bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the influencing factors of unmet palliative care needs in Chinese patients with end-stage renal disease undergoing maintenance hemodialysis: a cross-sectional study
Authors: Wang Xuefei , Mo Yongzhen , Yuan Yingying , Zhou Yi , Chen Yan , Sheng Juan , Liu Jing
Published: August 2023

Background

The role of palliative care for end-stage renal disease (ESRD) patients have been proven in some developed countries, but it is still unclear in the mainland of China. In fact, patients with ESRD experience many unmet palliative care needs, such as physical, psychological, social and spiritual needs, but the factors influencing these needs have not investigated.

Methods

A cross-sectional study was conducted at two hemodialysis centers in the mainland of China from January to September 2022. Convenience sampling was used to collect data on the participants' socio-demographics, clinical characteristics, the Palliative Care Outcome Scale (POS), the Dialysis Symptom Index (DSI), the Karnofsky Performance Status Scale (KPS), the Patient Health Questionnaire-9 item (PHQ-9), and the Social Support Rate Scale (SSRS). Data were analyzed using latent profile analysis, Kruskal–Wallis test, one-way analysis of variance (ANOVA), the chi-square test and multinomial logistic regression analysis.

Results

Three hundred five participants were included in this study, and divided palliative care needs into three categories: Class 1, mild palliative care needs (n = 154, 50.5%); Class 2, moderate palliative care needs (n = 89, 29.2%); Class 3, severe palliative care needs (n = 62, 20.3%). Based on the analysis of three profiles, the influencing factors of unmet needs were further analyzed. Compared with Class 3, senior high school education, the household per capita monthly income < 2,000, low KPS scores, high PHQ-9 scores, and low SSRS scores were less likely to be in Class 1 (OR = 0.03, P = 0.012; OR = 0.003, P < 0.001; OR = 1.15, P < 0.001; OR = 0.55, P < 0.001; OR = 1.35, P = 0.002; respectively) and Class 2 (OR = 0.03, P = 0.007; OR = 0.05, P = 0.011; OR = 1.10, P = 0.001; OR = 0.60, P = 0.001; OR = 1.32, P = 0.003; respectively), and high symptom severity were less likely to be in Class 1 (OR = 0.82, P = 0.001). Moreover, compared with Class 1, the household per capita monthly income < 2,000 (OR = 16.41, P < 0.001), high symptom severity scores (OR = 1.12, P = 0.002) and low KPS scores (OR = 0.95, P = 0.002) were more likely to be in Class 2.

Conclusions

This study showed that almost half of ESRD patients receiving MHD presented moderate to severe palliative care needs, and the unmet needs were mainly affected by education level, financial pressure, functional status, symptom burden and social support. In the future, it is important to identify the populations with the greatest need for palliative care and consider the influencing factors of unmet needs from a comprehensive perspective, so as to help them improve health-related quality of life.
Using integrated analysis from multicentre studies to identify RNA methylation-related lncRNA risk stratification systems for glioma
Authors: Huang Fanxuan , Wang Xinyu , Zhong Junzhe , Chen Hao , Song Dan , Xu Tianye , Tian Kaifu , Sun Penggang , Sun Nan , Qin Jie , Song Yu , Ma Wenbin , Liu Yuxiang , Yu Daohan , Meng Xiangqi , Jiang Chuanlu , Xuan Hanwen , Qian Da , Cai Jinquan
Published: August 2023

Background

N6-methyladenosine (m6A), 5-methylcytosine (m5C) and N1-methyladenosine (m1A) are the main RNA methylation modifications involved in the progression of cancer. However, it is still unclear whether RNA methylation-related long noncoding RNAs (lncRNAs) affect the prognosis of glioma.

Methods

We summarized 32 m6A/m5C/m1A-related genes and downloaded RNA-seq data and clinical information from The Cancer Genome Atlas (TCGA) database. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were used to identify differentially expressed (DE-) RNA methylation-related lncRNAs in order to construct a prognostic signature of glioma and in order to determine their correlation with immune function, immune therapy and drug sensitivity. In vitro and in vivo assays were performed to elucidate the effects of RNA methylation-related lncRNAs on glioma.

Results

A total of ten RNA methylation-related lncRNAs were used to construct a survival and prognosis signature, which had good independent prediction ability for patients. It was found that the high-risk group had worse overall survival (OS) than the low-risk group in all cohorts. In addition, the risk group informed the immune function, immunotherapy response and drug sensitivity of patients with glioma in different subgroups. Knockdown of RP11-98I9.4 and RP11-752G15.8 induced a more invasive phenotype, accelerated cell growth and apparent resistance to temozolomide (TMZ) both in vitro and in vivo. We observed significantly elevated global RNA m5C and m6A levels in glioma cells.

