bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Block Protection using Dense Polytetrafluoroethylene Membranes in Vertical Bone Augmentation Procedures for Atrophic Maxilla: A Case Report
Authors: Kashkash Wajih , Albash Ziad
Published: December 2024

Background

Large vertical bone defects in the posterior maxilla pose a significant challenge for oral and maxillofacial surgeons aiming to rehabilitate the region with dental implants. Autogenous bone grafts remain the gold standard for bone grafting due to their trifecta of osteogenesis, osteoinduction, and osteoconduction properties. Autogenous bone blocks harvested from the anterior iliac crest are a predictable and extensively researched treatment approach for the management of localized or generalized alveolar ridge defects. The primary complications associated with reconstructing atrophic alveolar bone are wound dehiscence and subsequent exposure of the bone graft material to the oral environment, a challenge that may be unavoidable in certain cases.

Case Presentation

In this case report, we present the reconstruction of the posterior maxilla in a 30-year-old patient, utilizing an autologous bone graft harvested from the anterior iliac crest. The bone block was then shielded with a dense polytetrafluoroethylene membrane. The bone block was fixed using tenting screws, and the membrane was attached to the tent screws with special screws (tenting cap screws). Membrane exposure occurred two weeks post-surgery, and the membrane was easily removed four weeks after the procedure. There were no signs of infection or loss of bone graft material during this timeframe.

Conclusion

Applying d-PTFE to cover the bone block in extensive posterior maxillary vertical augmentation procedures effectively shields the bone block from bacterial contamination, lowers the likelihood of complications, and enhances the predictability of the procedure.
The Role of Stress Reduction and Mindfulness Meditation in Glaucoma Management: A Review
Authors: Polski Ashley , Mai Anthony P. , Stagg Brian C. , Wirostko Barbara M.
Published: December 2024

Glaucoma is a progressive optic neuropathy that is increasing in prevalence worldwide and can lead to devastating vision loss and even blindness if left untreated. Current medical and surgical approaches to glaucoma treatment all aim to lower intraocular pressure (IOP), which is a well-known risk factor for glaucoma development and progression. Although the exact pathogenesis of glaucoma is not yet fully elucidated, multiple studies suggest that mental stress and elevated cortisol levels may contribute to IOP elevation and glaucomatous progression. In recent decades, various randomized-controlled trials have also demonstrated a significant reduction of IOP in patients practicing stress-reduction techniques, including mindfulness meditation and yoga. In this review, we discuss the relationship between mental stress and glaucoma and review the supporting literature to highlight the potential role of mindfulness meditation as an adjunctive strategy to reduce stress and thereby lower IOP in glaucoma patients.
Educational Content Focusing on Basic Skills for Novice Nurses to Work Independently in Intensive Care Units in Japan: A Qualitative Study
Authors: Imamura Sachiko , Tsujimoto Tomomi , Fujii Makoto , Takeshita Yuko , Nagayasu Mayumi , Inoue Tomoko
Published: December 2024

Introduction/Objectives

In Japan, novice nurses are assigned to intensive care units immediately after graduation and are expected to become independent within about a year. Therefore, in addition to long-term, comprehensive educational programs, establishing an educational system that allows novice nurses to learn intensive care unit nursing while working is necessary. This study explored senior nurses’ expectations for novice nurses working independently in the intensive care unit after one year and identified the foundational skills needed for novice nurses to achieve this independence.

Methods

The research collaborators were eight senior nurses working in the intensive care unit of an acute care hospital. They were recruited from four facilities and had five or more years of clinical experience. The study used semi-structured interviews to generate data about the reports, contacts, and consultations they would expect from novice nurses to determine their readiness to become independent.

Results

This study clarified the circumstances under which novice nurses with no practical experience should voluntarily seek support to work as independent nurses one year after being assigned to an intensive care unit. It reflects the characteristics of patients who require intensive management, such as “assistance with central line insertion and removal” and “evaluation of vital signs,” as well as other advanced procedures.

Conclusion

This study clarified the basic skills required for novice nurses and identified the areas in which they should seek support. In the future, this method may be utilized in the early stages of novice nurse education.
Adoption of IoT in Healthcare During Covid-19
Authors: Goel Silky , Markanday Snigdha
Published: December 2024

COVID-19 has shattered existence and implemented a change in the
strategies, priorities, and activities of people, organizations, and governments. These
progressions are the momentum for the advancement of technology. In this chapter, the
discussion is about the pandemic's effect on the reception of the Internet of Things
(IoT) in different areas, specifically healthcare, smart cities, smart buildings, smart
homes, transportation, and industrial IoT. Industrial IoT (IIoT) healthcare has
essentially decreased the expenses for monitoring and safeguarding individuals at home
by helping to improve human healthcare quality. Despite its significant convenience
and advantages, it faces challenges related to security and protection from the
perspective of bilateral fine-grained access control as well as the genuineness and
tamper resistance of shared health information.
IoT-Based Intelligent Transportation System through IoTV
Authors: Singh Gagan Deep
Published: December 2024

