bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and Safety of Multikinase Inhibitors for Patients With Refractory Thyroid Cancer: Systematic Review and Network Meta-Analysis
Authors: Jing Ren , Wu Nan , Wu Yang , Zhang Qian , Liang Qiankun , Huang Peng , Yi Shijian
Published: July 2024

Context

Multikinase inhibitors (MKIs) improve the treatment of refractory thyroid cancer, including radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) and advanced medullary thyroid carcinoma (aMTC).

Objective

This study aims to compare the efficacy of MKIs in improving survival outcomes and safety.

Data Sources

Comprehensive database searches of MEDLINE via PubMed, EMBASE, and Cochrane were performed from inception to December 2023.

Study Selection

Three independent authors selected these studies. Randomized controlled trials that compared the use of a MKI to other MKIs or placebo were included.

Data Extraction and Synthesis

This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Risk of bias was analyzed using the Cochrane risk of bias 2 tool. Bayesian network meta-analysis was performed. Treatments were grouped into common nodes based on the type of MKI.

Main Outcomes and Measures

Primary outcomes were progression-free survival (PFS) and overall survival (OS). Secondary outcomes included objective response rate, disease control rate, clinical benefit rate, and adverse events.

Results

Cabozantinib 60 mg/day (CAB60) was associated with the highest prolonged PFS in RAIR-DTC patients, followed by lentivatinib 18 or 24 mg/day (LEN18 or LEN24), and apatinib. PFS was also improved in aMTC patients who received CAB 140 mg/day (CAB140), CAB60, or anlotinib. A significantly greater improvement on the performance of OS was seen in CAB60, LEN24, anlotinib, and sorafenib in RAIR-DTC patients, but in aMTC patients there were lack of statistical differences. Compared with the low-dose MKIs, high-dose MKIs such as CAB, LEN, and vandetanib increased the incidence of adverse events.

Conclusion

CAB60, LEN, and apatinib are promising topical MKIs with statistically significant primary outcomes in RAIR-DTC patients, while CAB and anlotinib are effective in prolonging PFS in aMTC patients.
Approach to the Patient Considering Long-term Antithyroid Drug Therapy for Graves’ Disease
Authors: Azizi Fereidoun , Mehran Ladan , Abdi Hengameh , Amouzegar Atieh
Published: July 2024

Antithyroid drugs (ATD) are the treatment of choice for the majority of patients with Graves’ hyperthyroidism worldwide. However, relapse of hyperthyroidism after withdrawal of arbitrarily chosen conventional 12 to 18 months of therapy is very common. In the last 2 decades, many studies have shown that treatment with long-term ATD (LT-ATD) is effective and safe in the maintenance of euthyroidism. In addition, it has been reported that serum TSH receptor antibody may not decrease permanently before 5 to 6 years of ATD treatment, and clinical trials have shown that ≥5 years of ATD treatment is accompanied by remission in the majority of patients with Graves’ hyperthyroidism. The objective of this article is to discuss the optimal time to withdraw of conventional ATD therapy, to illustrate the decision-making of the management of recurrent hyperthyroidism, to review the proper management of LT-ATD, and to generate suggestions for lifelong ATD treatment by discussing 4 scenarios of decision-making in patients with Graves’ disease.
Association Between Periodontitis and Cardiovascular Disease: Clinical Implications for Treatment and Prevention
Authors: Krasnoborska Julia , Szmyt Katarzyna , Samojedny Sylwia , Szymańska Katarzyna , Walczak Kamil , Wilk-Trytko Klaudia , Superson Maciej , Zarębska Juia
Published: July 2024

Introduction and purpose: Chronic inflammation in the oral cavity poses significant risks to both the heart and the circulatory system. A growing number of studies indicate a correlation between periodontal health and the likelihood of developing cardiovascular conditions, including myocardial infarction, coronary artery disease, hypertension, and stroke. This review aims to summarize recent reports, define current state of knowledge, and propose optimal treatment and prevention strategies.
State of knowledge: Risk factors such as obesity, smoking, and genetic predisposition contribute to the development of both PD and cardiovascular diseases (CVDs). Inflammation serves as a common factor linking the two conditions, with periodontal pathogens directly affecting cardiovascular health. Epigenetic mechanisms, particularly in response to environmental stimuli, further exacerbate the relationship between PD and CVDs. Additionally, the oral microbiome plays a crucial role, with periodontal pathogens infiltrating systemic circulation and triggering immune-inflammatory responses that promote cardiovascular damage.
Conclusions: People with periodontitis have a higher risk of CVDs, especially when other risk factors such as smoking and obesity are present. Periodontal treatment has been demonstrated to enhance cardiovascular health parameters. Implementing  preventive strategy, addressing both periodontitis and cardiovascular risk factors, could potentially decrease morbidity and mortality associated with cardiovascular disease.
Use of arthroscopy in management of tibial plateau fractures
Authors: Łoś Dawid , Nowak Aleksandra , Dziedziński Dawid , Janus Anita , Kaptur Agata
Published: July 2024