Conclusion

Our study determined the prognostic implication of RNA methylation-related lncRNAs in gliomas, established an RNA methylation-related lncRNA prognostic model, and elucidated that RP11-98I9.4 and RP11-752G15.8 could suppress glioma proliferation, migration and TMZ resistance. In the future, these RNA methylation-related lncRNAs may become a new choice for immunotherapy of glioma.
Robot-assisted radical cystectomy vs open radical cystectomy in patients with bladder cancer: a systematic review and meta-analysis of randomized controlled trials
Authors: Liu Hongquan , Zhou Zhongbao , Yao Huibao , Mao Qiancheng , Chu Yongli , Cui Yuanshan , Wu Jitao
Published: August 2023

Purpose

Even though there isn't enough clinical evidence to demonstrate that robot-assisted radical cystectomy (RARC) is preferable to open radical cystectomy (ORC), RARC has become a widely used alternative. We performed the present study of RARC vs ORC with a focus on oncologic, pathological, perioperative, and complication-related outcomes and health-related quality of life (QOL).

Methods

We conducted a literature review up to August 2022. The search included PubMed, EMBASE and Cochrane controlled trials register databases. We classified the studies according to version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The data was assessed by Review Manager 5.4.0.

Results

8 RCTs comparing 1024 patients were analyzed in our study. RARC was related to lower estimated blood loss (weighted mean difference (WMD): -328.2; 95% CI -463.49—-192.92; p < 0.00001), lower blood transfusion rates (OR: 0.45; 95% CI 0.32 – 0.65; p < 0.0001) but longer operation time (WMD: 84.21; 95% CI 46.20 -121.72; p < 0.0001). And we found no significant difference in terms of positive surgical margins (P = 0.97), lymph node yield (P = 0.30) and length of stay (P = 0.99). Moreover, no significant difference was found between the two groups in terms of survival outcomes, pathological outcomes, postoperative complication outcomes and health-related QOL.

Conclusion

Based on the present evidence, we demonstrated that RARC and ORC have similar cancer control results. RARC is related to less blood loss and lower transfusion rate. We found no difference in postoperative complications and health-related QOL between robotic and open approaches. RARC procedures could be used as an alternate treatment for bladder cancer patients. Additional RCTs with long-term follow-up are needed to validate this observation.
Indicators and medical tests to identify lower limb swelling causes after total knee arthroplasty: a Delphi study with multidisciplinary experts
Authors: Yang Lin , Wu Bei-Ying , Wang Cai-feng , Li Hui-Wu , Bian Wei-Wei , Ruan Hong
Published: August 2023

Background

Lower limb swelling after total knee arthroplasty (TKA) hinders surgical effectiveness. The poor results of studies on swelling interventions are due to the lack of a classification of swelling causes through appropriate medical tests. A gold standard is missing. This study aimed to clarify the causes of TKA postoperative swelling and how to identify them through indicators and medical tests by consulting a wide range of experts from multiple disciplines.

Method

The Delphi method was used. A first draft of the index was prepared based on a systematic search of the literature. A total of 11 experts from several disciplines were invited to evaluate the rationality of the indicators and suggest modifications. After two rounds of consultation, the experts reached a consensus, and the consultation was stopped.

Results

The response rate of the 11 experts was 100%, and the authoritative Cr was 0.896. Kendall's W values for opinion coordination of the two rounds of consultation were 0.262 and 0.226, respectively (P < 0.001). Among the final indicators, there were 4 primary indicators for swelling cause classification (inflammatory response, poor venous return, joint hematoma, muscle damage, and healing), 19 secondary and 19 tertiary indicators.

Conclusion

The indications obtained by systematic literature review and multidisciplinary expert consultation are reliable and scientific. Multiple causes of lower extremity swelling after TKA were identified. Blood test indicators can reflect an inflammatory response, suggest poor venous return, and reflect muscle damage and healing progress. Ultrasound scans are needed to identify underlying thrombotic or valvular problems, joint hematomas, and muscle damage. These tests help clinicians and researchers determine the cause of swelling after TKA and take appropriate management.
Correlation investigation between a single nucleotide polymorphism in ADAMTS14 (rs4747096) and osteoarthritis: a meta-analysis
Authors: Li Baojie , Li Xiaojing , Zhang Linjing , Mou Leming
Published: August 2023

Background

Current evidence of the association between a single nucleotide polymorphism (SNP) in ADAMTS14 (rs4747096) and osteoarthritis (OA) is controversial. This study aimed to determine whether the ADAMTS14 SNP is closely related to OA risk.

Methods

An electronic search of for the association between the rs4747096 polymorphisms and OA was performed using four online databases (updated on September 10, 2022). The association between susceptibility to OA and rs4747096 polymorphism was evaluated in four genetic models: the allele (mutation [A] vs. wild type [G]), additive (AA vs. GG and AG vs. GG), recessive (AA vs. AG + GG), and dominant (AA + AG vs. GG). This meta-analysis was performed in the R software, and effects were assessed using odds ratios (ORs) and 95% confidence intervals (CI).

Results

Four studies (707 cases in the case group and 859 cases in the control group) were included. The results of the meta-analysis showed that, except in the recessive genetic model, there was a significant correlation between OA risk and the rs4747096 polymorphism using the allele (OR [95% CI] = 1.48 [1.26–1.73], P < 0.001), additive (AG vs. GG, OR [95% CI] = 2.56 [1.79–3.65], P < 0.001; AA vs. GG, OR [95% CI] = 2.81 [1.98–3.98], P < 0.001), and dominant (OR [95% CI)] = 1.72 [1.34–2.2], P < 0.001) genetic models.