Since India gained independence, the number of vehicles in the country has
increased by 170 times, while the road infrastructure has only expanded nine times in
proportion. The rate of vehicle population growth is approximately two and a half
million per year. Road fatalities far exceed those from rail, air, and terrorism, and it is
predicted that by 2030, road accidents will be the fifth largest cause of human deaths.
Technology, specifically IoT-based intelligent transportation systems (ITS), can
address the challenges posed by inadequate road infrastructure and development.
International consortia can collaborate to develop solutions tailored to such conditions.
This chapter presents facts related to Indian transport and road accidents and proposes
an IoT-based intelligent transportation system, termed IoTV, to improve transportation
and reduce accident rates. The authors recommend an IoTV solution for ITS in their
paper.
Role of Industrial IoT for Energy Production Using Byproducts
Authors: Sharma Hitesh Kumar , Mohanty Shlok
Published: December 2024

Energy production from fossil fuels is limited as fossil fuel resources are
limited on Earth. We have to find alternate resources for energy production. Energy
production from waste material or by-products can help us in two major ways: by
reducing waste on Earth and by producing energy without affecting conserved
resources. Industrial IoT (IIoT) is an advanced IT-based technology that can help us
detect the most useful waste and determine its availability in different places. It will
also help us automate the complete lifecycle of energy production from by-products
and distribute it to the required places. In this chapter, we will discuss the role of Industrial IoT in the production of
consumables from waste products/by-products. We will explain the various
applications of IIoT in this whole process and the challenges faced in integrating this
technology into it.
Solutions of First Order Differential Equations and Applications
Authors: Oyelami Benjamin Oyediran
Published: December 2024

In this chapter, first order linear differential equations together with the
nonlinear Bernoulli equations are considered and methods for obtaining their solutions
discussed. The methods are applied to find solutions to models in the vibration of LR
electrical circuits, radioactive dating, population dynamics, chemical reactions,
epidemiological and pollution problems.
Second Order Differential Equations and Applications to some Models
Authors: Oyelami Benjamin Oyediran
Published: December 2024

Second order differential equations and methods for solving them are studied.
Methods considered are: Undetermined coefficients, Green’s and Wronskian, principle
of superposition of solutions and variation of constant parameters. Also elucidated upon
are: Construction of Green’s functions and applications to boundary value problems,
Cauchy-Euler, Lagrange and Clairaut equations. Many solved examples and presents
which include Maple ones.
Role of Microbes and Microbiomes in Biofertilizer Production and as Plant Growth Promoters
Authors: Chavada Nikul B. , Poornima Ramesh
Published: December 2024

In 2050, 8.3 billion people will live on Earth, and 70 to 100% more food will
be needed. Food and its products are available through agricultural practices. Soil
biological systems play an essential role in food production. However, it is a complex
process that leads to the stability of crop production and the maintenance of soil health.
Healthy food with eco-friendly agriculture practices is required to sustain the soil
ecosystem globally. Additionally, the continued depletion of the Earth's natural
resources and the increasing use of harmful chemical fertilizers are significant concerns
for agriculture's future. Biofertilizers are gaining popularity as a viable alternative to
unsafe chemical fertilizers in the pursuit of sustainable agriculture. Biofertilizers have
an important role in enhancing crop output and preserving long-term soil fertility, both
of which are critical for fulfilling global food demand. Microbes can interact with
agricultural plants to improve their resistance, growth, and development. Nitrogen,
phosphorus, potassium, zinc, and silica are the fundamental elements needed for crop
growth, yet they are normally present in insoluble or complex forms. Certain microbes
dissolve them and make them accessible to plants.
Role of Microbes and Microbiomes in Biotic and Abiotic Stress Management in Agriculture
Authors: Vijayalakshmi M. , Gloria Jemmi Christobel R. , Ramanathan G. , Karthika S.
Published: December 2024

Agriculture is our sensible recreation and the foremost food source for all
animals and human beings. It gives laurels to us, but knowingly or unknowingly,
agricultural systems face stress, resource quality degradation, and depletion by human
activities. Abiotic stresses, such as nutrient deficiency, water logging, extreme cold,
frost, heat, and drought, affect agricultural productivity. Biotic factors like insects,
weeds, herbivores, pathogens, bacteria, viruses, fungi, parasites, algae, and other
microbes limit good-quality products. Climate change leads to more complications
when interpreting how plants and microbes interact to protect themselves from stress.
Plants need water, carbon, and nutrients to grow. The extreme conditions mentioned
restrict the growth of plants. Although plants can sense and exhibit natural mechanisms
during stress conditions, increased non-sustainable agricultural practices and other
human activities lead to highly stressful conditions for plant growth and yield. While in
stressful situations, fungi play an essential role in energy transfer and uptake of
nutrients by releasing the adverse effects of stress on plant growth. Many strategies in
bacteria and fungi need to be addressed here, including stress conditions such as cysts
and spore formation, cell membrane deformation, production of damage repair
enzymes, and chemical synthesis to relieve stress. The mechanism of salt tolerance,
symbiotic microbes, xenobiotics, and hazardous tolerance genes induces plant growth
in unfavorable conditions. In recent days, technological improvements such as gene
modification by genetic engineering have shown the potential to enhance the positive
effects on agricultural production and products.
Molecular Techniques in Ecosystem Restoration
Authors: Shivakumar R. , Balaji B.
Published: December 2024