Introduction
Tibial plateau fractures are periarticular injuries of the proximal tibia often associated with soft tissue injury. They account for 1-2% of all fractures. Their impact on the articular surfaces and the development of osteoarthritis make them an interesting research topic in the orthopaedic field. With the development of arthroscopic treatment methods, many are thinking of ways to incorporate less invasive methods in the reduction and fixation of these injuries.
Review methods
English-language scientific literature found in PubMed and Google Scholar was used for the review. Articles were searched based on keywords. Each article was analyzed for knowledge currency and relevance for use in the review.
Description of the State of Knowledge
After searching the articles, 35 articles were selected for final analysis. The collected data provided the latest information on treatment of tibial plateau fractures (TPF) using arthroscopic tools with studies diving deep into both the technique and longer-term results.
Summary
The use of arthroscopy in treatment of tibial plateau fractures grows year by year with more and more clinicians being interested in limiting the soft tissue damage and other adverse effects of ORIF
Keywords: Schatzker, arthroscopy, tibial plateau fracture
Practice panel: Tackling harmful sexual behaviour among children
Authors: Hayes Derren
Published: July 2024

Harmful sexual behaviour by children is a common feature in safeguarding practice yet can be difficult to identify at assessment. To help improve practitioners' knowledge, CYP Now convened a panel of experts
Plan to boost number of health visitors
Authors: Simpson Fiona
Published: July 2024

Sector hopes new careers pathway can make health visiting more attractive to affiliated practitioners and offer progression for existing staff
Risks of returning to Sure Start
Authors: Wilson Rob
Published: July 2024

Social mobility expert says review shows flagship New Labour childcare scheme had little impact
The big debate: How could government-funded childcare be more sustainable?
Authors: Hayes Derren
Published: July 2024

The number of children eligible for government-funded childcare places has risen in the past decade and will expand further in 2024, yet early years experts say funding rates fail to meet the cost of placements
Promoting private fostering
Authors: Seth Clare
Published: July 2024

Clare Seth, CoramBAAF kinship care consultant, on how to raise awareness of private fostering
King's Award recognises voluntary services
Authors: Virdi Amrit
Published: July 2024

Annual award for contributions to voluntary service have recognised dozens of charities and youth groups supporting young people
Moments of epistemic friction: resistance and acceptance of early prevention science in child protection social work practice and policy
Authors: Joy Eileen
Published: July 2024

Early prevention science (EPS) is a field encompassing recent advances in child development knowledge. This knowledge is increasingly being operationalised and (mis)applied in child protection, with some scholars noting oppressive consequences. This article uses theories of epistemic justice, specifically José Medina’s notion of epistemic friction, to discuss how EPS was accepted and/or resisted in child protection practice and policy in Aotearoa New Zealand, during the 2010s. It draws from a wider doctoral study, including policy analysis (n = 5) and interviews with social workers (n = 24). Analysis suggests that social workers moved between acceptance of and resistance to EPS. Further, they require institutional support to critically engage with alternative knowledges, thereby pursuing broader social and epistemic justice goals. Individual or institutional responsibility and accountability are resisted and problematised; instead, a both/and approach is advocated, allowing for multiple truths.
Does a history with sexual assault impact bystander intervention engagement?
Authors: Branscum Paul , Hirko Gwen , Rush-Griffin Sarah , Hackman Christine
Published: July 2024

Bystander intervention is a method of sexual violence prevention aimed at reducing the serious and pervasive issue of sexual assault on college campuses. The current study utilises the reasoned action approach (RAA) to examine potential differences in bystander intervention engagement between college students with exposure or experience related to sexual assault to students with no such history. Students (n=290) from two mid-sized universities completed a survey examining the RAA constructs (instrumental and experiential attitudes, injunctive and descriptive norms, capacity and autonomy), their sexual assault knowledge, and anticipated regret in reference to bystander intervention. Results showed that participants with exposure or experience related to sexual assault had significantly higher behavioural intentions (p=.018; d=.31), instrumental attitudes (p<.001; d=.55), injunctive norms (p=.026; d=.29), capacity (p=.002; d=.40), autonomy (p=.022; d=.28), anticipated regret (p<.001; d=.56), and sexual assault knowledge (p=.018; d=.31). The RAA constructs also explained a significant amount of the variance of intentions for both groups (with exposure/experience adjust R2 =.501; without exposure/experience adjust R2 =.660). The RAA constructs and anticipated regret appear to be important predictors to consider when planning bystander intervention programmes aimed at reducing sexual assault on college campuses.
A review of recent studies of both heat pipe and evaporative cooling in passive heat recovery
Authors: Mohsin Alsayah Ahmed , Faraj Johain J. , Eidan Adel A.
Published: July 2024

The present article aims to cover the most recent advancements in heat recovery technology in heating, ventilation, and air conditioning and identify areas that have not been thoroughly investigated. Extensive information is available on heat recovery technologies and exchangers in central systems. Furthermore, the research examines both direct and indirect evaporative cooling approaches. The literature discusses how the heat recovery process is influenced by climatic conditions, air flow rate, and the type of heat exchanger employed. The latest studies contributing to enhancing the performance of heat exchangers were also considered. The results of the study indicate that recent years have witnessed great interest from researchers in the field of lost energy recovery; the experimental, theoretical, and numerical studies have focused on studies of the influencing factors that contribute to improving the performance of the energy recovery process. The current project involves doing an analytical and comparative analysis of the newest research about enhancing the efficiency of thermosyphon heat exchangers and various forms of evaporative cooling.
Insights in caveolae protein structure arrangements and their local lipid environment
Authors: Ocket Esther , Matthaeus Claudia
Published: July 2024