Conclusions

The ADAMTS14 rs4747096 polymorphism is associated with susceptibility to OA.
“A picture is worth a thousand words”: smoking in multi-unit housing in Israel
Authors: Zeller Mitchell
Published: August 2023

A brief commentary on the need for policy change by the Israeli government to address the problem of tobacco smoke incursion in multi-unit housing. The commentary also includes a call for enhanced products, programs, and services to help smokers in Israel quit.
Comparison of microbial colonization rates between central venous catheters and peripherally inserted central catheters
Authors: Pitiriga Vassiliki , Bakalis John , Theodoridou Kalliopi , Dimitroulia Evangelia , Saroglou George , Tsakris Athanasios
Published: August 2023

Background

Central venous catheters (CVCs) and peripherally inserted central catheters (PICCs), have been widely used as intravascular devices in critically ill patients. However, they might evoke complications, such as catheter colonization that has been considered as predisposing factor for central line-associated bloodstream infections (CLABSIs). Although numerous studies have compared the risk of bloodstream infections between PICCs and CVCs, comparative studies on their colonization rates are limited.

Objectives

The episodes of catheter colonization in critically ill patients with CVCs or PICCs were retrospectively analysed during a two-year period in a Greek tertiary care hospital and colonization rates, microbial profiles and antimicrobial susceptibility patterns were compared.

Methods

Clinical and laboratory data of consecutive hospitalized critically-ill patients who underwent PICC and CVC placement between May 2017–May 2019 were analysed. All catheters were examined by the semiquantitative culture technique for bacterial pathogens, either as a routine process after catheter removal or after suspicion of infection. Species identification and antimicrobial resistance patterns were determined by the Vitek2 automated system.

Results

During the survey period a total of 122/1187 (10.28%) catheter colonization cases were identified among CVCs and 19/639 (2.97%) cases among PICCs (p = 0.001). The colonization rate was 12.48/1000 catheter-days for the CVC group and 1.71/1000 catheter-days for the PICC group (p < 0.001). The colonization rate per 1000 catheter-days due to multidrug-resistant organisms (MDROs) was 3.85 in all study cases, 7.26 (71/122) in the CVC group and 0.63 (7/19) in the PICC group (p < 0.001). Within the CVC group, the most common microorganism isolated was MDR Acinetobacter baumannii (n = 38, 31.1%) followed by MDR Klebsiella pneumoniae (n = 20, 16.4%). In the PICC group, the predominant microorganism isolated was Candida spp. (n = 5, 23.8%) followed by MDR K. pneumoniae and MDR A. baumannii in equal numbers (n = 3, 14.2%).

Conclusion

PICC lines were associated with significantly lower colonization rates comparing to the CVC ones. In addition, patterns of microbial colonization revealed a trend over the predominance of MDR gram-negatives in CVCs suggesting that PICCs might be a safer alternative for prolonged inpatient intravascular access. Prevention programs directed by local microbial ecology may diminish catheter colonization rates and CLABSIs.
Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation
Authors: Loesaus Sebastian , Zahn Peter Konrad , Bechtel Matthias , Strauch Justus Thomas , Buchwald Dirk , Baumann Andreas , Berres Dinah Maria
Published: August 2023

Background

The presence of Nucleated Red Blood Cells (NRBCs) in critically ill patients is associated with higher mortality and poor prognosis. Although patients on extracorporeal support such as veno-venous or veno-arterial extracorporeal membrane oxygenation (VV/VA-ECMO) are severely ill, NRBCs have rarely been investigated regarding their predictive value so far.

Methods

As part of a retrospective study, we examined all cardiothoracic surgery patients from July 2019 to September 2020 who received ECMO treatment during their inpatient stay. The aim of this study was to investigate the occurrence of NRBCs during ECMO support in terms of their predictive value for mortality.

Results

In total 30 patients (age at admission: 62.7 ± 14.3 year; 26 male; ECMO duration: 8.5 ± 5.1 days; ICU duration: 18.0 ± 14.5 days) were included. 16 patients (53.3%) died during their inpatient stay. There were no significant differences in demographic characteristics between VA- or VV- ECMO patients. NRBCs occurred in all patients while under ECMO support. NRBC value was significant higher in those who died (2299.6 ± 4356.6 µl) compared to the surviving patients (133.6 ± 218.8 µl, p < 0.001). Univariate analysis found that patients with a cutoff value of ≥ 270 NRBCs/µl during ECMO support were 39 times more likely to die (OR 39.0, 95% CI 1.5–997.5, p < 0.001). 12 out of 13 patients (92.3%) with ≥ 270 NRBCs/µl died. The area under the curve (AUC) of the receiver operating characteristic curve was 0.85 (95% CI 0.69–0.96) with a sensitivity of 75.0% and a specificity of 92.9%.

Conclusion

NRBCs appear to be an accurate biomarker for mortality in patients with ECMO support. They may be helpful in deciding if therapy becomes futile.

