bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of influence of ride smoothness of transport-technological machines on driving safety in off-road conditions
Authors: Bukirov Roman R.
Published: December 2024

BACKGROUND: Driving safety of transport-technological machines, especially in off-road conditions, largely depends on the stiffness and damping of suspension. These properties directly affect the ride smoothness and static transverse stability of the machine on a slope, ensure the ability of long-term motion on rough roads in the range of operating velocities without exceeding the established limits of vibration accelerations, causing unpleasant sensations and rapid fatigue of a driver, constant contact of wheels with the ground, as well as avoiding excessive wheel bump. Therefore, it is necessary to provide the suspension with the required elastic and damping characteristics by using a pneumohydraulic shock absorber in the design and to evaluate its effect on the safety of driving in off-road conditions.
AIM: Development of a method for assessing the impact of ride smoothness of transport and technological machines on the main indicators of driving safety in off-road conditions in the development of new technical solutions aimed at improving the ride smoothness.
METHODS: Modeling of oscillatory processes of the machine masses connected with each other by stiffness-damping links at unsteady and steady oscillations, modeling of the influence of the stiffness of the elastic suspension element on the static transverse stability of the machine on a slope are performed in the Mathcad software environment.
RESULTS: As a result of mathematical modeling of oscillatory processes of masses of the machine it was established that the application of the proposed shock absorber allows in case of driving over a single bump of 0.08 m height at a speed of 30 km/h to reduce body displacement from 0,070 m to 0,056 m and its acceleration from 3,50 m/s2 to 1,35 m/s2, there by achieving complete damping of the oscillatory process of the masses already in the fourth period, and in the case of driving over a sinusoidal bump, the oscillatory process is largely stabilized, the wheel copies the profile of the bump, as a result of which the movement of the body decreases from 0,045 m to 0,030 m, and the acceleration of the body after the transition process decreases from 2,2 m/s2 to 0,8 m/s2. The analysis of evaluation of influence of smooth running on static transverse stability of the machine has shown that as a result of taking into account the elasto-hydraulic characteristics of the shock absorber and the pneumatic tires themselves it is possible to increase the angle of static stability on lateral overturning from 38° to 43° with maximum permissible angle of body roll of 8.4°.
CONCLUSION: The knowledge of methods of estimation of influence of ride smoothness of transport-technological machines on the main indicators of driving safety in off-road conditions makes it possible to analyze the efficiency of application of the proposed technical solutions aimed at increasing the ride smoothness of the machine in off-road conditions.
Revisiting the diagnostics of immunopathological conditions
Authors: Kozlov Vladimir A. , Savchenko Andrey A. , Simbirtsev Andrey S. , Demko Irina V. , Anisimova Elena N. , Borisov Alexander G.
Published: December 2024

The immune system is one of the main regulatory homeostatic systems in the human body. The immune homeostasis is maintained by numerous versatile mechanisms. Immune system dysfunction leads to various immunopathological conditions. One of the major challenges is identifying immune system diseases and clinical conditions associated with reversible immune system dysfunctions. In the first case, these conditions may be determined as persistent immune dysfunctions; in the second case, as transient ones. Immunopathological conditions are manifested by various immunological symptoms and signs (syndromes) disrupting normal bodily functions as a result of immune system impairment. Accordingly, clinical practice implies the need to detect a particular immunopathological syndrome, determine its characteristics, assess its severity, identify its causes, perform additional laboratory studies and clinical investigations, and establish a specifically immunological diagnosis. However, no general clinical criteria for diagnosing immunopathological conditions are presently available. A discussion is proposed to be held in order to identify and describe the clinical symptoms associated with dysfunctions of various immune system components. This will serve as a valuable reference for practicing physicians who conduct immunoactive therapy.
MODERN POSSIBILITIES OF DRUG THERAPY FOR PATIENTS WITH BOTULISM.
Authors: Nikiforov Vladimir V
Published: December 2024