Caveolae are 50–80 nm sized plasma membrane invaginations found in adipocytes, endothelial cells or fibroblasts. They are involved in endocytosis, lipid uptake and the regulation of the cellular lipid metabolism as well as sensing and adapting to changes in plasma membrane tension. Caveolae are characterized by their unique lipid composition and their specific protein coat consisting of caveolin and cavin proteins. Recently, detailed structural information was obtained for the major caveolae protein caveolin1 showing the formation of a disc-like 11-mer protein complex. Furthermore, the importance of the cavin disordered regions in the generation of cavin trimers and caveolae at the plasma membrane were revealed. Thus, finally, structural insights about the assembly of the caveolar coat can be elucidated. Here, we review recent developments in caveolae structural biology with regard to caveolae coat formation and caveolae curvature generation. Secondly, we discuss the importance of specific lipid species necessary for caveolae curvature and formation. In the last years, it was shown that specifically sphingolipids, cholesterol and fatty acids can accumulate in caveolae invaginations and may drive caveolae endocytosis. Throughout, we summarize recent studies in the field and highlight future research directions.
Transmigrant identities and attitudes: the case of a Pangasinan-American family
Authors: Bernardo-Hinesley Sheryl , Arias Álvarez Alba
Published: July 2024

Identity plays a crucial role in determining whether diasporic minority communities either integrate into the host country or resist acculturation and assimilation. Since identity is performed and negotiated through discourse, the study of connections between identity and language practices of migrant groups is crucial in understanding how language is used to express their multilayered identities. Using sociolinguistic interviews as the primary data source, this research analyzes how three generations of a Pangasinan-American family negotiate their complex identities and express their attitudes towards English, Filipino, and Pangasinan. Findings show that their Pangasinan-American identity is performed through translingual practices, which enable the portrayal of their membership to their home community and their integration into the host society. Each participant situates their Pangasinan identity in relation to their other identities – Filipino and American – which emerge in the diasporic context. This study contributes to the research on the role of language in the development of community membership and allegiances of bi-/multilingual transmigrants.
Entropy generation analysis of MHD convection flow of hybrid nanofluid in a wavy enclosure with heat generation and thermal radiation
Authors: Hussain Syed M. , Parveen Rujda , Katbar Nek Muhammad , Rehman Sadique , Abd-Elmonem Assmaa , Abdalla Nesreen Sirelkhtam Elmki , Ahmad Hijaz , Qureshi Muhammad Amer , Jamshed Wasim , Amjad Ayesha , Ibrahim Rabha W.
Published: July 2024

This work examines the behaviour of flow and heat transmission in the presence of hybrid nanofluid in thermal radiation, heat generation, and magnetohydrodynamics. The hybrid state in this model is represented by two different fluids, TiO2 (titanium dioxide) and Ag (silver). The enclosure is wavy and slanted, with curving walls on the left and right. The finite difference approximation method was utilized to resolve the fundamental equations after they were non-dimensionalized, which are further reduced to a fourth-order bi-harmonic equation and are numerically solved based on the biconjugate gradient-stabilized approach method. The simulations are performed with various Rayleigh numbers, Hartmann numbers, an inclination angle of the enclosure, radiation parameters, heat generation parameters, inclination angle of the magnetic field, and volume fraction of hybrid nanoparticles. The streamlines, isotherms, and average Nusselt number contours are used to depict the thermo-fluid patterns. The findings show that the average Nusselt number relies on ϕ and increases as ϕ rises. The investigation’s findings demonstrated that the transfer of heat on the heated bottom wall significantly increases with the Rayleigh number (Ra = 105 and 106). At a cavity inclination of 45°, interesting multi-vortex structures are observed. The results of this study may enhance the effectiveness of solar collectors, heat exchangers, and other similar systems that depend on convective heat transfer in nature.
Decolonial Perspectives from Latin America
Authors: Zambonini Juan Pedro , Tosto Virginia
Published: July 2024

This editorial discusses specific coordinates for thinking about decolonial perspectives from Latin America. It explores the notions of academic dependence, epistemic colonialism and situated thought as axes within the decolonial perspective. It also extends an invitation to Latin American music therapists to participate in a special edition to be published in 2025. Lastly, a brief description of the articles included in this journal edition is provided.
Resumen 
Este editorial contempla certas coordenadas para pensar sobre as perspectivas decoloniais da América Latina. Ele explora as noções de dependência acadêmica, colonialismo epistêmico e pensamento situado como eixos dentro da perspectiva decolonial. Também faz um convite aos musicoterapeutas latino-americanos para participarem de uma edição especial a ser publicada em 2025. Por fim, é apresentada uma breve descrição dos artigos incluídos nesta edição da revista.
Resumen
Esta editorial contempla ciertas coordenadas para pensar las perspectivas decoloniales desde Latino America. Explora las nociones de dependencia academica, colonialismo epistemico y pensamiento situado como ejes dentro de la perspectiva decolonial. Asimismo, se extiende una invitacion a musicoterapeutas latinoamericanos para ser parte de una edición especial que será publicada en 2025. Por ultimo, se brinda una breve descripción de los artículos incluidos en esta edición de la revista.
Piperine inhibits the proliferation of colorectal adenocarcinoma by regulating ARL3-mediated endoplasmic reticulum stress
Authors: Wu Chenqu , Qian Yanqing , Jiang Jun , Li Deming , Feng Li
Published: July 2024

