bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of inhaled molecular hydrogen therapy in patients with respiratory failure due to chronic obstructive pulmonary disease exacerbation in post-COVID period
Authors: Shogenova L. V. , Gufranov Kh. F.
Published: October 2024

Molecular hydrogen (H2) is a powerful antioxidant and anti-apoptotic agent. H2 has been studied in a number of clinical studies in the recent years.

The aim of this research was to investigate the efficacy and safety of H2 inhalation therapy in patients with hypoxemic and hypercapnic respiratory failure (RF) against exacerbation of chronic obstructive pulmonary disease (COPD) in the post-COVID (Corona Virus Disease 2019) period.

Methods. The randomized prospective parallel comparative study included patients (n = 60: 40 men aged 71.2 ± 1.8 years, 20 women aged 70.9 ± 2.8 years) with a post-COVID-19 exacerbation of COPD complicated by hypoxemic/hypercapnic RF. The patients were divided into 2 groups: group 1 (main) (n = 30: 18 men, 12 women), group 2 (control) (n = 30: 18 men, 12 women). To maintain arterial blood saturation ≥ 90 %, patients in both groups received respiratory support (non-invasive ventilation) using the Prisma 25ST device (Lowenstein Medical, Germany) in the BiPAP S/T mode (BiLevel Positive Airway Pressure Spontaneous/Time spontaneous/forced mode 20–24/4–6 cm H2O and O2, respectively; the fractional oxygen concentration in the inhaled gas mixture was ≥ 24%). In addition to standard treatment, patients in the main group received additional H2 therapy (Suisonia device, Japan) through a nasal cannula for 90 minutes daily for 14 days.

Results. In patients of the main group, a decrease in the stiffness index was detected from 14.6 ± 1.2 to 6.2 ± 0.6 m/s, and the arterial blood lactate level – from 2.84 ± 0.1 to 0.02 ± 0.1 mmol/l (p < 0.001), the calculated shunt fraction Qs/Qt (venous admixture) – from 27.21 ± 3.4 to 7.14 ± 1.23 (p < 0.01) and an increase in the following parameters: reflection index – from 42.2 ± 2.0 to 66.2 ± 4.9% (p < 0.05), virus-specific IgG level – from 134 ± 125 to 669 ± 164 (p < 0. 05), blood flow velocity in arterioles – from 473 ± 108 to 868 ± 64 μm/s (p < 0.05), blood flow velocity in venules – from 299 ± 56 to 862 ± 69 μm/s (p < 0.05), the 6-minute walk distance – from 57.1 ± 4.4 to 328.9 ± 33.7 m (p < 0.05).

Conclusion. H2 inhalations were safe and increased the therapeutic effect when added to standard therapy for patients with hypoxemic and hypercapnic RF during exacerbation of COPD in the post-COVID period.
Chronic obstructive pulmonary disease and its treatment in the Russian Federation: Results of a cross-sectional assessment from the CORSAIR observational study
Authors: Arkhipov V. V. , Avdeev S. N. , Trofimov V. I. , Osipova G. L. , Vishneva E. M. , Shangina О. A. , Kirillova N. A. , Lagutina Т. A. , Van’kova E. I. , Shipilova I. A. , Ilkovich J. M. , Ananeva О. Y.
Published: October 2024

Abstract Up-to-date data on patients with chronic obstructive pulmonary disease (COPD) in the Russian Federation are necessary to improve medical care effectiveness.

This article presents the results of the retrospective part and the cross-sectional assessment of the CORSAIR study, which aimed to assess the distribution of COPD patients in the Russian population by symptom severity and exacerbation risk as per GOLD (2020) classification groups A, B, C, D.

Methods. The observational multicenter study CORSAIR included a cross-sectional assessment with data collection during the previous 12 months (retrospective part) and subsequent follow-up for 12 months (prospective part). Data from 704 patients obtained at 18 study sites from August 2021 to November 2022 are presented. At the first visit, the physician recorded medical history, clinical data on the disease course, and COPD therapy, assessed compliance of treatment with national guidelines, and determined whether treatment change was needed considering the predominant treatable trait (dyspnea or exacerbation).

Results. Upon inclusion, most patients had severe COPD symptoms (mMRC score ≥ 2; САТ score ≥ 10) and severe and very severe airflow obstruction (GOLD III and GOLD IV; FEV1 < 50% оf predicted). More than half of the patients had at least one moderate or severe COPD exacerbation within the previous 12 months. As per the GOLD (2020) classification, 57.2% of patients belonged to Group B (severe symptoms and low risk of exacerbations) and 30.3% to Group D (severe symptoms and high risk of exacerbations). 58.8% of patients received treatment that was not compliant with national clinical guidelines in force at the study initiation. 31.7% of patients had not COPD control. Blood eosinophil count was above 300 cells/μL in 15.1% of patients.

Conclusion. In most cases, patients had severe COPD symptoms with frequent exacerbations, and the prescribed treatment did not comply with national clinical guidelines. These data will be analyzed alongside the prospective study results.
Intrapulmonary electronic auscultation for asthma and chronic obstructive pulmonary disease
Authors: Glotov S. I. , Uryasev O. M. , Byalovskiy Yu. Yu. , Bulatetskiy S. V. , Ponomareva I. B.
Published: October 2024

The aim of the study was to develop and perform clinical testing of the intrapulmonary electronic auscultation method for audio and video recording at various levels of the tracheobronchial tree for the diagnosis of asthma and chronic obstructive pulmonary disease (COPD).