Botulism is not a common infectious disease, but the severity of the course, the possibility of using botulinum toxin as a biological weapon, the lack of truly effective ways and methods of treating patients with this pathology do not allow us to classify the problem as secondary. The review considers both the possibilities of "classical" therapeutic measures (serotherapy, immunotherapy) and promising antibotulinum drugs, which in the foreseeable future can be introduced into the practice of treating patients with botulism; their possible advantages and disadvantages are described.
Endoscopic treatment of intermediate bronchus rupture in a 4-year-old child with polytrauma
Authors: Kharitonova Anastasia Y. , Karaseva Olga V. , Shavrov Andrey A. , Gorelik Alexander L. , Merkulova Anastasia O. , Frolov Egor A. , Alekseev Ilya F. , Melnikov Ilya A.
Published: December 2024

BACKGROUND: In the structure of childhood traumatism, thoracic trauma occurs in less than 10% of cases, but it is the second most likely cause of death in children. A bronchial rupture that disrupts adequate ventilation of the lungs can be the culprit of the fatal outcome. The purpose of our publication is to demonstrate a rare clinical observation of successful endoscopic treatment of an intermediate bronchus rupture in a 4-year-old child with polytrauma.
CLINICAL CASE DESCRIPTION: A 4-year-old boy was injured in a traffic accident as a pedestrian. During the first three days, he was treated for multiple injuries (Injury Severity Score 41) in a local hospital where, because of emergency indications, drainage of the right pleural cavity with two drains for tension pneumothorax and laparotomy for intra-abdominal bleeding due to liver rupture were done. Because of patient’s relative stabilization by the 3rd post-trauma day, he was transferred to our clinic (level 1 trauma center). We could stabilize his hemodynamics; however, air blowing through the drains was maintained, complete straightening of the parenchyma of the right lung was not reached, and blood gas composition remained subcompensated. On day 5 of the post-traumatic period, laryngotracheobronchoscopy was performed, and the rupture of intermediate bronchus measuring 3×9 mm was diagnosed. Its occlusion with a positive effect was done. After 7 days, laryngotracheobronchoscopy was repeated, and blockers were removed. After that, complete straightening of the right lung was reached; no recurrence of bronchopulmonary fistula. Long mechanical ventilation and long hospital stay were results of severe traumatic brain injury. At the follow-up visit in a year, no pathology in respiratory organs was detected at clinical laboratory, radiological and endoscopic examination.
CONCLUSION: Bronchial rupture may be a cause of inadequate ventilation and aggravation of the post-traumatic period in a polytrauma patient. The present observation demonstrates that intraluminal endoscopy allows to timely detect the rupture of the large bronchus and to perform a minimally invasive surgical treatment. Such a tactics ensured further positive dynamics in child's condition and favorable outcomes after polytrauma, as a whole.
Sequential transcranial electrical stimulation in patients with dyscirculatory encephalopathy associated with post-COVID syndrome
Authors: Ladygin Dmitry A. , Fedorov Andrey A. , Kaisinova Agnessa S. , Taymazova Zarina A. , Akhkubekova Nelly K. , Gusov Ruslan M.
Published: December 2024

BACKGROUND: The primary hypothesis for the use of sequential transcranial electrical stimulation therapy in the rehabilitation of patients with dyscirculatory encephalopathy associated with post-COVID syndrome is the potential synergistic effect on the central nervous system. Specifically, the method combines brain micropolarization — involving neocortex neurons and diencephalic brain stimulation — affecting limbic system structures. This synergy is expected to improve connections between cortical and subcortical structures, as well as neurohumoral regulation.
AIM: To study the effectiveness of complex medical rehabilitation involving sequential transcranial electrical stimulation therapy in patients with dyscirculatory encephalopathy associated with post-COVID syndrome.
MATERIALS AND METHODS: An open, prospective, randomized comparative study included 142 patients with dyscirculatory encephalopathy: 79 female (55.6%) and 63 male (44.4%) patients, aged 59 (45–69] years. The average disease duration was 8.4 years, with a period after coronavirus infection of 3.6 months. After randomization, patients in Group 1 (comparison group 1, n=48) received brain micropolarization; Group 2 (comparison group 2, n=46) received diencephalic brain stimulation; and Group 3 (main group, n=48) received both therapies sequentially. Treatment outcomes were evaluated based on changes in clinical symptoms over time and a battery of neuropsychological tests.
RESULTS: In Group 3, which received sequential transcranial electrical stimulation therapy, all symptoms of dyscirculatory encephalopathy showed a significant improvement (1.2–1.6 times) compared to baseline (p 0.05–0.001). For brain micropolarization alone (Group 1), there was an average reduction in the severity of symptoms such as cranialgia, memory and attention deficits, irritability, and sleep disturbances by 1.2–1.4 times. In Group 2, diencephalic brain stimulation resulted in an improvement in tinnitus, fatigue, work productivity, and dizziness by 1.3–1.4 times. In the main group, there was an overall alleviation of all psychophysiological issues (1.1–2.0 times; p 0.05–0.01); in comparison groups 1 and 2, improvement was 1.1–1.5 times and 1.2–1.8 times, respectively.
CONCLUSION: Medical rehabilitation using a combined approach (sequential application of brain micropolarization and diencephalic brain stimulation) alongside pharmacological support in patients with dyscirculatory encephalopathy associated with post-COVID syndrome is shown to be the most effective due to the pronounced neurotropic effect of the physical factors involved, allowing for the correction of a whole range of neurological, neuropsychological, and motor disorders.
Efficacy of low-temperature argon plasma in the rehabilitation of patients undergoing radiation therapy for breast cancer
Authors: Kozyreva Valeriia O.
Published: December 2024