Trial registration DRKS00023626 (December 20th 2020).
How do prolonged anchorage-free lifetimes strengthen non-small-cell lung cancer cells to evade anoikis? – A link with altered cellular metabolomics
Authors: Sungthong Rungroch , Khine Hnin Ei Ei , Sumkhemthong Somruethai , Chanvorachote Pithi , Tansawat Rossarin , Chaotham Chatchai
Published: August 2023

Background

Malignant cells adopt anoikis resistance to survive anchorage-free stresses and initiate cancer metastasis. It is still unknown how varying periods of anchorage loss contribute to anoikis resistance, cell migration, and metabolic reprogramming of cancerous cells.

Results

Our study demonstrated that prolonging the anchorage-free lifetime of non-small-cell lung cancer NCI-H460 cells for 7 days strengthened anoikis resistance, as shown by higher half-life and capability to survive and grow without anchorage, compared to wild-type cells or those losing anchorage for 3 days. While the prolonged anchorage-free lifetime was responsible for the increased aggressive feature of survival cells to perform rapid 3-dimensional migration during the first 3 h of a transwell assay, no significant influence was observed with 2-dimensional surface migration detected at 12 and 24 h by a wound-healing method. Metabolomics analysis revealed significant alteration in the intracellular levels of six (oxalic acid, cholesterol, 1-ethylpyrrolidine, 1-(3-methylbutyl)-2,3,4,6-tetramethylbenzene, β-alanine, and putrescine) among all 37 identified metabolites during 7 days without anchorage. Based on significance values, enrichment ratios, and impact scores of all metabolites and their associated pathways, three principal metabolic activities (non-standard amino acid metabolism, cell membrane biosynthesis, and oxidative stress response) offered potential links with anoikis resistance.

Conclusions

These findings further our insights into the evolution of anoikis resistance in lung cancer cells and identify promising biomarkers for early lung cancer diagnosis.
Complications in Interventional Radiology: the role of clinical governance and iterative hospital systems in quality improvement
Authors: Clements Warren , Koukounaras Jim
Published: August 2023

As modern Interventional Radiology (IR) evolves, and expands in scope and complexity, it will push the boundaries of existing literature. However, with all intervention comes risk and it is the shared judgement of the risk–benefit analysis which underpins the ethical and legal principles of care in IR.

Complications in medicine are common, said to occur in 9.2% of in-hospital healthcare interactions. Healthcare complications also come at considerable cost. It is estimated that in the UK, prolonging hospital stays to manage complications can cost ₤2 billion per year.

However, complications can’t be viewed in isolation. Clinical governance is the umbrella within which complications are viewed. It can be defined as a broadly integrated and systematic approach to clinical care and accountability, that seeks to focus on quality of healthcare. This concept incorporates complications but acknowledges their interplay within a complex healthcare system in which negative adverse events are influenced by a range of intrinsic and extrinsic factors. It also includes the processes that result from monitoring and learning from complications, with feedback leading to systems-based improvements in care moving forward. The reality is that complications are uncommonly the result of medical negligence, but rather they are an unfortunate by-product of a healthcare industry with inherent risk.

It is also important to remember that complications are not just a number on an audit sheet, but a potentially life-changing event for every patient that is affected. The events that follow immediately from an adverse outcome such as open disclosure are vital, and have implications for how that patient experiences healthcare and trusts healthcare professionals for the rest of their life. We must ensure that the patient and their family maintain trust in healthcare professionals into the future.

Credentialling and accreditation are imperative for Interventional Radiologists to meet existing standards as well deal with challenging situations. These should integrate and align within the structure of an organization that has a safety and learning culture. It is the many layers of organisational clinical governance that arguably play the most important role in IR-related complications, rather than apportioning blame to an individual IR.
Moment-to-moment affective dynamics in schizophrenia and bipolar disorder
Authors: So Suzanne Ho-wai , Chau Anson Kai Chun , Chung Lawrence Kin-hei , Leung Chung-ming , Chong George H.C. , Chang Wing Chung , Mak Arthur D.P. , Chan Sandra S.M. , Lee Sing , Sommer Iris E.
Published: August 2023

Background

Affective disturbances in schizophrenia and bipolar disorder may represent a transdiagnostic etiological process as well as a target of intervention. Hypotheses on similarities and differences in various parameters of affective dynamics (intensity, successive/acute changes, variability, and reactivity to stress) between the two disorders were tested.

Methods

Experience sampling method was used to assess dynamics of positive and negative affect, 10 times a day over 6 consecutive days. Patients with schizophrenia (n = 46) and patients with bipolar disorder (n = 46) were compared against age-matched healthy controls (n = 46).

Results

Compared to controls, the schizophrenia group had significantly more intense momentary negative affect, a lower likelihood of acute changes in positive affect, and reduced within-person variability of positive affect. The bipolar disorder group was not significantly different from either the schizophrenia group or the healthy control group on any affect indexes. Within the schizophrenia group, level of depression was associated with weaker reactivity to stress for negative affect. Within the bipolar disorder group, level of depression was associated with lower positive affect.