Methods. We examined 31 patients with moderate (n = 17) and severe (n = 14) COPD with severe symptoms outside of exacerbation and 35 patients with moderate (n = 19) and severe (n = 16) partially controlled asthma. Traditional bronchoscopy was performed, including intrabronchial recording of acoustic noise with a microphone (introduced into the instrumental channel of the bronchoscope) at various levels of the tracheobronchial tree. Video recording in various modes revealed the causes of wheezing. At the same time, pulmonary sounds were recorded in the interscapular region of the chest at the projection points of the bronchoscope in the tracheobronchial tree using a 3M™ Littmann® 3200 electronic stethoscope (USA).

Results. The greatest intergroup differences between patients with moderate and severe COPD were demonstrated by intrapulmonary sound parameters (frequency and duration of wheezing, р < 0.0001) and frequency response (amplitude-frequency characteristics) of wheezing in the lumen of the 4th order bronchi (р < 0.0001), significantly exceeded the corresponding sound phenomena during auscultation from the surface of the chest (р < 0.01). The most significant intergroup differences in the groups of BA patients with moderate and severe disease were observed in the frequency response of wheezing during intrapulmonary auscultation in the lumen of the 3rd order (р < 0.0001) and 4th order (р < 0.0001) bronchi; smaller differences were observed in the frequency response during auscultation from the chest surface (р < 0.001).

Conclusion. Intrapulmonary auscultation is a modern auscultatory method which can improve the quality and efficiency of diagnosis of asthma and COPD in pulmonology.
Erdosteine in the treatment of acute and chronic diseases of the respiratory system: resolution of the scientific forum of experts “In the Spotlight”
Authors: Trofimenko I. N. , Avdeev S. N. , Aisanov Z. R. , Zaicev A. A.
Published: October 2024

Airway mucus hypersecretion is a pathophysiologic manifestation of acute and chronic airway inflammatory disease. Mucolytics can reduce mucus viscosity and promote mucus discharge and therefore can be considered pathogenetically based therapy.

The purpose of this publication with the resolution of the scientific forum of experts was to discuss pharmacological features, efficacy, and safety of erdosteine.

Results. Experts of thescientific forum not only reviewed the results of clinical trials, but also voted on the use of mucoactive drugs according to the principle of Delphi consensus. Comparison of the efficacy and safety of mucoactive drugs (erdosteine, acetylcysteine, carbocysteine, ambroxol) in patients with respiratory diseases by the experts during voting showed that the highest level of agreement among the experts was achieved for the drug Elmucin® (erdosteine) in terms of its mucolytic activity and other pharmacological features, as well as when discussing the safety of the compared drugs in the officially recommended doses. The highest level of agreement was also noted on the erdosteine efficacy in COPD patients in reducing the frequency and duration of disease exacerbations, as well as reducing the risk of hospitalization of COPD patients when used long-term as part of combination therapy. The demonstrated safety profile was the most beneficial among the reviewed mucoactive drugs.

Conclusion. Elmucin® is a mucolytic with pleiotropic effects such as complex mucoactive action, potent antioxidant, anti-inflammatory and antibacterial activity with anti-adhesive effect for pathogens that determine its clinical efficacy in the treatment of acute and chronic airway diseases.
Choice of therapy for patients who do not achieve control over bronchial asthma on basic therapy with medium doses of inhaled glucocorticosteroids/long-acting β2-agonists. Resolution of the Expert Council
Authors: Avdeev S. N. , Aisanov Z. R. , Arkhipov V. V. , Belevskiy A. S. , Ilyina N. I. , Kurbacheva O. M. , Nenasheva N. M.
Published: October 2024

Recently, new drugs for the treatment of bronchial asthma (BA) have been registered in the Russian Federation: fixed triple combinations, which include inhaled corticosteroids (ICS), long-acting β2-agonists (LABA) and anticholinergics, high-dose combinations of beclomethasone dipropionate (BDP) and formoterol (FORM) in the form of an extrafine metered-dose aerosol, which allows prescribing 800 mcg of extrafine BDP and 24 mcg of FORM per day.

The aim of publishing the resolution of the Expert Council “Choice of therapy for patients who do not achieve control over bronchial asthma on basic therapy with medium doses of inhaled corticosteroids/long-acting β2-agonists” was to compare possible ways of therapy optimization and propose criteria for choosing therapeutic alternatives based on the individual clinical and phenotypic characteristics.

Conclusion. If a patient does not achieve asthma control (or had asthma exacerbations over the past year) with alternative therapy at step 4, it is advisable to switch to a maintenance and relief therapy (MART) regimen with fixed combination of inhaled corticosteroids/formoterol and with medium doses of ICS in the maintenance part of the regimen. In patients with poor control on alternative therapy with a medium dose of ICS, it is advisable to consider increasing the dose of ICS as part of an ICS/LABA combination or as part of a triple combination instead of switching to MART. Switching to a medium- or high-dose triple combination is especially useful for patients with fixed obstruction and when bronchial asthma is combined with chronic obstructive pulmonary disease. In patients who require high-dose therapy, it is advisable to consider prescribing high doses of ICS using an extrafine combination of BDP/FORM (400/12 mcg in the morning and evening). If MART with a medium dose of ICS does not prevent exacerbations, provide normal spirometry results and/or good control of symptoms, MART in combination with an anticholinergic drug should be used at step 5. If triple therapy or high doses of ICS/LABA are insufficiently effective, biological therapy should be considered.
N-acetylcysteine – a drug for basic and symptomatic therapy of chronic bronchitis/chronic obstructive pulmonary disease
Authors: Leshchenko I. V. , Zaytsev A. A.
Published: October 2024