Background: During radiation therapy for breast cancer, healthy tissues are damaged, leading to both systemic and local reactions, including radiation dermatitis with such symptoms as erythema, dryness, peeling, and pain. Disturbances of the microcirculation lead to hypoxia and fibrosis. The use of low-temperature argon plasma is a promising method for preventing acute radiation-induced skin damage, which is crucial for maintaining quality of life, preventing complications, and minimizing long-term effects.
Aim: To evaluate the effectiveness of low-temperature argon plasma used in the complex medical rehabilitation of patients undergoing external radiation therapy for breast cancer.
Materials and methods: A prospective, randomized interventional study was conducted involving 60 breast cancer patients undergoing radiation therapy. All patients received a course of medical rehabilitation, including general magnetic therapy, exercise therapy, balance response training on a biofeedback simulator, nutritional support, and sessions with a medical psychologist. In the main group (n = 30), rehabilitation included low-temperature argon plasma treatment. Outcomes were assessed using the RTOG scale for acute complications of radiation therapy and laser Doppler flowmetry.
Results: After completing radiation therapy and complex medical rehabilitation, statistically significant differences were observed between the main group and the comparison group (which did not receive low-temperature argon plasma treatment) in the severity of radiation reactions on the RTOG scale (p = 0.016) and in peripheral blood flow parameters.
Conclusion: Low-temperature argon plasma supports nutritional blood flow and active mechanisms for microcirculatory regulation, preserving skin blood supply and preventing severe acute radiation dermatitis.
Real-Time On-Site Ground-Motion Prediction Using ResNet
Authors: Yang Tzu-Yi , Chen Da-Yi , Chin Tai-Lin
Published: December 2024

On-site warnings can decrease the range of late alert zone during earthquakes. This study develops a deep learning model to predict whether the maximum peak ground acceleration at a station exceeds 25 Gal based on the waveform of the initial P-wave. A ResNet architecture model is developed to address the degradation problem in multilayered models, thereby enhancing performance. The model exhibits high performance for a test dataset, achieving F1-scores higher than 90% over various time windows, and outperforms the traditional progressive displacement value (Pdv) method and newer convolutional neural network (CNN) methods. Ground motion of two actual earthquakes are applied to test the model and validate its prediction capabilities, and the results indicate that the proposed model has higher accuracy and speed than Pdv and CNN methods. In addition, the model is integrated with the Earthworm earthquake early warning system for real-time waveform analysis and prediction, extending the model’s applicability beyond experimental stages to online systems. The proposed method is also tested using data from earthquakes that occurred in March 2023.
Synthesis and In Vitro Testing of Mg-6Zn-xHAp Biocomposites from Beef Bone as Biodegradable Bone Implant Material
Authors: Manalu Jojor Lamsihar , Tjhay Francisca , Kristoforus Theodora , Aritonang Sovian
Published: December 2024