Colorectal adenocarcinoma (COAD) is a significant cause of cancer-related mortality worldwide, necessitating the identification of novel therapeutic targets and treatments. This research aimed to investigate the role of ARL3 in COAD progression and to explore the effects of Piperine on ARL3 expression, cell proliferation, epithelial–mesenchymal transition (EMT), and endoplasmic reticulum (ER) stress. Bioinformatics analysis of The Cancer Genome Atlas (TCGA)–COAD, GSE39582, and GSE44861 datasets assessed ARL3 expression levels. Immunohistochemical data from the Human Protein Atlas (HPA) database confirmed ARL3 overexpression in COAD. The association of ARL3 with COAD clinical parameters and prognosis was also examined. COAD cells were treated with Piperine, and in vitro assays evaluated cell proliferation, apoptosis, EMT marker expression, and ER stress (ERS) responses. ARL3 overexpression in COAD correlated with poor prognosis and varied across pathological stages. Piperine treatment inhibited COAD cell proliferation in a concentration- and time-dependent manner, as indicated by reduced Ki-67 levels and decreased colony-forming ability. Piperine induced S-phase cell cycle arrest and facilitated apoptosis in COAD cells, evidenced by changes in Bax, Bcl-2, cleaved caspase-3, and cleaved Poly (ADP-ribose) polymerase (PARP) levels. Moreover, Piperine downregulated ARL3 expression in COAD cells, thereby suppressing transforming growth factor beta (TGF-β)-induced EMT. Additionally, Piperine attenuated the ARL3-mediated ER stress response, significantly reducing binding immunoglobulin protein (BiP), inositol-requiring enzyme 1 alpha (p-IRE1α), activating transcription factor 6 (ATF6), and C/EBP homologous protein (CHOP) levels. Piperine exerts anti-cancer effects in COAD by modulating ARL3 expression, disrupting cell cycle progression, inhibiting the EMT pathway, and regulating ERS. These findings suggest that Piperine holds promise as a therapeutic agent for COAD through its targeting of ARL3.
Development and evaluation of interpretable machine learning regressors for predicting femoral neck bone mineral density in elderly men using NHANES data
Authors: He Wen , Chen Song , Fu Xianghong , Xu Licong , Xie Jun , Wan Jinxing
Published: July 2024

Osteoporotic femoral neck fractures (OFNFs) pose a significant orthopedic challenge in the elderly population, accounting for up to 40% of all osteoporotic fractures and leading to considerable health deterioration and increased mortality. In addressing the critical need for early identification of osteoporosis through routine screening of femoral neck bone mineral density (FNBMD), this study developed a user-friendly prediction model aimed at men aged 50 years and older, a demographic often overlooked in osteoporosis screening. Utilizing data from the National Health and Nutrition Examination Survey (NHANES), the study involved outlier detection and handling, missing value imputation via the K nearest neighbor (KNN) algorithm, and data normalization and encoding. The dataset was split into training and test sets with a 7:3 ratio, followed by feature screening through the least absolute shrinkage and selection operator (LASSO) and the Boruta algorithm. Eight different machine learning algorithms were then employed to construct predictive models, with their performance evaluated through a comprehensive metric suite. The random forest regressor (RFR) emerged as the most effective model, characterized by key predictors such as age, body mass index (BMI), poverty income ratio (PIR), serum calcium, and race, achieving a coefficient of determination (R²) of 0.218 and maintaining robustness in sensitivity analyses. Notably, excluding race from the model resulted in sustained high performance, underscoring the model’s adaptability. Interpretations using Shapley additive explanations (SHAP) highlighted the influence of each feature on FNBMD. These findings indicate that our predictive model effectively aids in the early detection of osteoporosis, potentially reducing the incidence of OFNFs in this high-risk population.
Сетевые образовательные программы как механизм повышения качества образования в университете
Authors: Каспржак Анатолий , Кобцева Анна , Кузнецова Алла , Маслова Галина , Озерова Мария
Published: July 2024

В восьмом выпуске серии учебно-методических пособий «Подготовка профессионалов для нового образования» представлены материалы, которые обеспечивают процесс разработки и реализации маги- стерских программ в сетевой форме «Управление образованием» (направление подготовки 38.04.04 «Госу- дарственное и муниципальное управление»), с 2020 г. реализуемых Институтом образования НИУ ВШЭ со- вместно с ДВФУ, ТОГУ и ТюмГУ. Представлена общая идея конструирования программ подготовки лидеров образования федеральным и региональным вузом во взаимодействии с исследовательским университетом. На основе осмысления результатов работы авторы дают рекомендации как разработчикам про- грамм, так и руководителям вузов, академическим руководителям программ, преподавателям; показы- вают новые возможности для университетов, которые появляются в ходе взаимодействия партнеров; обозначают риски. Особое внимание уделяется построению двумя университетами единой системы обеспечения качества реализации программ. Текст содержит образцы документов, регламентирующих порядок взаимодействия вузов и обеспечивающих реализацию образовательного процесса. Материал может быть использован в качестве учебно-методического пособия в системе дополни- тельного профессионального образования преподавателей и руководителей высшей школы.
cf-RRBS protocol v1
Authors: De Koker Andries , Van Paemel Ruben
Published: July 2024