Prevention and successful treatment of the disease exacerbations are crucial for patients with chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD). At present, a sufficient number of efforts are being made to improve both prevention of exacerbations in patients with stable disease progression and treatment of the exacerbations. According to international and domestic recommendations, mucolytic drugs are among the key therapies for both bronchitis phenotype of COPD and chronic bronchitis, the main clinical manifestation of which is a long-term productive cough. The aim of the review is to analyze modern literature data that reflect the role of N-acetylcysteine (NAC) in prevention of exacerbations during the stable course and treatment of exacerbations of chronic bronchitis and COPD.
Prospects of vaccination against pneumococcal infection based on the asthma phenotype
Authors: Kostinov A. M. , Konishcheva A. Yu.
Published: October 2024

According to recent studies, bronchial asthma is characterized by a wide variability of the mechanisms of occurrence and progression. This heterogeneity is caused by patterns of predominant cells and inflammatory mediators, which determine differences in immunological parameters observed in patients with certain endotypes depending on the dominant type of mediators (high and low T2 inflammation). In long-term observations, a substantial research base has been accumulated justifying the effectiveness of vaccination against pneumococcal infection in patients with asthma. The vaccination decreases the frequency of exacerbations of the disease and hospitalizations in the short and medium term. However, these studies evaluated the asthma patients as a wholesome population, and it remains unexplored whether the effect of pneumococcal vaccines on asthma differs depending on the endotype of the disease and what are the mechanisms of such a differentiated effect.

The aim of this work is to present the results of recent quality studies on changes in the profile of inflammatory asthma mediators under the action of immunobiological substances based on Streptococcus pneumoniae antigens, primarily from the vaccines.

Conclusion. The asthma heterogeneity can lead to different clinical outcomes in pneumococcal infection and, respectively, the clinical effects of immunization in patients differentiate according to the nature of inflammation. In other words, the uniformity of the clinical effect of vaccination against pneumococcal infection in all patients in ongoing studies may represent the combined effect of molecular mechanisms regulating the specific activity of Th1-, Th2-, Th17-, NKT-, and Treg-cells. The results of studies proving the ability of pneumococcal vaccines to modulate the Th1-, Th2-, Th17-, Treg immune response in patients with asthma contributed to increased interest in developing new immunoregulatory therapeutic agents based on S. pneumoniae antigens.
Influence of Technology Readiness and Flow Theory toward the Acceptance of Augmented Reality among Students in Private University in Jakarta, Indonesia
Authors:   Department of Informatics, Faculty of Science Engineering and Design, Universitas Trilogi, Jakarta, Indonesia, Arifitama Budi
Published: October 2024

Augmented Reality has recently gained popularity in the sphere of education. Unfortunately, most augmented reality research in private university in Indonesia is focused solely on software development. This will affect how ready and willing the student is to implement augmented reality. This research investigated the impact of readiness attitude and flow theory on augmented reality acceptance in a private university in Jakarta, Indonesia. This research was founded upon the Technology Acceptance Model and modified by adding the technology readiness index and flow to measure the influence of the readiness and the motivation among students’ acceptance of augmented reality technology. A quantitative methodology utilizing online questionnaire for data collection was designed to capture a wide range of responses efficiently, allowing for comprehensive analysis using SmartPLS3 by employing purposive sampling with 602 student respondents located in Jakarta. The results show that in terms of Technology Readiness, two variables, Innovativeness toward Perceived Usefulness (t = 5, p = 0) and Perceived Ease of Use (t = 3.613, p = 0) Insecurity toward Perceived Usefulness (t = 9.9, p = 0) and Perceived Ease of Use (t = 10.298, p = 0) ) are accepted and two variables Optimism toward Perceived Usefulness (t = 0.475, p = 0.635) and Perceived Ease of Use (t = 0.260, p = 0.795), Discomfort toward Perceived Usefulness (t = 0.050, p = 0.960) are rejected; In terms of Flow Theory and Technology Acceptance, all items were accepted. It is concluded that students are ready and accept augmented reality and showed no significant issues. However, there remains a lack of optimism among students regarding the feasibility of implementing AR and its benefits in classroom.
Embodied English Grammar Learning: Language Learning Anxiety Predicts Learning Progress Mediated by State Anxiety and Flow
Authors:   Faculty of Education, Beijing Normal University, Beijing, China, Ye Jian-Hong
Published: October 2024

Can shaking electronic devices (e.g., Pads or smartphones) affect participants’ embodied learning? To address this question, in this study we designed an application (app) named “Shaking-On” for students to answer quizzes, and applied the achievement emotion theory to design the research model. To understand whether activated/ deactivated emotions have positive/negative impacts on the learning process, the present study involved a 3-week teaching experiment with participants using Shaking-On during class for 15 minutes per week, totaling 45 minutes. The 288 seventh graders from three junior high schools were randomly selected to join this experiment, and 231 data were usefully returned. Questionnaires underwent reliability and validity testing for research model verification, and the results showed that the learners’ English learning anxiety was positively associated with their anxiety about using Shaking-On to take quizzes, but was negatively related to flow state while taking quizzes using Shaking-On. Their test anxiety was negatively associated with their learning progress, whereas their flow state was positively related to their learning progress. The results of this study imply that English as a second/foreign language teachers can use Shaking-On to reduce students’ state anxiety and promote their flow state and learning progress. Results indicate that adopting game-based learning enables students to be immersed in the learning process and enhances learning outcomes.
Passos e descompassos na experiência de discriminação racial por estudantes universitários
Authors: Oliveira Eliany Nazaré , De Almeida Paulo César , De Almeida Pereira Paulo Jorge , Alves Pedro Lucas , Rodrigues Caio San , Ferreira Lima Gleisson , Martins Pereira Pollyanna
Published: October 2024