This study aimed to develop biodegradable Mg-6Zn hydroxyapatite (Mg-6Zn HAp) biocomposites for potential use in bone replacement applications. The hydroxyapatite (HAp) powders, sourced from cow bone, were synthesized through an eco-friendly and cost-effective process, leveraging bioresources for material sustainability. The Mg-6Zn and HAp powders were mechanically mixed through ball milling for six hours to ensure homogeneity. The resultant powder mixture was then subjected to isostatic pressing at a high pressure of 570 MPa, forming a dense coin-shaped composite with a 1.5 cm diameter. This coin was consolidated in a capsule furnace at elevated temperatures for one hour to enhance material integrity. The Mg-6Zn HAp alloy was thoroughly characterized using X-ray diffraction (XRD) to assess phase formation and crystallographic structure, and Scanning Electron Microscopy coupled with Energy Dispersive X-ray Spectroscopy (SEM-EDX) to examine microstructural features and elemental composition. For composite preparation, varying amounts of HAp (5%, 8%, and 12%) were incorporated into the Mg-6Zn matrix. SEM analyses revealed a uniform distribution of HAp particles along the boundaries of matrix particles, enhancing composite structure and stability. Results demonstrated that with an increase in HAp content, there was a corresponding improvement in the relative density and hardness of the composites. The corrosion rate decreased with higher HAp content, indicating improved biocompatibility and stability in physiological environments. This suggests that the Mg-6Zn HAp biocomposites, with their tailored microstructure and enhanced mechanical properties, hold promise for use in biodegradable bone replacement applications.
Optimization of the Number of Cylinder Blades in Coffee Pulper Machine: Finite Element Analysis and Simple Additive Weighting Methods
Authors: Syahriza Mochamad Rifki , Djumhariyanto Dwi , Ilminnafik Nasrul , Darsin Mahros , Yudistiro Danang , Basuki Hari Arbiantara , Wibowo Robertoes Koekoeh Koentjoro , Syuhri Ahmad , Sumarji Sumarji
Published: December 2024

The increasing interest in coffee in all circles means that coffee production and quality must always increase due to consumer demands. One way to maintain the quality of coffee beans is by breaking them down using a huller machine. This research aims to improve the optimization of coffee machines by modifying the cylinder blades of huller machines with variations of 3, 4, 5, and 7 cylinder blades in terms of static loading design and quality and production capacity of coffee bean breaking. The experiment was carried out using 400 rpm and breaking 10kg of dry coffee cherries every time the sample was taken. The research results show that the best sample collection is the variation of 3 cylindrical blades with the maximum stress and lowest deformation values of 6.67 MPa and 0.000737 mm. In terms of production quality, it shows that the best sampling was the three cylindrical blade variations with 50% whole and good coffee beans. In terms of production capacity, the most significant capacity was the seven cylindrical blade variations with a value of 294.11 kg/hour. Sampling from the four most optimal variations uses the SAW (Sample Additive Weighting) method. The most optimal result from the 4 test criteria, the variation of 3 cylindrical blades is the best because it has the highest score with a value of 0.9754.
The Influence of Sodium Chloride Treatment on the Sisal Fiber Bundle’s Properties
Authors: Setyayunita Tamaryska , Suryanto Heru , Aminnudin Aminnudin
Published: December 2024

Currently, composite board manufacturing using natural fiber has the potential to be expanded due to environmental awareness. To produce high-performance natural fiber, treatment is needed to improve natural fiber’s mechanical and physical properties. One of chemical treatments is by using sodium chloride (NaCl). This study aimed to investigate the characteristics of sisal fiber after NaCl treatment. The concentrations of NaCl treatment were 1, 3, and 5 (wt.%) at room and boiling temperature and the soaking duration was 1 hour. Meanwhile, tensile strength, strain, and Young’s modulus were tested to evaluate the mechanical properties. Fiber bundle diameter, weight change due to treatment, and contact angle were tested to assess the effect of NaCl treatment. Sisal fiber bundle was treated with 5 wt.% NaCl for 1 h exhibited the highest value of tensile strength, Young’s modulus, reduction of fiber bundle diameter, percentage of weight change, and decrement of contact angle in comparison with untreated fiber bundle. Treatment with 5 wt.% NaCl at boiling temperature successfully increased the tensile strength and Young's modulus by 48.39% and 76.8%, respectively, compared to untreated fibers. NaCl treatment was shown to be an effective method to improve the mechanical properties and wettability of fibers, which has potential for application in high-performance plant fiber composites. The surface of sisal fiber treated with 5 wt.% NaCl at boiling temperature appeared rougher than that of the untreated one. In addition, this treatment also reduced the contact angle between the fiber and the adhesive by 38.71% compared to the untreated.
Correlación entre índice de masa corporal y control glucémico en pacientes con diabetes mellitus tipo 2: Estudio retrospectivo en un hospital de referencia de Paraguay
Authors: Esquivel Brizueña Rosalba Ramona , Morínigo Martínez Macarena , Araújo Pino Silvia Stella
Published: December 2024

