients in the IM1 group and 26 (34.6%) patients in the IM2 group). Overall mortality and the frequency of repeat- ed hospitalizations for heart failure were higher in MI2 compared to MI1 [8 (10.6%) vs. 2 (1.1%) (p = 0.001) and 9 (12.0%) vs. 8 (4.4%) (p = 0.03), respectively]. The main predictors of adverse events in patients with MI2 were: obesity, p = 0.005; diabetes mellitus, p = 0.006; two-vessel lesion, p = 0.001; three-vessel lesion, р = 0.001; low adherence to drug therapy (< 6 points) on the Morisky-Green scale, p = 0.007; personality type D, p = 0.040. In patients with MI1, the main predictors of adverse events were: obesity, p = 0.019; male, p = 0.009. There were no statistically significant differences in both groups in the frequency of mortality from MI, the development of recurrent MI, as well as complications such as subacute/late stent thrombosis and restenosis in the stent.

Conclusion. In patients with MI2, compared with MI1, after 12 months of follow-up the indicators of total mortality (10.6% vs. 1.1%) and repeated hospitalizations due to decompensation of heart failure (12% vs. 4.4%) are higher.
Gut microbiota – a new link in the pathogenesis of osteoarthritis (literature review)
Authors: Korneva Yu. S. , Borisenko M. V. , Deev R. V.
Published: April 2024

The intestinal microbiota (IMB) can indirectly affect the course of ostearthritis (OA) at the systemic level by stimulating a chronic nonspecific inflammatory reaction in the synovial membrane and subchondral bone, the cause of which is an increase in the amount of circulating lipopolysaccharides (LPS) of the bacterial wall, as well as provoke the development of metabolic syndrome, which links the two necessary components of the pathogenesis of OA. The result of direct exposure is the formation of leaky gut syndrome with the activation of LPS of the bacterial wall of mild inflammation, provoking the production of proinflammatory cytokines, the effect of which on synoviocytes and chondrocytes leads to their activation with subsequent production of IL-6 and IL-8, which contributes to the persistence of inflammation. By correlation analysis, the relationship of three taxa with OA joint damage was proved, namely, the order Desulfovibrionales and the genus Ruminiclostridium 5 – with knee joint OA, Methanobacteriaceae – with knee joint OA, and OA of any localization, and the appearance and degree of contamination with the genus Streptococcus correlated with the severity of pain syndrome. The metabolic syndrome itself can provoke the development of dysbiosis, so it can also be its consequence. A change in the composition of the microbiota in the form of the predominance of the genus Clostridium and the species Staphylococcus aureus with a decrease in the diversity of microorganisms is associated with an increase in the amount of adipose tissue in the body, dyslipidemia, insulin resistance with impaired carbohydrate metabolism. Low levels of LPS in the blood are found in obese patients even in the absence of an obvious focus of infection due to violations in the CMB, they signal TLR-4, triggering systemic inflammation. Studies have shown a positive effect of prescribing proand prebiotics on the course of OA, which makes IMB a promising target for the treatment and prevention of OA.
Rationale and design of a prospective randomized study of the effect of ferric carboxymaltose therapy on quality of life and clinical picture of heart failure with preserved ejection fraction in patients with iron deficiency
Authors: Tukish O. V. , Garganeeva A. A. , Kuzheleva E. A. , Soldatenko M. V. , Kondratiev M. Yu. , Vitt K. N.
Published: April 2024

Introduction. The prevalence of iron deficiency (ID) among patients with chronic heart failure (CHF) ranges from 50% to 80%. It has been established that ID is a significant predictor of adverse outcomes and mortality in CHF, and is also associated with a decrease in exercise tolerance. The use of oral iron preparations for the purpose of its correction is limited by the high frequency of adverse events and, in some cases, their ineffectiveness in CHF. Ferric carboxymaltose has a high potential in the correction of ID, which has proven itself well in the cohort of patients with CHF, but its effectiveness has not been precisely established in CHF.

Aim: To evaluate the effect of ferric carboxymaltose therapy on the quality of life, functional status, and clinical picture of CHF in patients with diagnosed iron deficiency.