The methylation profile of circulating cell-free DNA (cfDNA) in blood can be exploited to detect and diagnose cancer and other tissue pathologies and is therefore of great diagnostic interest. There is an urgent need for a cost-effective genome-wide methylation profiling method that is simple, robust and automatable and that works on highly fragmented cfDNA. We report on a novel sample preparation method for reduced representation bisulfite sequencing (RRBS), rigorously designed and customized for minute amounts of highly fragmented DNA. Our method works in particular on cfDNA from blood plasma. It is a performant and cost-effective methodology (termed cf-RRBS) which enables clinical cfDNA epigenomics studies.
Roles of Feedback and Phishing Characteristics in Antiphishing Training Performance: Perspectives of Goal Setting and Skill Acquisition
Authors: Pan Shihe ,   Tianjin University, Kwak Dong-Heon , Kuem Jungwon , Kim Sung S. ,   Kent State University,   State University of New York at Albany,   University of Wisconsin-Madison
Published: July 2024

Because phishing attacks often exploit individuals’ inexperience in detecting them, it is important for managers to provide workers with proper feedback on their reactions to phishing scams. However, little is known about what types of feedback are more effective in facilitating antiphishing training behavior and performance. The objectives of this study are to identify (1) the determinants of decision avoidance and detection accuracy, (2) the contextual effect of type of feedback in antiphishing training, (3) the impacts of perceived detection efficacy on training outcomes, and (4) the interaction effects between feedback characteristics and perceived detection efficacy/phishing characteristics on training outcomes. Drawing upon goal-setting theory, skill acquisition theory, and antiphishing training literature, our model provides a theoretical account of how feedback characteristics (e.g., type, quantity), phishing characteristics (e.g., phishing cue saliency), and perceived detection efficacy affect antiphishing training outcomes (e.g., decision avoidance and detection accuracy). To empirically test the model, we performed four experiments with 652 subjects in the United States from three different online panels via Amazon Mechanical Turk, Esearch.com, and Clickworker.com. Our results indicate that examplebased feedback is superior to abstract feedback in teaching how to correctly discern between phishing and legitimate emails in the context of link-embedded emails. We also show that perceived detection efficacy is essential for a better understanding of antiphishing training behavior and performance. Finally, we show an interaction effect between feedback quantity and phishing cue saliency on antiphishing training behavior and performance.
Human-Centered Design and Evaluation of a NeuroIS Tool for Flow Support
Authors: Adam Marc T. P. ,   University of Newcastle, Bonenberger Lukas , Gimpel Henner , Lanzl Julia ,   Technical University of Applied Sciences Augsburg, University of Hohenheim,   University of Hohenheim, FIM Research Center,   University of Hohenheim, FIM Research Center
Published: July 2024

Flow is a mental state in which a person is fully immersed and actively involved in a task, even during extrinsically motivated activities at work. IT-mediated interruptions can disrupt flow, with ramifications for workers’ well-being and work performance. In this design science research paper, we develop and evaluate design knowledge for neuroadaptive flow support systems. Building on foundations in flow theory, we conduct expert interviews and present a conceptual framework, three meta-requirements, and five design principles for flow support systems. We then implement the design principles in three prototypes and evaluate these prototypes in a lab experiment and a field study. With this paper on flow and IT-mediated interruptions in the work domain, we present an approach toward flow support systems that enable intelligent interruption management.
CLINICAL CASE OF SUCCESSFUL TREATMENT OF A PATIENT WITH AORTIC ROOT ANEURYSM AND PULMONARY ARTERY STENOSIS AFTER RADICAL CORRECTION OF PULMONARY ARTERY ATRESIA WITH VENTRICULAR SEPTAL DEFECT
Authors: Charchyan Eduard R. , Breshenkov Denis G. , Lezhnev Alexander A. , Baidin Sergey P. , Belov Yuri V.
Published: July 2024

Highlights

The article presents a clinical case of successful treatment of a patient with aortic root aneurysm and pulmonary artery stenosis after radical three-stage repair of pulmonary atresia with ventricular septal defect.

 

Abstract

Aortic root aneurysm with aortic regurgitation is a rare cause of re-operation in patients who have had primary repair of pulmonary atresia with ventricular septal defect or tetralogy of Fallot. Recently, due to an increase in cases of primary radical treatment of congenital cardiac surgery and life expectancy of these patients, the number of cases of re-operation due to aortic root dilatation has also increased. One of the main reasons for long-term aortic regurgitation and of aortic root enlargement is the presence of a subaortic ventricular septal defect below the aortic valve, which deforms the aortic annulus geometry and changes intra-aortic hemodynamics. All of these factors make the aortic root surgical reconstruction just a question of time. This is a real challenge for both adult and pediatric heart surgeons, requiring a team approach. This article presents a clinical case of successful treatment of a patient with aortic root aneurysm, aortic regurgitation with concomitant pulmonary conduit restenosis and residual ventricular septal defect who underwent a three-stage repair of pulmonary atresia and ventricular septal defect.
ASSESSMENT OF THE FUNCTIONAL SIGNIFICANCE OF STENOSIS IN MULTIVESSEL CORONARY ARTERY DISEASE BASED ON INTEGRAL INSTANT FLOW RESERVE
Authors: Gromovoy Roman M. , Pekarskiy Stanislav E. , Baev Andrey E. , Gergert Egor S. , Tarasov Mikhail G. , Sultanov Syrgak M. , Bogdanov Yuri I. , Suslov Ivan V. , Gorokhovsky Alexey A. , Falkovskaya Alla Y. , Manukyan Musheg A.
Published: July 2024

Highlights

The assessment of the anatomical significance of multivessel atherosclerosis of the coronary arteries – SYNTAX score takes into account the level and multiplicity of lesions by assigning higher scores for proximal stenoses and subsequent summation. Functional assessment of coronary blood flow – instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) uses one threshold value for all stenoses, and does not take into account their multiplicity.