Introducción: La diabetes mellitus tipo 2 (DM2) es un problema de salud pública creciente, frecuentemente asociada con sobrepeso y obesidad. El índice de masa corporal (IMC) y la hemoglobina glicosilada (HbA1c) son indicadores clave en el manejo de la DM2.
Objetivo: Correlacionar el IMC y la HbA1c en pacientes con DM2 atendidos en el Hospital Distrital de Capiatá, Paraguay, en diciembre de 2022.
Materiales y métodos: Estudio correlacional con datos secundarios de 38 pacientes DM2. Se recolectaron datos demográficos, clínicos, antropométricos y bioquímicos. Se utilizó la correlación de Pearson para determinar la correlación entre IMC y HbA1c, con un nivel de significancia de p<0,05. El protocolo de investigación fue aprobado por el Comité de Ética en Investigaciones de la FCQ-UNA (CEI913/2022).
Resultados: El 65,8% fueron mujeres, con edad promedio de 55,8±5,2 años. El 86,8% presentó exceso de peso. La glucemia en ayunas promedio fue 245,0±57,0mg/dL y la HbA1c 8,8±3,4%. Se observó una tendencia al aumento de los niveles de HbA1c con el incremento del IMC. Los pacientes con peso normal presentaron una HbA1c promedio de 6,8±1,5% (buen control), mientras que aquellos con sobrepeso y obesidad mostraron valores de 8,6±2,7% (mal control) y 11,2±3,0% (control crítico), respectivamente. Estas diferencias resultaron estadísticamente significativas (p<0,01). Se observó una correlación fuerte y significativa entre IMC y HbA1c (r=0,681, p<0,01).
Conclusión: Existe una correlación directamente proporcional entre el IMC y el control glucémico en pacientes con DM2. Estos hallazgos resaltan la importancia del control del peso en el manejo de la DM2.
Sığınmacı İşgücünün Hayvancılık Sektöründeki İstihdama Etkilerinin Yerel Aktör Perspektifinden Değerlendirilmesi: Konya İli Örneği
Authors: Çankal Gülsen , Koyuncu Ahmet
Published: December 2024

Kırsal alanlardaki yerleşik nüfusun kentsel alanlara/yerleşimlere hareketliliği çalışan sayısında azalmayı ve hayvancılık sektöründe istihdam sorununu beraberinde getirmiştir. Bu sorunun aşılması için sığınmacı işçi gücünün bu alanlarda istihdamı yaygın hale gelmiştir. Çalışma sığınmacıların Türkiye işgücü piyasasındaki istihdam alanlarından birisi olan hayvancılık sektöründeki etkilerini ele almıştır. Bu kapsamda sektörün lokomotif illerinden biri olan Konya özelinde değerlendirmeler yapılmış, sığınmacıların hayvancılık sektöründeki istihdamı, katkıları hem işverenler hem de çalışanlar için mevcut sorunlar ve çözüm önerileri tartışılmıştır. Nitekim Türkiye’de sığınmacıların istihdamı ile ilgili mevcut çalışmaların büyük bir kısmı kentsel alanlara ve özellikle de sanayi sektörüne odaklanırken, sığınmacıların kırsal alanlarda özellikle hayvancılık sektöründeki konumları yeterince ele alınmamıştır. Bu bağlamda araştırma, alanda bu eksikliği gidermeyi, literatüre özgün katkılar sağlamayı hedeflemektedir. Çalışmada nitel yöntem ve yarı yapılandırılmış mülakat tekniği tercih edilerek Konya’da hayvancılık sektörünün kurumsal temsilcileri, yerel yöneticiler ile üreticilerle görüşmeler gerçekleştirilmiş ve elde edilen veriler temel sorun alanlarına göre tasnif edilmiştir. Araştırma sonuçları, hayvancılık sektöründe işgücü eksikliği yaşandığını ve bu nedenle sığınmacıların istihdamının kaçınılmaz olduğunu göstermekte ancak mevcut politikaların yetersiz olduğu ve istihdamın düzenlenmesi ile ilgili sorunların çözülmesi gerektiği vurgulanmaktadır.
A Magyar Fejfájás Társaság (MFT) és a Magyarországi Fájdalom Társaság (MOFT) Fejfájás Munkacsoportjának közös vezérfonala az akut és krónikus migrén gyakorlati ellátásához
Authors: Fehér Gergely , Szok Délia , Ambrus Szilvia Judit , Balogh Eszter , Bartha Áron , Tajti János , Budai Erika , Kerényi Levente
Published: December 2024