Conclusions

Patients with schizophrenia endured a more stable and negative affective state than healthy individuals, and were less likely to be uplifted in response to happenings in daily life. There is little evidence that these affective constructs characterize the psychopathology of bipolar disorder; such investigation may have been limited by the heterogeneity within group. Our findings supported the clinical importance of assessing multiple facets of affective dynamics beyond the mean levels of intensity.
Morphometric study of the lumbar vertebrae in dried anatomical collections
Authors: Ashish Sharad , Kalluraya P. , Pai Mangala , Murlimanju B.V. , Rao Y. , Prabhu Latha , Agrawal Amit
Published: August 2023

Background: The objective of this anatomical study was to perform the morphometry of dried lumbar vertebrae in human cadavers.

Methods: This study utilized 200 adult human cadaveric dried lumbar vertebrae. The digital Vernier calipers was used to perform the measurements. The height, antero-posterior length, transverse length of the body of the vertebrae, interpedicular distance at the lateral ends, lamina length, height and thickness, superior and inferior articular facet height and width, mid sagittal and transverse diameter of vertebral foramen, height, width and thickness of the pars inter-articularis were measured.

Results: The vertebral body’s anteroposterior length was more at the lower border than at the superior border (p < 0.01). The length of lamina was higher over the right in comparison to the left (p < 0.001). The height of lamina, width of inferior articular facet, diameter of lateral recess and thickness of pars inter-articularis were greater for the left sided specimens (p < 0.01). The statistical significance was not observed for the comparison of the remaining parameters (p > 0.05).

Conclusion: This anatomical study offered several dimensions of lumbar vertebrae, which are essential in the surgical practice. The implants at the lumbar vertebrae need to be manufactured based on the anatomical dimensions of that particular sample population.
Potential of goats’ milk from Aceh hybrid and Etawa goats in producing specific anti-S. mutans antibodies as candidate antibodies for caries immunotherapy
Authors: Chismirina Santi , Sungkar Suzanna , Adlim Muhammad , Darmawi Darmawi
Published: August 2023

Background: Mother goats produce immunoglobulin G (IgG) as a specific antibody in serum, which is then transferred into milk as natural immunity for their children. Based on this, IgG from goat milk has the potential to replace the role of igg from mammalian blood in preventing caries. The goal of this study was to see if goat milk could be used to produce specific antibodies against Streptococcus mutans (S. mutans) as a candidate antibody for caries immunotherapy.

Methods: In this study, pregnant goats were divided into two groups: control and treatment. The treatment group received an injection of S. mutans and then received the second injection, which was the administration of antigen added Freud adjuvant complete (booster 1) subcutaneously, and the third injection, which was the administration of antigen added Freud adjuvant complete (booster 1), and antigen added Freud adjuvant incomplete (booster 2). Blood serum was analyzed qualitatively using the Agar Gel Precipitation Test (AGPT) method to determine antibody formation. Furthermore, colostrum and goat milk were analyzed using the Sandwich ELISA method to determine the formation of anti-S mutans IgG in colostrum and goat milk.

Results: Pregnant goats that had been given booster 1 and 2 with a dose of antigen + Freud Adjuvant 1.5:0.5 produced anti-S. mutans antibody titers. Normal levels of IgG in goat colostrum range from 40-60 mg/ml while in milk 0.6-7.5 mg/ml and there is a decrease in the concentration of IgG anti-S. mutans in each week.

Conclusions: Colostrum and goat milk produced contain IgG-anti S. mutans antibodies that can be used to prevent dental caries.
Indocyanine green based antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment in periodontal maintenance patients: a clinico-microbiological study
Authors: Roy Chowdhury Urbashi , Kamath Deepa , Rao Pooja , Shenoy M Suchitra , Shenoy Ramya
Published: August 2023

Background: Antimicrobial Photodynamic therapy for the treatment of periodontitis is being increasingly gaining attention but at present, very limited data are available on the clinical and microbiological outcomes obtained following Indocyanine Green as the photosensitizer in Maintenance patients. The objective was to evaluate the efficiency of Indocyanine(ICG)-green based photodynamic therapy as an adjunct to scaling and root planing in patients enrolled in maintenance therapy.

Methodology: Using a split mouth study design, 24 participants enrolled in the maintenance therapy, having diagnosed as Periodontitis, were randomly subjected to scaling and root planing(SRP). The test group additionally received ICG-based (Aurogreen®, Aurolabs, Madurai, India,1mg/ml) aPDT with an 810nm diode laser. Clinical assessment of Plaque index, modified Sulcus bleeding index, Probing pocket depth, Clinical loss of attachment and microbiological analysis of A. actinomycetemcomitans, P. gingivalis, T. forsythia and F.nucleatum were performed at baseline and 3 months after treatment.

Results: It was observed that although there was no significant difference between the test and control group at baseline and 3 months, there was a statistically significant reduction in the mean values in both the groups at 3 months. Microbiological analysis showed substantial reduction in detection frequency of the bacteria assessed at 3 months in both the groups.

Conclusion: Within the limits of the study, ICG-based aPDT did not show additional advantage over SRP alone at 3 months, though it could be a promising treatment modality in maintenance patients in terms of patient comfort and the treatment time taken. More randomised clinical trials should be employed to understand the exact mode of action of ICG based aPDT and its role in treatment of periodontal disease.
METHODOLOGICAL ASPECTS OF LUNG ACOUSTIC IMPEDANSOMETRY
Authors: Dragan Sergey P. , Bogomolov Aleksey V. , Kezik Vladimir I. , Drozdov Sergey V.
Published: August 2023

Background. The pandemic caused by a new coronavirus infection has determined the relevance of the development of non-invasive methods for express examination of the function of external respiration in the interests of medical diagnostics and development of personal protective equipment against infectious diseases transmitted by airborne droplets.