Objetivos: Discutir as experiências de discriminação racial sofrida por estudantes universitários. Métodos: Estudo exploratório, descritivo e transversal, com abordagem quantitativa, realizado em 2023, com amostra de 751 estudantes. Utilizaram-se da Escala de Experiências de Discriminação e dos dados sociodemográficos, coletados de forma on-line e presencial. Resultados: A maioria dos estudantes era do sexo feminino (53%). Em relação à disposição positiva para compartilhar as experiências de discriminação com outras pessoas, as mulheres lideraram, com 80,2%. No que tange às vivências de experiências discriminatórias, os homens revelaram maior proporção, com 32,3%, e as mulheres, com 29,2%. Revelou-se que referente à infância, as mulheres apresentaram maior preocupação com o tratamento injusto em razão da raça ou cor da pele (66%). Em relação aos ambientes com alta exposição à discriminação, a escola foi a mais apontada, por 33,4% dos homens e 29,9% das mulheres. Conclusões: Os estudantes pardos e pretos estão mais suscetíveis a vivenciarem experiências de discriminação. Além disso, grande parte dos participantes se mostraram encorajados a buscar formas de combater os atos discriminatórios, descartando o silêncio como resposta.
Non-Medical Treatments of Drooling by Speech and Language Pathologists in Cerebral Palsy Children: A Systematic Review
Authors: Zamani Sakineh Mohammad , Naderifar Ehsan , Torabi Mohammad Hassan , Kamali Mohammad
Published: October 2024

Background: Drooling, commonly observed in cerebral palsy children, negatively impacts different aspects of their lives. There are several treatment options for drooling, with no consensus on a single method as the most effective one. The current systematic review provides an overview of the evidence of the different non-medical intervention methods used by speech and language pathologists to reduce drooling in cerebral palsy children.
Methods: A comprehensive and systematic search was conducted in the following electronic databases for publications from 2010-22: PubMed, Scopus, Science Direct, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. The National Health and Medical Research Council (NHMRC)and the Physiotherapy Evidence Database (PEDro-P) scale were respectively used to determine the level of evidence and the methodological quality of articles.
Results: Out of 2740 articles identified, 15 records met the inclusion criteria and were included in the study. The studies considered in this systematic review differed in the following criteria: design, participant characteristics, types of assessments and treatments, and follow-up periods. Non-medical interventions for drooling were found to be effective in alleviating the severity and decreasing the frequency of drooling.
Conclusion: The results showed the effectiveness of nonmedical interventions for drooling in cerebral palsy children. The treatments provided by SLPs can be classified into three categories: oromotor and sensory interventions, behavioral interventions, and the use of Kinesio-tape. Among these, the use of oromotor interventions and oral sensory interventions, alone or combined with other approaches, was the most widely used method.
The Severity of Wound Infection in Washing the Primary Prep Area with 70% Alcohol and Normal Saline in the Orthopedic Surgery Prepped with Povidone-Iodine: A Randomized Clinical Trial
Authors: Rahimi Foad , Gholamveisi Behzad , Rahimi Sara , Seidi Jamal
Published: October 2024

Background: Despite significant advances in patient treatment, infection remains a complication after surgery. The present study compared the incidence and severity of wound infection with two methods of washing the primary prep area with 70% alcohol and normal saline in patients who are candidates for orthopedic surgery in Kowsar Hospital of Sanandaj, Iran.
Methods: This single-blinded randomized clinical trial was conducted on 190 candidates for upper limb orthopedic surgery aged 18 to 65. Patients were randomly assigned to two alcohol and normal saline groups based on the table of random numbers. The primary outcome of this clinical trial was the incidence and severity of wound infection after surgery, which was measured by the standard scale of the Asepsis index. The results were analyzed using SPSS version 23, and statistical values less than 0.05 were considered significant.
Results: Patients’ hospitalization duration in the intervention group was (3.02±1.04 days) and in the control group (2.86±1.03 days) showed no significant statistical difference (p=0.297). The frequency of wound infection in the alcohol group was lower than in the normal saline group. this difference was statistically significant (p=0.023). Also, the severity of wound infection in the 70% alcohol group (Mean=5.12, SD=3.19) was lower than in the normal saline group (Mean=7.69, SD=4.12). This difference was statistically significant (p<0.001).
Conclusion: The present clinical trial showed that the incidence and severity of wound infection after surgery were lower in the group washing the skin of the surgical area with alcohol compared to the group washing with normal saline.
The Effect of Single-and Dual-Task Exercises on Functional Balance of Children with Autism Spectrum Disorder: A Randomized Clinical Trial
Authors: Yaghoubi Maryam , Raji Parvin , Mousavi Seyedeh Tahmineh , Mehdizadeh Hajar , Hadigol Saeed , Salmani Fatemeh
Published: October 2024