A migrén a populáció jelentős részét érintő,
jelentős életminőség-romlást okozó, elsődleges fejfájás. Gyakorisága ellenére mind
felismerése, mind kezelése kihívást jelent.
A mindennapi ellátás javítása érdekében
témában jártas szakemberként közös útmutatót írtunk, amit a Magyarországi Fájdalom
Társaság és a Magyar Fejfájás Társaság is
jóváhagyott. A migrén jellemzőit, diagnosztikai kritériumait, típusait, a kihívást jelentő
esetek differenciáldiagnózisát részletesen
tárgyaljuk. A jelenlegi evidenciákon alapuló
akut és krónikus migrénkezelés is részletes leírásra kerül, különös tekintettel olyan
mindennapi kihívást jelentő témákra, mint a fogamzóképes nők kezelése (például menstruációs migrén, terhesség és migrén) és a
migrén cardiovascularis hatásai.
Corticobasal degeneration: An update
Authors: Révész Tamás , Lees Andrew J. , Morris Huw R.
Published: December 2024

Corticobasal degeneration (CBD) is one of
the primary tauopathies with a disease onset
in the 5th to 7th decade. CBD is a progressive condition of unknown aetiology, which
is characterised neuropathologically by
neuronal loss, astrogliosis and deposition
of filamentous tau inclusions, composed
entirely of 4-repeat tau isoforms, in neurons
and glial cells in cerebral cortical areas, basal
ganglia, brainstem and cerebellar nuclei.
The term CBD is now a neuropathological
diagnostic one and for the canonical clinical
syndrome associated with CBD neuropathological changes, the corticobasal syndrome
(CBS) term is used. In addition to CBS, the
clinical spectrum also includes a behavioural
variant of frontotemporal dementia syndrome, speech disorders, Richardson’s
syndrome and, rarely, posterior cortical
syndrome. In addition to CBD, CBS can also
be caused by other pathologies. A number
of genetic risk factors of CBD have been
identified. As specific biomarkers confirming
CBD as the underlying pathology responsible
for CBS or other clinical manifestations are
still lacking, for a definitive diagnosis of CBD
neuropathological investigation is required.
Recent cryo-electron microscopic studies
have proven that CBD is a distinct tauopathy
associated with a unique molecular structure
of the tau filaments, which firmly differentiates it from other primary tauopathies.
Assessing parkinsonism & cerebellar dysfunction with spiral & line drawings
Authors: Jenei Attila Zoltán , Valálik István , Sztahó Dávid
Published: December 2024

Background abd purpose – Recognising
neurological diseases is challenging without
accurate diagnostic tools. Therefore, many
approaches have been taken to recognise
and evaluate these diseases through speech,
movement, or drawing modalities.
The purpose of the study is to compare
the recognition of Parkinson’s and cerebellar
symptoms using spiral and line drawings
recorded from the same subjects. We also
investigate the importance of pin pressure
in classification. Furthermore, an attempt
is made to use the two types of drawings
together for more accurate classification.
Methods – Images were generated from the
raw data with and without pressure data.
We then performed classification with the
help of pre-trained and own deep learning
feature extraction models. Mann-Whitney
U test is used to test the significance of the
results with a 0.05 significance level.
Results – The results showed that spiral
drawings significantly performed better
than lines (p-value: 0.001). Furthermore,
combining the two types of drawings
improves recognition when pressure is
available (p-value: 0.017). However, no
performance degradation can be expected
without pressure data using one drawing
task (p-value: 0.507).
Conclusion – The spiral is recommended
as the primary drawing, but combining
multiple drawings can contribute to a more
confident recognition. By excluding pressure,
no significant decrease is expected in the
model’s performance.
Incidence of Secondary Overtriage in Trauma Patients During the COVID-19 Pandemic
Authors: Hill Joshua , Shah Bhairav , Rady Emily , Yost Gregory , Schonfeld Samuel
Published: December 2024