 

Aim. To develop a new indicator for the integral assessment of the functional significance of multivessel atherosclerosis of the coronary arteries, taking into account the level and multiplicity of lesions.

Methods. The model for the integral assessment of the functional significance of a multivessel lesion was the sum of the transstenotic gradients (in our variant 1-iFR) of all stenoses >50%, weighted by the volume of the dependent LV myocardium, which was evaluated on the Duke jeopardy score: Σ(1-iFRi)*Nd, where Nd is the number of Duke dependent segmental arteries supplying blood to 1/6 of the myocardium. To bring the obtained values to the range 0–1 and the threshold level 0.89, the 1/(1+X) transformation was used, i.e. in the case of single non-proximal stenoses, the integral assessment index is equal to the value of the standard iFR. To test the ability of the indicator to take into account the level and multiplicity of lesions, we evaluated its relationship with SYNTAX in patients with multivessel coronary artery disease (>2 segments with stenoses >50%), including in comparison with standard iFR (minimum value). The VERRATA PLUS conductor and the Core module of the Phillips Azurion angiographic system were used for iFR measurements.

Results. The study included 42 patients, 29 men and 13 women, aged 65.3 ± 8.9 years, with multivessel coronary artery disease, SYNTAX score = 11.5 ± 2.7. The calculated values of integral iFR were expected to be less than the minimum standard iFR: 0.71 ± 0.11 versus 0.81 ± 0.14, respectively, p < 0,001. Integral iFR demonstrated significant inverse dependence on SYNTAX, p = 0,34, p < 0,05, whereas the standard iFR did not depend on SYNTAX. The number of patients with non-significant standard iFR, but significant integral iFR was 23.5% compared to patients with significant standard iFR. In accordance with the nature of the calculations, there were no cases of significant standard iFR and insignificant integral iFR.

Conclusion. The obtained data demonstrated the possibility of taking into account the level and multiplicity of stenoses when assessing the functional significance of coronary artery lesions using the iFR method.
PREDICTION OF CARDIOVASCULAR RISK IN ABDOMINAL SURGERY: RESULTS OF AN OBSERVATIONAL MULTICENTER STUDY
Authors: Zabolotskikh Igor B. , Veyler Roman V. , Trembach Nikita V. , Magomedov Marat A. , Popov Alexander S. , Malyshev Yuri P. , Dmitriev Alexey A. , Grigoryev Evgeny V. , Fisher Vasily V. , Khoronenko Victoria E. , Kokhno Vladimir N. , Spasova Arina P. , Davydova Veronika R. , Gritsan Alexey I. , Lebedinskii Konstantin M. , Dunts Pavel V. , Bayalieva Ainagul Z. , Ovezov Alexey M. , Martynov Dmitry V. , Kirov Mikhail Yu. , Ershov Vadim I. , Murashko Svetlana S. , Kuzovlev Artem N. , Fedunets Dmitriy E.
Published: July 2024

Highlights

The developed prediction model is a simple and accurate method for assessing the postoperative risk of cardiovascular complications in a large population of patients undergoing non-cardiac surgery. Its widespread use will optimize perioperative management tactics and improve surgical results.

 

Aim. To develop a model for predicting cardiovascular risk in patients undergoing abdominal surgery and compare its accuracy with foreign analogs validated on a domestic cohort of patients.

Methods. The multicenter prospective study included 8 241 patients over 18 years of age undergoing elective abdominal surgery. The following postoperative complications were assessed: acute myocardial infarction, stroke, cardiac arrest, cardiogenic pulmonary edema, pulmonary embolism, and 30-day mortality. First of all, we compared baseline characteristics of patients with and without complications, and factors, associated with surgery and anesthesia. Next, we performed a logistic regression analysis to assess the contribution of factors to the development of postoperative cardiovascular complications. Following that, we developed a model for predicting postoperative cardiac risk based on the data of multivariate logistic regression analysis. Finally, we compared the obtained model with other prediction models found in the literature.

Results. Out of 8241 patients, 53 patients (0.64%) presented with cardiovascular complications (62 cases): cardiac arrest in 39 patients (0.47%), cardiogenic pulmonary edema in 4 patients (0.049%), stroke in 3 patients (0.036%), pulmonary embolism in 9 patients (0.11%), and acute myocardial infarction in 7 patients (0.084%). 36 patients (0.43%) had lethal outcome. Retrospectively, the obtained model assigned 2251 patients to the high-risk group for developing cardiovascular complications, the incidence of cardiovascular complications in the group was 2.1%. The low-risk group consisted of 5 990 patients; the incidence of cardiovascular complications in the group was 0.13%.