Background: Autism Spectrum Disorder (ASD) is a neurodevelop-mental disorder. According to the DSM-V, this condition has a variety of symptoms including impaired social relationships, and behavioral disorders. Various studies have shown that these children also have balance problems that are rarely investigated in this population. The purpose was to investigate the effect of single- and dual-task exercises on the functional balance of these children.
Methods: The study design was a clinical trial research. The participants were 40 children with ASD (9 to 14 years) who were randomly divided into two groups. The single-task exercise group only performed balance exercises, while the dual-task exercises group performed both balance exercises and cognitive tasks at the same time. The sessions consisted of 45-minute sessions (3 times a week for 4 weeks). The functional balance tests were performed before and after the intervention.
Results: There were no significant differences between two groups in the Timed Up and Go test, 10-meter walk test and Mini-BESTest endpoint of the study, but there was a significant difference in Pediatric Berg Balance Scale (p=0.01, effect size=0.82). Dual-task exercises could not cause significant improvements in the functional balance of the participants compared to the single-task group.
Conclusion: It seems that evidence that dual-task exercises cause significant improvements of functional balance of the participants compared to the single-task group is inconclusive.
The Status and Expectations of the Relatives of Surgery Patients in the Waiting Area of Guilan Academic Hospitals
Authors: Naderi Nabi Bahram , Haghighi Mohammad , Mirsadeghi Misa Naghdipour , Soltanipour Soheil , Ashoobi Mohammad Amin , Zahergivar Pourya , Rastekenari Hananeh Haghighatpanah , Biazar Gelareh
Published: October 2024

Background: The situation of the relatives of surgery patients in waiting areas is an important issue, which has not been investigated in Guilan province, so this study was planned.
Methods: This cross-sectional descriptive study was conducted in Guilan academic hospitals (Razi-Poorsina-Heshmat-Alzahra–Amir al Momenin) from Feb 2022 to Dec 2022. Relatives of patients who underwent elective surgeries enrolled the survey. A questionnaire containing two parts of demographic data and 12 items assessing relative’s conditions in waiting area was filled out via a direct interview.
Results: 318 relatives enrolled the survey. 93.2% of patients’ relatives were first-degree relatives.76.7% had information about the surgery. 41.5% were informed of their patient’s status in operating room. Fear of not emergence from anesthesia 109(34.3%) and death 105(33.0%) were the main causes of anxiety which was reported as 8.23±28.2 from 10 and only 6(1.9%) had financial concern. 86.8% of the responders declared that being informed from their patient’s condition in operating room, was the most effective approach to reduce their anxiety. A positive and highly significant association was observed between the level of education and receiving explanation from surgeon, anesthesiologist and being informed from patients’ status in waiting area (p=0.001).
Conclusion: It was found that relatives of surgery patients suffered from high degrees of anxiety mainly due to fear of death and not emergence from anesthesia. They stated that being informed from their patient’s conditions was the most powerful factor in reducing their anxiety.
Effectiveness of Cabergoline in Comparison with Control in Women with Fibroids Uterus: A Randomized Clinical trial
Authors: Dastjerdi Marzieh Vahid , Tehranian Afsaneh , Hatamian Sare , Jani Lida Tozande , Ghahghaei-Nezamabadi Akram
Published: October 2024

Background: Uterine fibroids are one of the most common benign tumors that cause abnormal bleeding and pain in women of reproductive age. One of the objectives of this study is to evaluate the effect of cabergoline drug on the size and volume of uterine bleeding as well as menopausal symptoms in women with uterine myomas.
Methods: This double-blind clinical trial was conducted among 80 women with fibroid myomas and Abnormal Uterine Bleeding (AUB). The participants were allocated to two groups after random allocation. Group I received Cabergoline, 1 tablet (0.5 mg/w) orally once a week for 3 months. Group II obtained a placebo tablet (0.5 mg/w), taken at the same time.
Results: 80 patients were included in the study (40 patients in the control group and 40 patients in the cabergoline treatment group). No statistically significant difference was observed between the two groups in terms of age, number of pregnancies, number of births, body mass index, uterine myoma characteristics, myoma type, myoma volume, and myoma number. A 37% decrease in myoma size was observed in the cabergoline recipients, as well as a 25% decrease in the placebo group, which is not statistically significant (p-value >0.05).
Conclusion: Cabergoline drug reduces the volume of bleeding and the number of uterine myomas, but this reduction is not statistically significant and requires more studies in this field.
Comparing the Effect of Granisetron with Meperidine on Post-Shivering in Elective Cesarean Section under Spinal Anesthesia
Authors: Karami Tohid , Hooshyar Hadi , Hanari Hesam
Published: October 2024