Material and Methods. It is a prospective randomized cohort study. It is planned to include 70 adult patients with CHF (NYHA II-III) and diagnosed ID: group 1 (n = 35) – group of drug therapy with ferric carboxymaltose, group 2 (n = 35) – without drug therapy. A control group of patients without ID (n = 30) will also be recruited. The prospective part involves the observation of patients with repeated visits after 6, 12 months, during which the indicators of quality of life, functional status, clinical picture of CHF, structural and functional echocardiographic indicators of LV and right heart, as well as the presence of repeated hospitalizations for CHF and death from all causes will be evaluated.
Clinical significance of echocardiographic signs of right heart dysfunction in patients with chronic heart failure with preserved left ventricular ejection fraction
Authors: Vitt K. N. , Kuzheleva E. A. , Tukish O. V. , Soldatenko N. V. , Kondratiev M. Yu. , Kirillova V. V. , Antipov S. I. , Garganeeva A. A.
Published: April 2024

Aim:To analyze the features of clinical signs, quality of life and psycho-emotional state in patients with heart failure with preserved left ventricular ejection fraction (HFpEF) and non-obstructive atherosclerosis of the coronary arteries, depending on the presence of echocardiographic criteria for dysfunction of the right heart.

Material and Methods.Patients underwent an extended protocol of echocardiography with an assessment of the structure and function of the right heart; ultrasound examination of the lungs with the determination of the number of B-lines; a six-minute walk test, a test for the presence of a symptom of bendopnea with the determination of blood oxygen saturation (SpO2) before and during the test. In addition, quality of life was assessed using the Minnesota questionnaire and the SF-36 questionnaire (The Short Form-36); the psycho-emotional state of patients was analyzed according to the HADS (Hospital Anxiety and Depression Scale), the level of adherence to treatment was analyzed according to the Morisky – Green questionnaire. Patients were divided into two groups depending on signs of right heart dysfunction: Tei index more than 0.54, tricuspid annulus systolic excursion (TAPSE) less than 17 mm, tricuspid annulus systolic velocity (RV S’) less than 9,5 cm/sec.

Results.Echocardiographic signs of right heart dysfunction in patients with HFpEF was associated with lower quality of life indicators according to the SF-36 questionnaire, in particular, general health status (p= 0.008) and role limitations due to emotional problems (p= 0.03). During the bendopnea test (p= 0.04), the majority of patients with signs of dysfunction of the right heart (66.7%) had a decrease in SpO2, while in the comparison group the proportion of such patients was 36.7% (p= 0.04). The psycho-emotional state according to the HADS scale and adherence to treatment did not differ in both groups (p> 0.05). The frequency of detection of B-lines according to lung ultrasound was also comparable.
The Spawns of the Saturation Framework
Authors: Tourret Sophie
Published: April 2024

The saturation framework by Leo Bachmair and Harald Ganzinger is the primary reference for proving the completeness of saturation-based calculi. In my invited talk, I presented a recent extension of this framework, its mechanisation in Isabelle/HOL and its various instances. Here I focus on the instances, using them to highlight various interesting features of the extended framework.
Integrating Answer Literals with AVATAR for Program Synthesis
Authors: Hozzová Petra
Published: April 2024

We recently introduced a framework for program synthesis based on functional specifications using a saturation-based theorem prover.

To make our synthesis technique efficient, we need to incorporate it into the prover's architecture.

In this paper, we describe the considerations of integrating our synthesis technique with the AVATAR splitting framework used in first-order theorem proving.

We present an example that illustrates the issues accompanying the integration and describe our solution: constraining the splitting and adding an additional inference rule replacing certain clauses with AVATAR assertions by assertion-free clauses.

Our experimental results indicate that the integration significantly improves the synthesis performance on some benchmarks.
ABORDAGEM TRAUMÁTICA NA COLUNA CERVICAL: IMAGEM, CLASSIFICAÇÃO E MANEJO AGUDO
Authors: Sousa Pablo Cid Magalhães de
Published: April 2024

Introdução: A coluna vertebral (CV) é o principal estabilizador, portador de carga do esqueleto axial e protetor de estruturas neurais e vasculares do corpo humano. No esqueleto saudável, o trauma med
USO DO SULFATO DE MAGNÉSIO EM PACIENTES COM AGUDIZAÇÃO DA ASMA: UMA REVISÃO SISTEMÁTICA
Authors: Vieira Leonardo Ditadi , Recuero Mariana Piltcher
Published: April 2024

Introdução: O sulfato de magnésio é um dos tratamentos padrão para crises de asma aguda em diversas diretrizes, contudo, o seu real benefício na clínica dos pacientes possui discordâncias. Essa revisã