Purpose. The purpose was to study the possibility of increasing the information content of diagnosing the state of the respiratory system by measuring the acoustic impedance using the modernized two-microphone method.

Materials and methods. An experimental study of the impedance and biophysical characteristics of the lungs was carried out on groups of healthy (12 heads) and patients with pneumonia (7 heads) male rabbits weighing 2.5-3 kg. To study the acoustic characteristics of the lungs, a direct method of impedancemetry based on a two-microphone measurement technique was used; the determination of the biophysical parameters of the lungs is based on measuring their weight and volume.

Results. The fact of an increase in active energy losses of low-frequency acoustic oscillations during their propagation in the respiratory system has been experimentally established, which makes it possible to create an informative criterion for diagnosing its condition. When examining healthy lungs using acoustic impedancemetry, the active energy loss of acoustic vibrations at low frequencies should not differ significantly from the corresponding values of the energy loss of such vibrations at the resonant frequency. In case of violations of the conductivity of the airways or in the presence of exudate in the lungs, active losses at low frequencies will significantly exceed losses at the resonant frequency: the worse the condition of the lungs, the higher the losses. It has been established that the presence in the lungs of a cavity with its own resonant frequency leads to a decrease in the resistance of the respiratory system at these frequencies.

Conclusion. The experimentally recorded fact of a decrease in resistance at frequencies below the resonant frequency of the respiratory system makes it possible to explain the insufficient diagnostic information content of pulsed oscillometry. To increase the sensitivity and specificity of pulsed oscillometry, it is necessary not to limit the determination of acoustic indicators only at frequencies of 5 and 20 Hz, but to determine them in an extended frequency range with a more detailed step.
MORPHOLOGICAL AND QUANTITATIVE STUDIES OF THE HEMOCYTES IN NYMPH AND IMAGO OF BLAPTICA DUBIA (SERVILLE, 1839)
Authors: Grebtsova Elena A. , Prisnyi Andrey A.
Published: August 2023

The purpose of the research is to analyze how the hemocyte counts and their morphological characteristics change during development of Blaptica dubia, especially during molting. And to suggest a possible scheme of the transformation of spherulocytes into crescent-cells.

Materials and methods. Quantitative and morphological features of hemocytes of imago and nymphs of 1-4 stages of Blaptica dubia using light microscopy and AFM were researched. Cell, nucleus and granule sizes were determined using NIS-Elements and NOVA software. Cytochemical tests with neutral red and alcyan blue allowed us to identify different cell types.

Results. This study presents a classification of hemocytes in Blaptica dubia, that based on morphological and cytochemical characteristics of cells. We analyzed the dynamics of the hemocytes counts in 6 nymphs (1-4 stages) and 6 imago. Special attention is given to the moment of molting. Seven hemocyte types were described and identified as: prohemocytes, plasmocytes, granulocytes, vermicytes, spherulocytes, coagulocytes and crescent-cells. The stem cells (prohemocytes) and spherulocytes were the predominant hemocytes. Prohemocytes counts decrease as a result of insect development, instead the relative number of plasmocytes and granulocytes increases. Spherulocytes counts could increase to 35% at the moment of leaving the ootheca and at the molting period. Due to the study of hemocytes diversity in different nymph stages, interim cells and possible ways of their transformations were identified. The unusual crescent-cells, that were unique for Gromphadorhina portentosa, had been found in Blaptica dubia. For the first time, the cytochemical test allowed to determine the origin of crescent-cells from spherulocytes.
EFFECTS OF THE IMMUNOMODULATOR ‘GALAVIT’ ON THE DEVELOPMENT OF B16 MELANOMA IN MICE
Authors: Yatsenko Elena M. , Baranovsky Denis S. , Pronkevich Marianna D. , Isaeva Elena V. , Smirnova Anna N. , Petrov Vasiliy N. , Ivanov Sergey A. , Kaprin Andrey D.
Published: August 2023

In recent years, major attention has been devoted to immunotherapy in oncology. Immunotherapy is a promising treatment approach targeted to inhibit tumor growth via stimulating the body’s antitumor immune response.

Purpose. The study was aimed to investigate the relationship between melanoma growth and metastasis in mice with the various schemes of Galavit treatment.

Materials and methods. We used B16-F10 melanoma in F1-mouse as an experimental model. We divided animals in 3 groups: control (no therapy after tumor transplantation); immediate Galavit therapy at a dose of 5 mg/mouse after tumor transplantation; postponed Galavit therapy a week after tumor transplantation at doses of 5mg/mouse. We evaluated the rate of tumor node growth, 50-day survival rate and metastatic development after the 50th day follow-up period.

Results. We revealed 80% survival rate for 50-day observation period in the control group. Interestingly, the 50-day survival rate was 60% for the animals treated with Galavit immediately after tumor inoculation. In other group with postponed Galavit therapy, survival rate was 100 %. A similar pattern was observed for tumor growth rates.