A damaged ecosystem must be rebuilt to its original form, or a new
ecosystem must be created in a degraded area. Ecosystem restoration is a complex
procedure. Researchers can now investigate the structure and function of ecosystems at
the molecular level thanks to the development of molecular techniques as a potent tool
for ecosystem restoration. This chapter examines the application of molecular methods
to ecosystem regeneration. The various available molecular methods and how they
have been applied to monitor ecosystem health, identify microbial communities in
ecosystems, and comprehend interactions between microbes and plants are discussed.
The chapter also examines the application of molecular methods to the restoration of
ecosystems that have been damaged, including the use of plant-microbe interactions to
promote plant development in contaminated soils. The chapter emphasizes the
significance of molecular methods in ecosystem restoration and their potential to offer
a more precise and thorough comprehension of ecosystem processes. The conclusion
highlights the importance of ongoing investigation into the use of molecular methods
for ecosystem restoration, especially in creating novel methods and their incorporation
with existing restoration techniques. In the end, applying molecular methods can help
develop practices for ecological restoration that are more efficient and long-lasting.
Data Management, Security Challenges, and Solutions in Blockchain Network
Authors: Baruah Pallabi , Sarma Bhairab
Published: December 2024

Data management challenges are one of the primary concerns in businessrelated organizations. It may result in poor risk management decisions, data loss, data
breaches, illegal access, data silos, noncompliance with legislation, an unregulated
environment, a limited number of resources, and so on. Again, data security, or
information security, includes the practices, policies, and principles to protect digital
data and other kinds of information. Data security is based on three foundational
principles — confidentiality, integrity, and availability. All operations around the globe
are becoming increasingly reliant on data to operate their day-to-day operations and
make educated business decisions. With so much data being created, it has become
challenging to manage data throughout the enterprise, which may be dispersed over
different geolocations and using tens of business line applications. It's accepted that
data is the new oil for any organization. There may be very crucial data that may result
in tremendous opportunities for companies, which is why it is vital to have welldefined data management plans in place in order to face the most difficult challenges
that data management implies. In this chapter, emphasis is given to the most common
data management challenges and pain points and to solving them in blockchain
networks. It also includes the implementation of blockchain network technology in a
wide range of applications, opportunities, and challenges.
AI-enabled Security in Blockchain System
Authors: Whig Pawan , Thatikonda Ramya , Madavarapu Jhansi Bharathi , Bhatia Ashima Bhatnagar
Published: December 2024

Blockchain allows the safe interchange of sensitive data without the need for
duplication, reducing inaccuracies in medical records and gaining time through time
savings. The data is timestamped as well, further enhancing its security. Blockchain
technology is able to increase the safety and effectiveness of payments in a broad range
of medical contexts. As a consequence, only those who have given permission to read
or change health data are able to do so. In a safe and secure health sector with
Automation tech, this book chapter suggests using chain technologies to construct an
information and knowledge repository and retrieval mechanism for patients and
healthcare providers. For the benefit of scholars within the same area, a case study
focused on security and privacy concerns of the virtual world will be explored in this
book chapter.
Crispr-Cas Technology: Targeted Genome Editing in Plant Physiology
Authors: Habibi Mohammad Mehdi
Published: December 2024

The phenomenon of global climate change poses a significant threat to
global food security, primarily due to the limited adaptability of major staple crops and
plant species to the changing climatic conditions. This poses a significant challenge for
farmers, agricultural experts, and policymakers worldwide as they seek to develop
sustainable solutions to ensure adequate food supply in the face of climate changeinduced threats. Significant improvement has been made to preserve crop yield,
employing traditional breeding methods and cutting-edge molecular techniques to
enhance the procedure. The utilization of CRISPR/Cas technology has recently gained
traction as a viable alternative to transgenic methods in plant breeding. Our study in
this chapter, for the first time, delves into the advantages of the CRISPR/Cas system in
plant physiology, exploring key areas such as its impact on environmental factors, the
underlying mechanisms of the CRISPR/Cas system, enhanced quality and yield,
mitigation of biotic and abiotic stresses, ethical considerations, and regulatory issues,
as well as the future prospects of this method.
Soil Biodiversity, Microbiota
Authors: Popoviciu Dan Răzvan
Published: December 2024

Microorganisms form the bulk of soil biota. Having densities of hundreds of
millions per gram, bacteria are the dominant organisms. They are the starting point of
most trophic chains, they ensure a major part of soil functionality as an ecosystem and
they effectively create soil, especially by breaking down organic matter. Their
taxonomic diversity is enormous, such as the ecological one: heterotrophs,
photoautotrophs, chemoautotrophs, etc. Besides them, there are also archaea, viruses,
different types of microalgae, and the eclectic group we usually call “protozoans”.
Cycles of Matter in Soil: Phosphorus, Sulfur, Metals
Authors: Popoviciu Dan Răzvan
Published: December 2024