Conclusion. Eight independent variables associated with postoperative cardiovascular complications were identified: high and moderate surgical trauma, smoking, statin use, Stange test less than 40 seconds, American Society of Anesthesiologists functional class 3, intraoperative need for vasopressors and transfusions. The cardiovascular risk prediction model has good predictive power (AUROC = 0.880).
ERYTHROCYTE MEMBRANE ADRENOREACTIVITY IN CHILDREN WITH DRUG-RESISTANT VENTRICULAR EXTRASYSTOLE BEFORE AND AFTER RADIOFREQUENCY ABLATION
Authors: Rebrova Tatiana Yurievna , Perevoznikova Yulyana Evgenievna , Muslimova Elvire Faritovna , Svintsova Liliya Ivanovna , Plotnikova Irina Vladimirovna , Afanasiev Sergei Aleksandrovich
Published: July 2024

Highlights

For children aged 11–15 years with the duration of ventricular arrhythmias from 1 to 2 years, the increased value of β-adrenergic reactivity of erythrocyte membranes (β-ARM) is characteristic in comparison with the group of healthy children of the same age, which indicates desensitization of β-adrenoreceptors. In the early postoperative period after the elimination of ventricular ectopic focus as a result of radiofrequency ablation β-ARM continues to increase. The possibility of using the β-ARM index to assess the state of the sympathetic part of the autonomic nervous system in the category of patients with methodological limitations of heart rate variability analysis was studied.

 

Abstract

Aim. To evaluate the activity of the autonomic nervous system by changes in β-adrenoreactivity of erythrocyte membranes (β-ARM) in children with drug-resistant ventricular arrhythmia (VA) before and three days after radiofrequency ablation (RFA).

Methods. The study included 11 children aged 13 [11;15] years old with drug-resistant ventricular arrhythmia, who had documented ventricular extrasystoles (VE) with ectopic activity exceeding 10%, including those accompanied by episodes of ventricular tachycardia (VT) (ZHA group). The control group consisted of 11 children 14 [12;16] years old who did not have the pathology of the cardiovascular system. Determination of β-ARM of erythrocytes in blood samples was performed using the BETA-ARM AGAT reagent kit (AGAT LLC, Russia).

Results. At the time of hospitalization in the VA group the β-ARM indicator was significantly (p = 0.026) higher than the values in the control group. 3 days after RFA in children with VA the median β-ARM increased by 62.3% compared to the initial values in the group (p = 0.027).

Conclusion. Children with VA and an arrhythmological history of more than 1 year are characterized by a predominance of activity of the sympathetic division of the autonomic regulation of the cardiovascular system. The systemic nature of the predominance of sympathetic influence is manifested in an increase in the β-ARM index relative to control values. In the early postoperative period, after the elimination of the ventricular ectopic focus as a result of RFA, an increase in β-ARM occurs, which indicates desensitization of adrenergic receptors, which also contributes to a decrease in the influence of the sympathetic system. The study demonstrated the possibility of using the β-ARM indicator to assess the response of the sympathetic system in a category of patients with methodological limitations in HRV analysis.
SIXTY-FIVE YEARS OF SURGICAL TREATMENT OF LEFT VENTRICULAR ANEURYSM USING CARDIOPULMONARY BYPASS: D. COOLEY, C. LILLEHEI, BORIS V. PETROVSKY
Authors: Protopopov Andrey V. , Sirota Dmitry A. , Zhulkov Maxim O. , Agaeva Khava A.
Published: July 2024

Highlights

The literature review is dedicated to the 65th anniversary of the first left ventricular aneurysm resection performed with cardiopulmonary bypass.

The main stages of the development of surgical treatment of aneurysms are highlighted.

The life and professional path of the leading specialists of the twentieth century who made an invaluable contribution to the treatment of patients with heart aneurysms are described.

 

Abstract

The article is devoted to a review of development of left ventricular aneurysm surgery, as well as a brief autobiographical review, from the first description by John Hunter in the 18th century to the stages of emergence and development of modern methods of left ventricular reconstruction both on the working heart and with cardiopulmonary bypass.

The review analyzes the stages of development of surgical treatment of left ventricular aneurysms: starting with the first description of the disease made by J. Hunter in the 18th century, before the advent of modern methods of aneurysm surgery both off- and on-pump.
Optimization of the automotive millimeter-wave radar data processing using the modified MFNN neural network
Authors: Panokin Nikolay V. , Kostin Ivan A. , Karlovskiy Alexander V.
Published: July 2024

BACKGROUND: Recognition and representation of the road scene is a relevant task in the field of autonomous driving. One of the ways to improve the characteristics of the existing sensory hardware is the use of neural networks for signal processing.
AIM: To conduct an experimental study of the possibilities of using the modified MFNN neural network to increase the resolution of a radar with a small number of channels, to compare it with the classical algorithm based on the fast Fourier transform (FFT), and, in addition, to compare the results with the data obtained from other types of sensors (lidars).
METHODS: The algorithm of the road scene representation, in particular, the detection of pedestrians and cars, is used with a millimeter-range automotive radar and a method for determining data components in relation to the DOA problem, based on the MFNN neural network, modified for the case of representing signals taking complex values in the form of excessive basis coefficients minimizing these coefficients according to the L1 norm. The algorithm based on the fast Fourier transform (FFT) is used for comparative analysis.
RESULTS: As a result of the conducted research, confirmation of the practical feasibility of the developed modifications of the MFNN method was obtained, and the advantage of using a neural network, consisting in increasing the degree of detail of objects, the accuracy of determining their shape and position using a radar with a small number of channels, was demonstrated.
CONCLUSION: The obtained results can be used to develop solutions to improve the efficiency of detecting obstacles on the way of transport, automatic vehicle control, continuous environmental monitoring, and so on, which helps to improve the safety and efficiency of highly automated and autonomous systems.
Snakebites and their Impact on Disability
Authors: Fernandez Eduardo , Funes Ivan , Youssef Peter
Published: July 2024