Conclusion. We found that therapy with Galavit a week after tumor inoculation significantly increased the 50-day survival rate, suppressed tumor growth and the development of metastases in comparison with the control group and the group with immediate Galavit administration.
INTERRELATION SYSTEM OF TRANSFORMATIONAL PROCESSES OF AGRICULTURAL ECONOMIC STRUCTURES AND PROBLEMS OF SUSTAINABLE FOOD SECURITY
Authors: Maksimova Tatiana P. , Bondarenko Tatiana G. , Zhdanova Olga A. , Prodanova Natalia A.
Published: August 2023

The relevance of the problem under study is connected with the identification of the relationship between the transformation processes of agrarian structures and issues of sustainable food security; with the definition of contradictions and uncertainties of the harmonious interaction of different forms of management formed in the process of transformation; revealing their functional differences; typology and scenario forecasts of development. The dualistic nature of the results of the transformation of the main forms of management in the system of the national economy is substantiated.

Purpose. Identification of key aspects of the specifics of the results of transformational processes of economic structures in the agrarian economy of the Russian Federation and substantiation of the importance of a harmonious relationship with each other in accordance with the tasks of food security in the face of modern challenges.

Materials and methods. The methodology of an integrated approach was used based on the systematic approach of Western and Russian researchers, as well as on the methodology of small economic structures Chayanova A.V., Kondratieva N.D. Methods of comparative economic analysis using the data of official statistics of the Russian Federation and FAO, as well as methods of visualizing the results of the study are involved. The case method was used to study the specifics of various economic structures, and the scenario modeling method was used to determine the trends for further development.

Results. Based on a comparative analysis of the results of the market transformation of economic structures and the economic effects of their activities, it was revealed that: firstly, the dynamics and rates of food inflation in the system of the Russian economy are lower than the global ones; secondly, large economic structures prevail in the structure of production and rates of output of food products; thirdly, the predominance of market power on the part of large economic structures leads to the deformation of market relations and the need to find a solution to the problem of creating equal opportunities for large and small economic structures.

Conclusion. The importance of creating a model of harmonious relations between different forms of management is substantiated. Scenario forecasts of possible trends in the further development of small and large economic structures have been made.
FUNCTIONAL STATE OF THE AUTONOMIC NERVOUS SYSTEM IN ELDERLY PERSONS WITH POSTURAL INSTABILITY
Authors: Shiryaeva Taisiya P. , Fedotov D. M. , Krainova I. N. , Ramirez Navarro F.
Published: August 2023

Background. Preservation of postural balance allows the elderly people to remain mobile and lead an active lifestyle. There is evidence of the contribution of the ANS to the coordination of postural responses and the maintenance of postural stability in young adults. However, similar data for the elderly is not enough and this issue requires further study.

Purpose. To reveal the peculiarities of ANS functioning in elderly people with postural instability.

Materials and methods. In 120 women aged 60-74 years, a survey, anthropometry, assessment of the dynamic component of postural balance by stabilometry and heart rate variability by cardiointervalography were performed. The study group included elderly people with postural instability (60 people), the control group included 60 women who did not report such facts. Data analysis was performed using “SPSS 27.0”.

Results. The state of postural balance in the study group was characterized by a decrease in walking speed (p = 0.008) and a rise index when moving from the right leg (p = 0.016), an increase in the speed of oscillations of the center of body mass in the lifting phase (p = 0.047), oscillations of the center of gravity during rotation when moving on the left (p=<0.001) and right (p=0.003) legs, turn time when moving on the left (p=0.44) and right (p=0.36) legs.

Conclusion. The results demonstrate a decrease in the quality and efficiency of postural balance regulation in elderly women with postural instability. We did not reveal any significant differences in the indicators characterizing the activity of different parts of the ANS depending on the facts of postural instability.
INCLUSION OF OPEN INJURIES IN AN UPDATED SCHENCK CLASSIFICATION OF KNEE DISLOCATIONS BASED ON A GLOBAL DELPHI CONSENSUS STUDY
Authors: Scheepers Waldo , Held Michael , von Bormann Richard , Wascher Daniel , Richter Dustin , Schenck Robert , Harner Christopher
Published: August 2023

Introduction

Knee dislocations (KDs) are complex injuries which are often associated with damage to surrounding soft tissues or neurovascular structures. A classification system for these injuries should be simple and reproducible and allow communication among surgeons for surgical planning and outcome prediction. The aim of this study was to formulate a list of factors, prioritised by high-volume knee surgeons, that should be included in a KD classification system.

Methods

A global panel of orthopaedic knee surgery specialists participated in a Delphi process. A list of factors to be included in a KD classification system was formulated by 91 orthopaedic surgeons, which was subsequently prioritised by 27 experts from 6 countries. The items were analysed to find factors that had at least 70% consensus for inclusion in a classification system.

Results

The four factors that reached consensus agreement and thus deemed critical for inclusion in a classification system were vascular injuries (89%), common peroneal nerve injuries (78%), number of torn ligaments (78%), and open injuries (70%).