Phosphorus and sulfur, together with alkaline, alkaline earth and transitional
metals are important nutrients and constituents of living matter. The sulfur cycle
involves an atmospheric phase, but its main stages are due to terrestrial biota, through
processes like sulfate reduction, sulfide oxidation, anoxygenic photosynthesis, etc. The
cycles of phosphorus and metals lack significant atmospheric stages. The main
biogeochemical processes involving soil microorganisms are those of solubilization
and precipitation, that determine their general bioavailability.
Soil Biology & Ecology: The Basics
Authors: Popoviciu Dan Răzvan
Published: December 2024

Soil Biology & Ecology: The Basics offers an accessible introduction to the diverse and dynamic world beneath our feet. This book explores soil as a thriving habitat, detailing the rich biodiversity of microorganisms and macroorganisms that sustain essential ecological cycles. It covers the key biochemical cycles in soil, including carbon, nitrogen, phosphorus, and sulfur, explaining how these processes contribute to soil fertility and ecosystem health. With a focus on ecological relationships like symbiosis and competition, this guide illuminates the vital role of soil in supporting life and agricultural productivity.

Ideal for students, researchers, and nature enthusiasts, the book is a foundational resource for understanding soil's impact on the biosphere and human food production.

Key Features:
- Comprehensive overview of soil as a living ecosystem
- Detailed coverage of soil microbiota, macrobiota, and biochemical cycles
- Insights into ecological relationships and their practical applications
The Study of Antifungal Activity of Chlorhexedin and Decasan Antiseptics in Relation to Candida spp. Clinical Strains
Authors: Ohiienko Tetiana , Kutsyk Roman , Ohiienko S. , Pyuryk Y. , Kulynych Haliia
Published: December 2024

Topicality. Diseases of the oral mucosa (OM) continue to be an urgent problem in modern dentistry. OM mycotic lesion is the most prevalent among them. Increased use and insufficient course of antifungal drugs administration, of both high-quality and low-quality ones, leads to the occurrence of more resistant Candida strains. Therefore, we studied an antimycotic effect of the most widely used antiseptics such as Chlorhexedine and Decasan on modern clinical strains of Candida selected from patients with OM candidiasis.
The aim. Studied an antimycotic effect of the most widely used antiseptics such as Chlorhexedine and Decasan on modern clinical strains of Candida selected from patients with OM candidiasis.
Materials and methods. The study of antiseptics antifungal activity was performed on clinical strains of yeast-like fungi (C.albicans and C. non-albicans) selected from the samples of the oral mucosa of patients with oral candidiasis. Agar diffusion test and broth microdilution were used to study the anti-candidal activity of Chlorhexidine and Decasan (decamethoxine) in relation to Candida spp. clinical strains selected from the patients with candidiasis.
Discussion of the results. Agar diffusion test demonstrated that the solutions of both mentioned antiseptics in the concentrations which were directly applied to the oral mucosa in the affected area had a pronounced fungicidal effect. According to the testing results, both antiseptics had rather low values of fungistatic and fungicidal concentrations.
Conclusions. Thus, despite the existence of antimycotic polyresistance as the main property of modern Candida strains, which are the causative agents of oral candidiasis in dental patients, the antiseptic agents Chlorhexidine and Dekasan retain a sufficiently high therapeutic potential. The conducted studies substantiate microbiologically the expediency of their inclusion in modern therapeutic regimens.
Strategy of Surgical Correction of Aesthetic Defects of the Anterior Abdominal Wall in Patients with Obesity
Authors: Atamanyuk Oleg , Trombola Oleh
Published: December 2024

The aim. According to forecasts, by 2035, 50% of the world's population will suffer from obesity, and we aimed to develop an effective strategy for the surgical correction of its consequences, in the form of aesthetic defects of the anterior abdominal wall.
Materials and methods. For its implementation, from 2020 to 2024, a prospective study was conducted on the basis of the Postgraduate Surgery Department of IFNMU, which included 93 patients, divided into three homogeneous groups, depending on the surgical interventions performed: №1 – liposuction of the anterior abdominal wall, performed according to principles of the SAFE technique, №2 – traditional abdominoplasty, №3 – a combination of both techniques. The expression of pain syndrome was measured in the postoperative period on the first and seventh days using the Visual Analog scale. Treatment results were evaluated after 1, 6, and 12 months by determining patients' satisfaction with the aesthetic consequences of surgical interventions using the Global Aesthetic Improvement Scale, and the dynamics of psycho-emotional changes using the Ukrainian version of the Body Shape Questionnaire-34. The presence of postoperative complications was recorded.
Results. During analyzing the Visual analog scale, a statistically significant difference was observed between the results of groups 1 and 2 and groups 1 and 3. At the same time, it was absent between groups 2 and 3. The obtained results of patient satisfaction according to the GAIS showed a positive trend, as all study participants noted an improvement in the aesthetic parameters of the anterior abdominal wall, and this indicator was the most pronounced ("very significant improvement" in 45.2% of patients) was in group 3 for the 6th month from the moment of the surgical intervention. The treatment had a significant impact on the psycho-emotional state of the patients, since, according to the results of the questionnaire, 100% of the study participants demonstrated a positive trend in the perception of their own appearance. Already 1 month after the surgical intervention, a statistically significant difference with the data obtained before the start of treatment is observed in all studied groups. The development of postoperative complications was observed in 5.4% of patients. Among the most significant: seroma, infection of the postoperative wound and deformation of the postoperative scar.
Decoding Digestive Dilemmas: ChatGPT outperforms Bard in Gastroenterology Clinical Questions from MKSAP-19
Authors: Singh Jassimran , Agrawal Aditi
Published: December 2024