Background: Post-operative shivering after spinal anesthesia is a common issue in women undergoing cesarean section, then its management is necessary to increase patients’ satisfaction. Therefore, the current study aimed to compare the prophylactic effect of Granisetron and meperidine on post-spinal shivering in elective cesarean section.
Methods: In this double-blinded clinical trial study, 100 women under elective cesarean section using block randomization were divided into two groups. The spinal anesthesia was performed in all women with 10 mg hyperbaric bupivacaine 0.5 %. Then, after the birth of the baby, the patients received 0.04 mg/kg Granisetron or 0.4 mg/kg meperidine intravenously. Mean Arterial Pressure (MAP), Heart Rate (HR), and percentage of arterial blood oxygen saturation (SpO2) were measured before intervention and 60 minutes after surgery using a standard monitoring device. Shivering was evaluated 30 minutes after the surgery in the recovery room according to the clinical examinations.
Results: The changes in hemodynamics parameters were similar between the two groups. There was a statistically significant difference in the rate of shivering between the two groups. The rate of shivering in the Granisetron group was higher than in the meperidine group. Thus, 13 patients (26%) and 5 patients (10%) had shivering in the Granisetron and meperidine groups, respectively (p=0.037).
Conclusion: Granisetron was not more effective than meperidine as routine treatment in preventing shivering after spinal anesthesia in women under elective cesarean section.
Prediction of Illness Attitude Based on Early Maladaptive Schemas and Intolerance of Uncertainty in Patients with Multiple Sclerosis
Authors: Ghasemloo Zohreh , Pashmdarfard Marzieh , Alimehdi Mansoor , Loabichian Maedeh
Published: October 2024

Background: The present study was conducted to predict attitudes towards illness based on early maladaptive schemas and intolerance of uncertainty in individuals with Multiple Sclerosis (MS).
Methods: This was a cross-sectional study conducted on 62 patients with MS (72% of them were female). They were selected based on availability and voluntary participation. Data were collected through three questionnaires: the Illness Attitudes Scale, the Intolerance of Uncertainty scale, and the Yang Schema Questionnaire.
Results: The mean age (±SD) of the participants and duration of diagnosis was 36.10±7.05 yr, and 4.21±3.78 yr, respectively. The results showed that 18 early maladaptive schemas, together with intolerance of uncertainty, can predict up to 8.9% of illness attitude in patients with MS. Among the early maladaptive schemas, schemas of emotional deprivation, social isolation-alienation, abandonment-instability, failure, dependence-underdeveloped self, vulnerability, trapped-victim, emotional inhibition, stubborn/fault-finding standards, self-control disciplinary, seeking attention-seeking approval, and negativity/pessimism had a significant relationship with attitudes towards illness (p<0.05). Additionally, there was a significant relationship between intolerance of uncertainty and all its dimensions with attitudes towards illness (p<0.05).
Conclusion: Early maladaptive schemas and intolerance of uncertainty can predict illness attitudes in patients with MS. Patients with MS who have high intolerance of uncertainty are more likely to interpret ambiguous information as threatening. Therefore, effective interventions in the field of uncertainty intolerance for these patients can likely be effective in improving their attitudes towards illness and preventing the exacerbation of their symptoms.
Does Topiramate Add-On Enhance the Response to the MATRIX Program in Individuals with Methamphetamine Use Disorder? A Double-Blinded Randomized Placebo-Controlled Trial
Authors: Ahmadkhaniha Hamidreza , Ebdam Aida , Soraya Shiva , Naserbakht Morteza , Khajeh-Azad Mohamad-Amin
Published: October 2024

Background: Methamphetamine dependence significantly impacts individuals and society. Treating methamphetamine use disorder is challenging due to limited evidence on effective pharmacotherapies and their interaction with nonpharmacologic interventions. This study evaluated the efficacy of topiramate compared to placebo in treating methamphetamine use disorder among participants in a Matrix program.
Methods: Participants were recruited from the Addiction Center of Iran Psychiatric Hospital between January 2020 and June 2023 and randomly assigned to receive either topiramate or a placebo for 12 weeks, alongside Matrix program sessions. Blinding was maintained for participants, personnel, outcome assessors, and statisticians. Main outcomes included craving, desire to use, positive urine amphetamine toxicology rates, and depression severity. Craving was assessed using the Visual Analog Scale (VAS) and the Substance Craving Questionnaire–brief (SCQ-B). The desire to use was evaluated with the Addiction Severity Index (ASI), while depression severity was measured using the Beck Depression Inventory. Data analysis utilized IBM SPSS Statistics® 20.0, employing various statistical tests for comparison.
Results: Both groups exhibited improvement in craving as per VAS scores (p=0.007), with greater reduction in the topiramate group; however, no significant difference was found between groups (p=0.06). The negative urine toxicology rates showed no significant difference (Hazard ratio=1.15, 95% CI: 0.75, 1.78). Depression scores decreased in both groups without significant between-group differences (p=0.78).
Conclusion: The findings do not support the efficacy of topiramate in enhancing outcomes within a Matrix program for individuals with methamphetamine use disorder.
Determining the Optimal Morphometry of Pedicle Screws in Lumbar and Thoracic Spine in the Iranian Population
Authors: Ajudani Reza , Alizadeh Pooyan , Zeinali Masoud Zeinali , Jafari Marandi Hossein
Published: October 2024

Background: The improper length and direction of pedicle screw may also cause it to penetrate the adjacent organs. Unknowing the safe zone of dimensions and directions of the pedicles is essential to proper screw placement.
Methods: The present study is a cross-sectional morphometric study on patients with spinal trauma referred to the neurosurgical department in 2021. The MARCO PACS software scale measured the CT scan images and included the vertebral left pedicle diameter, pedicle body distance, body aorta distance, pedicle diameter, height, and area. The entry point and direction of the pedicle screw were made with the “free-hand” method.
Results: 301 patients were included, consisting of 113 females (37.5%) and 188 males (62.5%). The mean age of the participants was 42.87±12.3 years. “Among all T12 vertebra parameters, just body aorta distance was not significant between genders (p-value=0.311). The pedicle height and body aorta distance were lowest among 18-35 years patients (p-value=0.001) (p-value=0.003), respectively. Post-hoc analysis revealed a significant difference between 18-35 and 51-70 years for body aorta distance in the L1 vertebra (p-value=0.002).
Conclusion: The present investigation has shown significant differences between genders for optimal left pedicle screw parameters, which should be considered before surgery.
Double Ovarian Stimulation Versus Using Antagonist with a High Dose of Gonadotropin in Women with Poor Ovarian Response: A Randomized Clinical Trial Study
Authors: Montazeri Farnaz , Zolghadri Zhaleh , Yazd chi Katayoun , Zafardoust Simin , Sehat Zahra
Published: October 2024