Conclusion

The wide geographic distribution of participants provides diverse insight and makes the results of the study globally applicable. The most important factors to include in a classification system as determined by the Delphi technique were vascular injuries, common peroneal nerve injuries, number of torn ligaments, and open injuries. The Schenck anatomic classification system most accurately identifies these patient variables with the addition of open injuries. The authors propose to update the Schenck classification system with the inclusion of open injuries as an additional modifier.
ADVICE GIVEN TO CLIMBERS PRIOR TO KNEE ARTHROPLASTY: PATIENT AND SURGEON EXPERIENCE
Authors: Warder Holly , Hall-Thompson Beth , Sanders Tim , Wright Nicholas , Alford Simon , Johnson David
Published: August 2023

The Montgomery ruling advocates patients be informed of ‘material risks’ of a procedure. With no guidelines for patients wishing to return to high activity levels after knee arthroplasty, we explore patient and surgeon perceptions in climbers.

Ethical approval was granted by the University of Central Lancashire. Anonymous questionnaires were sent via email and social media to consultant knee arthroplasty surgeons and to climbers/mountaineers across the UK. Consultants were asked about advice given for patients who participate in climbing. Climbers were asked about their experiences of knee arthroplasty and return to activity.

Of 33 knee arthroplasty surgeons, 11(33%) were firmly against any return to climbing, 10(30%) counselled against it, and 12(36%) were open to return to previous activity. Of 11(33%) surgeons who do not gather information about levels of climbing, 8 would not provide specific advice regarding risks of returning to sport. Of 28 climbers, only 5(18%) were informed to cease completely, with 11(39%) cautioned against and 12(43%) permitted to return. There was no correlation between the advice received and climbing ability post-operatively, (kappa=0.143,p=0.058), with a substantial agreement between ability 1-year post-operatively and currently, (kappa=0.689,p<0.001).

There is a discrepancy between the advice given and received by climbers/mountaineers prior to knee arthroplasty, with ability post-operatively having no relationship to advice given. Climbing is possible at high level with no reported complications following knee arthroplasty. The 1-year time point is predictive of longer-term outcome. This information should help surgeons better inform their patients preoperatively.
JAMES LIND ALLIANCE FIRST-TIME SOFT-TISSUE KNEE INJURIES PRIORITY-SETTING PARTNERSHIP: TOP TEN
Authors: Osmani Humza , Nicolaou Nicolas , Anand Sanjeev , Metcalfe Andrew , McDonnell Stephen
Published: August 2023

Introduction

The knee is the most commonly injured joint in sporting accidents. They cause substantial disability, time off work and long-term problems. There remains a limited number of high-quality randomised controlled trials assessing first time, acute soft tissue knee injuries. Key areas requiring answers include prevention, diagnosis, treatment, rehabilitation and delivery of care. In association with the James Lind Alliance, this BASK, BOSTAA and BOA supported prioritising exercise was undertaken over a year.

Methodology

The James Lind Alliance methodology was followed. An initial survey invited patients and healthcare professionals to submit their uncertainties regarding soft tissue knee injury prevention, diagnosis, treatment, rehabilitation and delivery of care. Over 1000 questions were submitted. Seventy-four questions were formulated to encompass common concerns. These were checked against best available evidence. Following the interim survey, 27 questions were taken forward to the final workshop in January 2023, where they were discussed, ranked and scored in multiple rounds of prioritisation by groups of healthcare professionals, patients and carers.

Results

The Top 10 includes prevention, diagnosis, treatment and rehabilitation questions, reflecting the concerns of patients, carers and a wider multidisciplinary team. These will be presented and explained.

Conclusion

This validated process has generated an important Top 10, which has been submitted to the National Institute for Health and Care Research. All 27 questions will be published, thus being available for researchers to investigate. The questions in the Top 10 will lead to future high quality research, thus improving patient outcomes.
EARLY TIBIAL FAILURES IN PRIMARY TOTAL KNEE ARTHROPLASTY IN OBESE PATIENTS: ANALYSIS AND IMPLANT CHOICE RECOMMENDATIONS
Authors: Deo Sunny , Jonas Sam , Jhaj Jasmeet
Published: August 2023

INTRODUCTION

The most frequent mode of aseptic failure of primary total knee replacements is tibial baseplate loosening. This is influenced by stresses across the implant-bone interface which can be increased in obese patients leading to potentially higher rates of early failure. The evidence is mixed as to the true effect of elevated BMI (body mass index) on revision rates. We present the experience of early tibial failures in our department and how our implant choices have evolved.

METHODOLOGY

We retrospectively reviewed our unit's arthroplasty database and identified all patients who had sustained mechanical tibial failure. Data were collected on patient demographics, operative details of primary and revision operations, components used, alignment pre and post operatively and indication. Complications and further surgery performed were recorded.

RESULTS

12 patients were identified who had been revised for mechanical tibial failure. All were female, mean age 60 years (46–76). Mean BMI was 11/12 had significant comorbidities and 6/12 had risk factors for reduced bone density (inflammatory arthritis, diabetes, hypothyroid).

CONCLUSION

In our consecutive series of 12 patients who presented with tibial mechanical failure, all were female and had a high BMI with the majority over 40. We recommend that a stemmed tibia construct should be used in female patients with an elevated BMI, particularly if it is over 40.