Abstract
Aim: This study aims to evaluate the performance of large language models (LLMs), specifically OpenAI’s ChatGPT and Google Bard, in answering gastroenterology clinical questions from the Medical Knowledge Self-Assessment Program-19 (MKSAP-19), thereby assessing their potential utility in clinical decision-making within the field of gastroenterology.
Materials and Methods: A comparative analysis was conducted using a dataset of 50 gastroenterology questions from MKSAP-19, assessing the ability of ChatGPT and Bard to provide correct answers without prior training or access to MKSAP-19 materials. The performance of each LLM was evaluated based on the percentage of correct answers, with a passing score set at 50%.
Results: ChatGPT outperformed Bard, achieving a 68% success rate in answering the questions correctly, compared to Bard’s 44%. ChatGPT attempted all questions, while Bard abstained from answering two. The analysis also identified specific areas where both LLMs struggled, indicating gaps in their clinical reasoning capabilities.
Conclusions: ChatGPT demonstrated a higher efficacy in clinical decision-making for gastroenterology questions than Bard, suggesting the potential of LLMs as supplementary tools in clinical settings. However, the limitations of LLMs, including their inability to interpret images and consider real-life factors such as social determinants of health, highlight the need for further development before they can independently guide medical decisions.
The Formation of the Creative Personality in the Institutions of Higher Education
Authors: Skrobach Nadia , Kuryliv Halyna , Ivasyshyn Iryna
Published: December 2024

The current development of a civil democratic state gives rise to a new worldview approach. According to this approach, the human personality comes into focus with its unique interests, values, and ability to improve, develop, educate, and be creative.
The notion of a creative personality comes as a subsystem of the personality concept, characterized by a set of creative individual qualities that ensure their success in creative activity. The formation of a creative personality is influenced by both general and specific social patterns caused by historical conditions of social development. The development of a creative personality follows particular patterns. Also, a creative personality develops in creative activity and communication.
A creative personality is a subject of creative social relations and conscious creative activity. On the other hand, it is the source of creative activity in a specific social environment. A creative personality is defined as a person "whose creative scope covers actions ranging from non-standard solution of a simple task to the creation of something objectively new in a particular field, as a person characterized by specific personal qualities, namely: determination, the ability to keep going, courage of thought, the ability to see beyond the boundaries, courage to go against the tide and destroy the common beliefs". 
We consider the creative potential of a personality as an integrated manifestation of a variety of personal qualities. A creative personality is not only defined by high creative potential, but also by the degree of their commitment to bring it to life.
Association of single nucleotide variants of the clock gene (rs1801260) with seizures after alcohol withdrawal
Authors: Achuvakov R. S. , Efremov I. S. , Bobrik D. V. , Efremova U. S. , Khakimova R. A. , Asadullin A. R.
Published: December 2024

Objective: to study the association of single nucleotide variants of the CLOCK gene (rs1801260) and seizures aﬅer alcohol withdrawal.

Materials and methods: 399 patients were analyzed, including 83 women (21%) and 316 men (79%). The average age of the patients was 41.52±8.42 years. The patients were divided into 2 groups. The main group (patients who suﬀered a seizure in a hospital setting) consisted of 108 patients, 12 women (11%), 96 men (89%), and the comparison group consisted of 291 patients, 71 (25%) women and 220 (75%) men. The examination of patients took place from February 2019 to August 2023. The laboratory study included a comparative genetic examination of two groups of patients: the ﬁrst group — patients with alcohol dependence syndrome with seizures aﬅer alcohol withdrawal (F10.2); the second group — patients with alcohol dependence syndrome (F10.2) without seizures aﬅer alcohol withdrawal. Statistical processing was carried out using Microsoﬅ Excel, IBM SPSS Statistics 26. During the frequency analysis, the criterion χ² (Pearson Chi-squared) was used, and the odds ratio for each of the genotypes was estimated. The diﬀerences were recognized as statistically signiﬁcant at a signiﬁcance level of p<0.05. ><0.05.

Results: when conducting a frequency analysis of the occurrence of seizures aﬅer alcohol withdrawal, carriers of the CC genotype had seizures much less frequently than carriers of other genotypes.