Background: Poor Ovarian Response (POR) to ovarian stimulation is a challenging factor in Assisted Reproduction Technology (ART). This study aimed to compare the efficacy of a conventional antagonist with high doses of gonadotropin protocol with double stimulation protocol in females with POR.
Methods: This randomized clinical trial study was conducted on 60 women aged >35 with PORS at the Avicenna Infertility Center, Tehran, Iran. The participants were randomly divided into 2 groups (n=30 /each). In group 1, from the second day of the menstrual cycle, gonadotropin started at a dose of 450-600 units. In group 2, the second day of the menstrual period began with Letrozole 5 mg every night and an oral tablet of Clomiphene citrate 50 mg every day, and from the fourth day started 150 units of gonadotrophin (Triptorelin, 0.2 mg).
Results: In this study, at the end of the follicular phase, there was a significant correlation between protocol type and the number of Germinal Vesicles (GV) (p=0.04). The mean number of oocytes retrieved was 2.76±1.9 in the conventional method and 3.23±2.1 in the double stimulation group (p=0.90). The number of fertilized oocytes was 31 in the conventional protocol and 25 in the double stimulation protocol. The mean number of pregnancies that led to the fetus was 1.38±1.3 in the conventional protocol and 0.96±0.9 in the double stimulation group (p=0.018).
Conclusion: The results of this study show that the embryos in the double-stimulation group were more capable of completing the pregnancy, and the double-stimulation group had a higher live birth rate.
Correlation of Tongue Dimensions and Posture with Lower Central Incisor Inclination and Alveolar Bone Thickness in Skeletal Class I and II Malocclusion: A CBCT Study
Authors: Dalaie Kazem , Rafsanjan Katayoun Talebi , Safi Yaser , Tahmasbi Soodeh , Hajimiresmail Yasaman Sadat
Published: October 2024

Background: In this study, Cone-Beam Computed Tomography (CBCT) was used to assess the dimension and posture of the tongue, as well as Alveolar Bone Thickness (ABT) and labiolingual inclination of mandibular central incisors in order to look for any correlations.
Methods: A total of 200 CBCT images of skeletal Class I and II individuals were studied. Each group of malocclusion was divided into three subgroups: low-angle, normal-angle, and high-angle. Buccal and lingual alveolar bone thickness (BT & LT), and the Inclination of Mandibular Plane Angle (IMPA) were measured and compared by using T-test. The spearman rank correlations test analyzed the correlations between dental variables and tongue measurements (p<0.05).
Results: Significant weak correlations were identified between dental variables and tongue measurements. In Cl I malocclusion, IMPA and Tongue Length (TGL) were found to be significantly correlated with a correlation value of 0.324 (p=0.001). In Cl II malocclusion, there was a significant correlation between BT3 and TGH. About BT3, there was a significant correlation with D4’ and a negative correlation with D5’. Further comparison among vertical subgroups revealed the same results.
Conclusion: Class I patients with superior tongue posture may have thicker lingual alveolar bone around mandibular incisors and Class II patients showed that thicker labial alveolar bone of  lower incisor and thinner alveolar bone at the lingual side may be associated with a superior position of the posterior portion of the tongue.
The Prevalence of Various Stages of Heart Failure in Individuals Over 40 Years Old: The Findings from Yazd Health Study
Authors: Zare Elahe , Sadeghi Sedigheh , Haghaninejad Hasan , Seyed Hossieni Tezerjani Seyed Mostafa , Mirzaei Masoud , Soltani Mohammadhossein , Sareban hassanabadi Mohammadtaghi , Akbari Arefe , Tabatabaee Forough Sadat , Jokar Mojtaba
Published: October 2024

identification and prevention of HF. Therefore, this study aims to evaluate the prevalence of various stages of HF in individuals over 40 years old within a large population of Iranian adults.
Methods: In this descriptive cross-sectional study, a random sub sample of Yazd Health Study (YaHS) participants aged 40-70 years was evaluated. History and clinical examination of the patients was conducted by a cardiologist and then, the participants underwent echocardiography to determine the stages of heart failure.
Results: Among 410 Yazd population -the representative sample with mean age 58.0±9.2 years, 183 patients (44.6%) were in stage 0, 121 (29.5%) in stage A, 77(18.8%) in stage B, and 29 (7.1%) in stage C heart failure. No individuals were in stage D. There was a significant difference between the frequency of individuals with different stages of HF in terms of diabetes, hypertension, obesity, and history of ischemic heart disease (p<0.05). In addition, the frequency of HF increased in the age group >60 years and the obesity group (p<0.05).
Conclusion: According to these, about half of the patients with HF were in stage A and B. Therefore, appropriate measures are needed to identify these groups of patients, especially individuals with risk factors of diabetes, hypertension, obesity and those over 60 years to prevent the progression of the disease to higher stages which lead to poorer outcome.
Impact of Advanced High-Power Pain Threshold Static Ultrasound and Muscle Energy Technique on Pain Thresholds and Functional Improvement in Myofascial Trigger Points
Authors: Singh Anand Kumar , Ali Kamran
Published: October 2024