Snakebites represent one of the main causes of mortality and according to some estimations there are three times the number of disabilities in victims of poisoning by the bites. Disability can be classified as total if it prevents the victim from performing his/her productive routine activities or requires long term physiotherapy to recover part of the function. Partial disability can be related to the time, or the degree of lost function related to her/his productive activity. In general, snakebites are classified as neglected diseases, and its study focuses on the immediate morbidity or mortality while the consequences in the long term are less studied. A neglected disability is related to mental health, wherein many victims suffer the effects of post-traumatic stress disorder (PTSD), or changes in self-image because of deformities left by the ophidic accident. The review of the topic had the objective to identify the level of discussion of disability issues caused by snakebites and for this purpose publications in Medline (English literature) and Scielos (Spanish, Portuguese and English publications) were explored. The results were obtained around the terms Snakebites and disabilities, snakebites and permanent sequelae, and Snakebites and rehabilitation. The results were organized according to type of disability, world region and type of snake-species. Disability can be the product of local damage (muscle and local tissue loss), or neurological loss reflected in different degrees of sensorial loss or partial/total loss of motricity. Particular interest must be given to the loss of productivity of individuals affected in their muscular, neurological, and mental conditions. Mental health sequelae can also prevent people from restoring their productive activity. Describing the consequences of snakebites in the long term serves a purpose as education to those affected by snakebites in often neglected areas of the world.
Use of artificial intelligence in the field of forensic medicine & criminal investigation: A way forward
Authors: Gambhir Singh O , Kumar Suresh , Shah Bhagwan , Shandil Anil , Kumar Rahul
Published: July 2024

Forensic Medicine deals with applying medical knowledge in the administration of justice, bridging medical science with the law. The new technology of Artificial Intelligence (AI) is increasingly applied in the various fields of Forensic Medicine & crime investigation. It is used by forensic pathologists to establish the identity of an unknown person, estimate the age of injuries, primarily bruises, detect and analyze trace evidence, etc. It is very convenient to store, analyze, and transmit massive data within a very short time. This new technology is also helpful in conducting non-invasive autopsy by using various technologies such as Sonography, CT scans, MRIs, 3D surface scanning, etc. Detection and analysis of many trace evidence can be carried out by using AI. It is also very convenient to reconstruct the crime scene by creating video animation. However, as of now, its use is minimal and at a nascent stage. Moreover, it is not legally acceptable in a court of law.
Examining compensated cases of negligence in caesarean sections and it’s legal implications- A case series
Authors: Bhimrao Patekar  Manoj , Rayate Ajinkya Vinod , Kamble Sangharatna Mahajan , Shinde Amol Balwant
Published: July 2024

Litigation related to Caesarean section which itself is a lifesaving procedure, is a complex issue with global implications. By addressing the factors that contribute to litigations and encouragement of better communication, we can ensure safer childbirth experiences for both mothers and babies. This case series investigates illustrations of compensation claims related to negligence in cesarean section procedures. The focus is on cases where patients experienced adverse outcomes, such as urinary problems and abdominal pain, following cesarean operations. In these cases, subsequent medical examinations revealed complications in newborns, retained surgical instruments, and foreign bodies inside the patients' bodies. All of these issues resulted in claims for compensation due to negligence against the doctors, which were subsequently settled by the commissions under the purview of the Consumer Protection Act, 2019.

The series sheds light on the implications of negligence in the context of cesarean sections, where the failure to adhere to standard care protocols led to evident harm. The cases highlight the need for doctors to ensure thorough post-operative procedures, including proper instrument accountability and removal. The consequences of negligence in these cases necessitated additional surgical interventions to relieve patient’s symptoms, prompting claims for compensation.

By analyzing this case series, we aim to contribute to the understanding of legal consequences associated with cesarean section negligence and highlight the importance of maintaining the highest standards of care to prevent adverse consequences and subsequent litigation.
Delitos culposos de tránsito cuando la víctima es cónyuge, conviviente o pareja del infractor
Authors: Ortega Mercedes Angelica , Tapia Páez Enrique Xavier , Sánchez Rovalino Ronald
Published: July 2024

Dentro de esta investigación se estudia la institución de la pena natural, la cual es relativamente nueva en el ordenamiento jurídico ecuatoriano, recién implementada desde agosto del 2014 con la adopción del Código Orgánico Integral Penal. La razón de ser de esta institución es limitar el poder punitivo del Estado, en virtud de la no necesidad de aplicación de una pena estatal (que no es lo mismo que castigo), a quien, a causa y consecuencia de un delito culposo, ha tenido suficiente castigo por su mal causado.  El objeto de estudio se centra directamente en la pena natural, descrita en el artículo 372 del Código Orgánico Integral Penal (2014), y en cómo el legislador ha excluido por completo de esta figura jurídica al cónyuge, conviviente o pareja, así como las consecuencias de aquello.