Conclusion: the presence of the T allele of the CLOCK gene in the genotype is associated with seizures aﬅer alcohol withdrawal. Moreover, carriers of the homozygous genotype have a higher chance of experiencing seizures than carriers of the homozygous genotype.
Hypercalciemia in severe kidney failure, differential diagnosis
Authors: Gafurova N. A. , Gorbatova E. V. , Strelkova A. V. , Postoeva A. V.
Published: December 2024

Hypercalcemia is a metabolic condition characterized by an increase in total serum calcium concentration above normal. The prevalence of hypercalcemia in the population is about 1–3% according to pilot screening trials, and hypercalcemia is most oﬅen parathyroid-dependent. In the majority cases hypercalcemia remains asymptomatic, and clinical features are appeared only when the level of total calcium rises to 3,0–3,5 mmol/l. Detection of hypercalcemia in a patient allows the doctor to suspect ﬁrst the pathology of parathyroid glands - primary hyperparathyroidism or malignant neoplasms, when under the inﬂuence of metastases of solid tumors there is destruction of bone tissue. This paper presents a clinical case of hypercalcemia in a patient with severe kidney failure, arterial hypertension and multiple cystic lucencies on radiographs of the leﬅ shoulder joint. Determination of intact parathyroid hormone concentration within the reference range allows us to reject the hyperparathyroidism and do extend diﬀerential diagnostic search. The result of nephrobiopsy was the diagnosis of multiple myeloma, myeloma nephropathy. Unusual for terminal stage of chronic kidney disease hypercalcemia and searching of its cause allows to verify the diagnosis of multiple myeloma in a short period of time.
Clinical characteristics of patients with gestational diabetes mellitus depending on the type of treatment (a retrospective study)
Authors: Volkova N. I. , Davidenko I. Yu. , Degtyareva Yu. S.
Published: December 2024

Objective: to evaluate the clinical characteristics of patients with GDM depending on the treatment received to conﬁrm the presence of various subtypes of GDM.

Materials and methods: a retrospective analysis of the medical records of 474 pregnant women with GDM was carried out. The subjects were divided depending on the treatment method received: I group — 353 pregnant women with GDM who received only diet therapy, II group — 121 pregnant women with GDM who used both diet and insulin therapy. Biochemical and general blood tests, coagulograms at the 20th and 30th weeks of pregnancy, ultrasound results, pharmacological history, concomitant complications and pregnancy outcomes were analyzed. The statistical analysis of the results of the study was carried out using R. The diﬀerences were recognized as statistically signiﬁcant at the level of p < 0.05.

Results: age, blood pressure, weight and BMI in each trimester and before childbirth did not diﬀer statistically signiﬁcantly among the groups. Patients receiving insulin therapy had higher levels of urea (p = 0.009), AST (p = 0.03), ALT (p = 0.02), prothrombin (p = 0.02) and D-dimer (p = 0.047). According to the ultrasound data, no signiﬁcant diﬀerences were found. An assessment of the pharmacological history revealed a more frequent use of progesterone preparations in patients with insulin therapy. Concomitant diseases were comparable in patients from diﬀerent groups.

Conclusion: despite the absence of signiﬁcant diﬀerences among the observation groups, the results obtained do not exclude the presence of diﬀerent subtypes of GSD, but suggest that there is an unjustiﬁed prescription of insulin therapy in cases where more intensive dietary changes are required. Of course, further study of this problem is required to conﬁrm the presence of various subtypes of GDM.
Predictors of unfavorable progression and prognosis in patients with heart failure with preserved left ventricular ejection fraction
Authors: Sobolevskaya M. S. , Gvozdeva A. D. , Svirida O. N. , Filatova A. Y.
Published: December 2024

Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure (HF) worldwide and is characterized by a severe course, poor prognosis, and limited eﬀective treatments. To date, there are no reliable prognostic algorithms to identify high-risk patients, and prognostic signiﬁcance has been determined only for generally accepted clinical and standard resting echocardiographic parameters. The discovery of independent predictors of poor prognosis/severe course of HFpEF is important for determining individual treatment tactics for such patients.The article provides a review of studies devoted to determining clinical, biochemical and hemodynamic predictors of unfavorable progression and prognosis of heart failure with preserved ejection fraction (HFpEF). Signiﬁcance of assessing of these predictors for determining prognosis and choosing optimal treatment for patients with HFpEF is shown. Directions for further research were identiﬁed: identifying phenotypes of HFpEF, developing personalized therapy, construction of prognostic models to identify high-risk patients who require more careful monitoring and/or more intensive drug treatment.
Reserves for reducing the frequency of cesarean section in a level 3A hospital
Authors: Lebedenko E. Yu. , Bespalaya A. V. , Mikhelson A. A. , Feoktistova T. E. , Kormanukov H. Yu.
Published: December 2024

Objective: to substantiate the reserves for reducing the frequency of cesarean section in a level 3 A hospital by retrospectively analyzing delivered patients using the M. Robson classiﬁcation.