bands and hypersensitive Trigger Points (TrPs), contributing to musculoskeletal pain. The objective of this study is to investigate and assess the effectiveness of Advanced High-Power Pain Threshold Static Ultrasound (AHPPTSU) and Muscle Energy Technique (MET) in altering pain thresholds and enhancing functional outcomes in individuals with myofascial trigger points.
Methods: In this randomized clinical trial involving 86 individuals with TrPs in the upper trapezius muscle, the participants were divided into experimental and control groups. 33 males and 53 females, underwent six sessions of treatment over two weeks. A repeated measure Analysis of variance was used to compare baseline values and altered values at 1 and 2 weeks.
Results: The study demonstrated that the Pressure Pain Threshold (PPT) and the Neck Pain Disability Index (NPDI) score, showed a significant improvements in participants receiving AHPPTUS in experimental group compared to the other group. Experimental group showed a significantly greater improvement in PPT (p=0.001) and both groups experienced a significant enhancement in function. However, when comparing the two groups, experimental group showed a significantly greater improvement (p=0.001). Importantly, no adverse effects were reported in either group.
Conclusion: In the treatment of myofascial trigger point, AHPPTSU can be considered as an alternative therapy method, which is more effective than previously used High-Power Pain Threshold Static Ultrasound (HPPTSU) therapy and it also shortens the total treatment protocol to 2 weeks.
Estratégia para o lançamento de um produto inovador na indústria farmacêutica brasileira
Authors: Maluf Ligia Maura Primo , Caldeira Adilson , Marcondes Reynaldo Cavalheiro
Published: October 2024

Com o objetivo de promover o desenvolvimento de negócios de uma empresa do setor farmacêutico mediante o lançamento de um medicamento inovador para o tratamento de pacientes internados por Covid-19, em estágios moderado e grave, a ação intervencionista descrita seguiu método para a construção de trabalhos práticos aplicados à resolução de problemas organizacionais e aproveitamento de oportunidades. Chegou-se, assim, à definição, avaliação e implementação das estratégias adotadas para a finalidade proposta, mediante inovação radical em produto, de uma molécula farmacêutica inédita patenteada, inovação de posição, por sua aplicação a finalidades diversas, visto que anteriormente estava em testes para outras enfermidades, assim como inovação de paradigma, por envolver estudos clínicos realizados no Brasil de um produto composto por uma molécula desenvolvida por uma empresa norte-americana. Desse modo, atingiu-se o objetivo estabelecido, pois amplia-se o portfólio de negócios da empresa por meio da oferta de um produto inédito e patenteado, que, por atender à demanda de melhoria da saúde pública, constitui uma importante contribuição à sociedade. A adoção de procedimentos metodológicos de natureza científica  confere ao projeto o potencial de replicação em situações assemelhadas enfrentadas pela própria empresa ou por outras, similares.
Learning Analytics Dashboard Design and Evaluation to Support Student Self-Regulation of Study Behaviour
Authors: De Vreugd Lars , Van Leeuwen Anouschka , Jansen Renée , Van der Schaaf Marieke
Published: October 2024

For university students, self-regulation of study behaviour is important. However, students are not always capable of effective self-regulation. Providing study behaviour information via a learning analytics dashboard (LAD) may support phases within self-regulated learning (SRL). However, it is unclear what information a LAD should provide, how to present information in a usable manner, and what the information’s perceived usefulness is in supporting self-regulation of study behaviour. This study entails a sequential mixed design: assessing information needs in focus groups (n=7), exploring usability via think-aloud interviews (n=8), assessing usability with the System Usability Scale (n=42), and assessing perceived usefulness via interviews (n=16). Results showed that students and tutors agreed on the relevance of the constructs chosen from literature but differed in ranking the importance of new constructs. Usability exploration led to several design improvements. Perceived usefulness assessment showed the LAD supported the appraisal of study behaviour. A need for reference frames to facilitate data interpretation was vocalized. Impacts on study behaviour varied, possibly because preparatory activities were not used. Impact could be improved by further integrating the LAD into existing learning processes.
Mathematical Modeling of the Planetary Mechanism for the Drive of Mixing Machines
Authors: Alimov Bahtiyar , Sultonov Shohruh , Kodirova Elena
Published: October 2024

A study on the development of a kinematic scheme of a planetary mechanism with an opening kinematic circuit for driving the working body of mixing machines is presented. The main purpose of the study is to create two kinematic cycles in the planetary mechanism, in which, during one revolution, the satellite drivers consistently perform movements of the epicyclic trajectory of hypocyclic motion. To achieve this goal, braking devices for damping the kinematic energy of satellites and synchronizer devices were used in the transition zones between two segments of different names, for smooth entry of the satellite gear into the gear engagement of these gears. The oscillatory process of the synchronizer at the entrance of the tooth of the satellite gear with the front teeth of the synchronizer is considered. Practical significance includes ensuring the possibility of assembling a planetary mechanism, taking into account the choice of the angle of rotation of the synchronizer around the axis of the support. The discussion makes recommendations for further improvement of the developed biplanetary mechanism for driving mixing machines.