Materials and methods: a retrospective analysis of 3771 birth histories of patients delivered in 2017 at the Rostov State “Perinatal center” was carried out. The patients were divided into 10 groups according to M. Robson's classiﬁcation. The results were processed using mathematical statistics methods using MS Excel 2010 soﬅware.

Results: an analysis of delivery methods showed that out of 3,771 deliveries, 2018 women were delivered by abdominal delivery, which accounted for 53.2% of the total number of births in 2017. A detailed analysis of the indications for cesarean section in each of the groups according to M. Robson's classiﬁcation revealed the true reserve for reducing the overall level of abdominal delivery in the studied institution.

Conclusions: in order to structure in detail the reserves for reducing the frequency of cesarean section in a particular institution and to compare this indicator between maternity care institutions, in addition to the traditional analysis according to M. Robson's classiﬁcation, it is necessary to develop and implement a uniﬁed form of analysis taking into account indications for abdominal delivery.
Adjuvant activity of glucosaminylmuramyldipeptide and prospects of its use for the treatment and prevention of infectious diseases
Authors: Filippenko A. V. , Ivanova I. A. , Omelchenko N. D. , Trufanova A. A.
Published: December 2024

The purpose of the review was to analyze the literature data on the eﬀect of glucosominylmuramyldipeptide on factors of innate and adaptive immunity in the treatment and prevention of various infectious diseases. The purpose of the review was to examine studies conducted over the past 20 years concerning the use of GMDP for the treatment and prevention of infectious diseases of various etiologies. The literature was searched using databases such as RSCI, eLibrary, MedLine. The following search words were used: muramyldipeptide, muramyldipeptide mechanism of action, glucosominylmuramyldipeptide for the treatment of infectious diseases, glucosominylmuramyldipeptide for the prevention of infectious diseases, glucosominylmuramyldipeptide as an adjuvant. GMDP is an activator of innate and acquired immunity, strengthens the body's protection against viral, bacterial and fungal infections, and also has an adjuvant eﬀect in the development of a post-vaccination immune response, which determines the prospects for its further use to improve treatment regimens and speciﬁc prevention of various infectious diseases.
Immunotherapy in patients with recurrent implantation failure
Authors: Trunova O. A. , Gulmamedova I. D. , Maylyan E. A.
Published: December 2024

Objective: to evaluate the eﬀect of personalized immunotherapy on the frequency of pregnancy and gestation in women with recurrent implantation failure.

Materials and methods: the clinical immunogram before and aﬅer courses of personalized immunotherapy in 65 women with a history of recurrent implantation failure during the period of preparation for treatment under the ART program (24 cryoprotocols in the natural cycle, 41 cryoprotocols with hormone replacement therapy without pituitary blockade): CD3+, CD3+CD4+, CD3+CD8+, CD3+CD20+, CD16+ in direct reaction of surface immunoﬂuorescence using monoclonal antibodies; concentration of serum Ig G, A, M by ELISA; total circulating immune complexes; Nitroblue tetrazolium (NBT) dye reduction test; phagocytic activity of neutrophils.

Results: the immune status of 100% of patients with secondary infertility and 36.4% of women with primary infertility is characterized by secondary T-immunodeﬁciency and signiﬁcant activation of both B-lymphocytes and cellular factors of nonspeciﬁc body protection — peripheral NK cells (CD16+) and neutrophils. Repeated courses of personalized immunotherapy in women with a history of recurrent implantation failure led to normalization of altered immune parameters and showed their eﬀectiveness in 67.7% of patients who gave birth to live children.

Conclusion: one of the leading reasons for habitual ineﬀective implantation in the presence of euploid embryos of good quality is general and local (endometrial) immunological imbalance. A personalized approach to the selection of immunotherapy for each patient optimizes the frequency of implantation, the onset and outcome of pregnancy.
The innate immune response is a key player in the process of coronary artery and aortic valve calcification
Authors: Shlyk I. F. , Kharitonova M. V. , Morgunov M. N. , Blinov I. M. , Vasilyeva E. D. , Besedina D. Yu.
Published: December 2024

The presented literature review allows us to understand and supplement the existing ideas about the pathogenesis of coronary calciﬁcation and aortic valve calciﬁcation at the stage of formation of these changes. To study in detail the participation of the most studied immunocompetent cells of innate immunity, such as macrophages, dendritic and mast cells, neutrophils, natural killers in calciﬁcation of arteries and aortic valve, their functional role in the progression of this process. The review also presents gaps and missing data present in the study of these cell populations, the replenishment of which will contribute to the development of targeted therapy for the calciﬁcation process.

The search for literature sources was conducted in the following databases: Scopus, web of Science, MedLine, The Cochrane Library, RSCI, Springer, Science Direct — taking into account the year of publication (no more than 10 years), language of publication (English/Russian), availability of full-text publications and access to them.
Changes in Physical Activity Across Cancer Diagnosis and Treatment Based on Smartphone Step Count Data Linked to a Japanese Claims Database: Retrospective Cohort Study
Authors: Inayama Yoshihide , Yamaguchi Ken , Mizuno Kayoko , Tanaka-Mizuno Sachiko , Koike Ayami , Higashiyama Nozomi , Taki Mana , Yamanoi Koji , Murakami Ryusuke , Hamanishi Junzo , Yoshida Satomi , Mandai Masaki , Kawakami Koji
Published: December 2024

Background

Although physical activity (PA) is recommended for patients with cancer, changes in PA across cancer diagnosis and treatment have not been objectively evaluated.

Objective

This study aimed to assess the impact of cancer diagnosis and treatment on PA levels.

Methods

This was a retrospective cohort study using a Japanese claims database provided by DeSC Healthcare Inc, in which daily step count data, derived from smartphone pedometers, are linked to the claims data. In this study, we included patients newly diagnosed with cancer, along with those newly diagnosed with diabetes mellitus for reference. We collected data between April 2014 and September 2021 and analyzed them. The observation period spanned from 6 months before diagnosis to 12 months after diagnosis. We applied a generalized additive mixed model with a cubic spline to describe changes in step counts before and after diagnosis.

Results

We analyzed the step count data of 326 patients with malignant solid tumors and 1388 patients with diabetes. Patients with cancer exhibited a 9.6% (95% CI 7.1%-12.1%; P<.001) reduction in step counts from baseline at the start of the diagnosis month, which further deepened to 12.4% (95% CI 9.5%-15.2%; P<.001) at 3 months and persisted at 7.1% (95% CI 4.2%-10.0%; P<.001) at 12 months, all relative to baseline. Conversely, in patients with diabetes, step counts remained relatively stable after diagnosis, with a slight upward trend, resulting in a change of +0.6% (95% CI –0.6% to 1.9%; P=.31) from baseline at 3 months after diagnosis. At 12 months after diagnosis, step counts remained decreased in the nonendoscopic subdiaphragmatic surgery group, with an 18.0% (95% CI 9.1%-26.2%; P<.001) reduction, whereas step counts returned to baseline in the laparoscopic surgery group (+0.3%, 95% CI –6.3% to 7.5%; P=.93).

Conclusions

The analysis of objective pre- and postdiagnostic step count data provided fundamental information crucial for understanding changes in PA among patients with cancer. While cancer diagnosis and treatment reduced PA, the decline may have already started before diagnosis. The study findings may help tailor exercise recommendations based on lifelog data for patients with cancer in the future.
Evaluation of a Telemonitoring System Using Electronic National Early Warning Scores for Patients Receiving Medical Home Care: Pilot Implementation Study
Authors: Lin Cheng-Fu , Chang Pei‐Jung , Chang Hui-Min , Chen Ching-Tsung , Hsu Pi-Shan , Wu Chieh-Liang , Lin Shih-Yi
Published: December 2024

Background

Telehealth programs and wearable sensors that enable patients to monitor their vital signs have expanded due to the COVID-19 pandemic. The electronic National Early Warning Score (e-NEWS) system helps identify and respond to acute illness.

Objective

This study aimed to implement and evaluate a comprehensive telehealth system to monitor vital signs using e-NEWS for patients receiving integrated home-based medical care (iHBMC). The goal was to improve the early detection of patient deterioration and enhance care delivery in home settings. The system was deployed to optimize remote monitoring in iHBMC and reduce emergency visits and hospitalizations.

Methods

The study was conducted at a medical center and its affiliated home health agency in central Taiwan from November 1, 2022, to October 31, 2023. Patients eligible for iHBMC were enrolled, and sensor data from devices such as blood pressure monitors, thermometers, and pulse oximeters were transmitted to a cloud-based server for e-NEWS calculations at least twice per day over a 2-week period. Patients with e-NEWSs up to 4 received nursing or physician recommendations and interventions based on abnormal physiological data, with reassessment occurring after 2 hours.

Implementation (Results)

A total of 28 participants were enrolled, with a median age of 84.5 (IQR 79.3‐90.8) years, and 32% (n=9) were male. All participants had caregivers, with only 5 out of 28 (18%) able to make decisions independently. The system was implemented across one medical center and its affiliated home health agency. Of the 28 participants, 27 completed the study, while 1 exited early due to low blood pressure and shortness of breath. The median e-NEWS value was 4 (IQR 3‐6), with 397 abnormal readings recorded. Of the remaining 27 participants, 8 participants had earlier home visits due to abnormal readings, 6 required hypertension medication adjustments, and 9 received advice on oxygen supplementation. Overall, 24 out of 28 (86%) participants reported being satisfied with the system.

Conclusions

This study demonstrated the feasibility of implementing a telehealth system integrated with e-NEWS in iHBMC settings, potentially aiding in the early detection of clinical deterioration. Although caregivers receive training and resources for their tasks, the system may increase their workload, which could lead to higher stress levels. The small sample size, short monitoring duration, and regional focus in central Taiwan may further limit the applicability of the findings to areas with differing countries, regions, and health care infrastructures. Further research is required to confirm its impact.