Introduction: Secondary Overtriage (SO) has been defined as transfer to a higher level of care, without operative intervention or ICU admission, and discharge from the accepting facility within 48 hours. The COVID-19 pandemic placed additional stressors on healthcare delivery. This study aimed to evaluate the effect of the COVID-19 pandemic on the rates of SO to our facility.

Materials/Methods: We define the beginning of the COVID-19 pandemic as March 18th, 2020. 15 months of data before and after this date were classified as pre-pandemic (PP) and intra-pandemic (IP), respectively. We included all patients ≥18 years transferred to our facility for trauma evaluation. Primary aim was comparing PP and IP rate of SO. Secondary outcomes were: most common interventions and consulting service after transfer, insurance status, transfer distance, and number of pre and post transfer computed tomography (CT) scans.

Results: 6774 patients were transferred to our facility. 1983 (29.3%) patients met the criteria for SO. 30.0% PP and 28.6% IP (p=0.19). The most common consultation was to Speech and Language Pathology (39.8% PP, 35.5% IP). The most common intervention was bedside laceration repair (6.4% PP, 4.1% IP). Patients had and average 2.5 pre-transfer CTs and 2.1 post-transfer CTs. Average transfer distance was 43.9 miles. Insurance status was not significantly different between the PP and IP groups. (p= 0.23)

Conclusion: Over a large cohort of transferred patients, our incidence of SO was 29.3%, consistent with previous data. The COVID-19 pandemic was associated with a lower, but not significant, change in SO rates.
Achieving Chronic Care Equity by Leveraging the Telehealth Ecosystem (ACCTIVATE): A Multilevel Randomized Controlled Trial Protocol
Authors: Omomukuyo Adenike , Ramirez Andy , Davis Aliyah , Velasquez Alexandra , Najmabadi Adriana , Kong Marianna , Grace Rachel , Brown III William , Broderick Andrew , McCulloch Charles , Franco Nora , Sarkar Urmimala , Lyles W Courtney , Tran Amber , Sharma Anjana , Tuot Delphine
Published: December 2024

Background: Racial/ethnic and socioeconomic disparities in diabetes and hypertension outcomes persist in the United States (U.S.), and worsened during the COVID-19 pandemic. This was in part due to suboptimal implementation of telehealth in U.S. safety-net settings alongside the pre-existing “digital divide” – structural determinants that limit access to digital tools by marginalized communities. To improve health equity, it is critical that health systems in the U.S. integrate principles of digital and health literacy for more equitable chronic disease care.

Methods: We are conducting a 2x2 factorial randomized controlled trial, in partnership with a Community Advisory Board, assessing a multi-level intervention addressing barriers that affect the equitable use of telehealth amongst low-income patients in San Francisco County. Patient-level support is provided through the evidence-based strategies of health coaching and digital navigation (“digital coaching”); clinic-level support includes equity dashboards, patient advisory councils, and practice facilitation. We are randomizing 600 low-income, racially/ethnically diverse English and Spanish-speaking patients with uncontrolled diabetes to receive digital coaching (n=200) vs. usual care (n=400) for 3 months; and 11 public health primary care clinics to clinic support vs. usual care for 24 months. We aim to evaluate the impact of patient and clinic level interventions to determine individual effectiveness and potential synergistic impact on clinical and process measures related to diabetes and telehealth outcomes.

Results: The study's primary clinical outcome is change in patient-level Hemoglobin A1C (A1c); the primary process outcome is patient portal usage. Secondary clinical outcomes include changes in patient-level systolic blood pressure (SBP) and microalbuminuria (UACR), and changes in clinic-level A1c, SBP, and UACR. Secondary process outcomes assess patient-level changes in digital literacy, medication adherence, patient activation, and visit show rates, and clinic-level measures of telehealth adoption.

Discussion: The ACCTiVATE trial tests a multi-level intervention developed through a stakeholder-engaged research approach and user-centered design to be feasible and acceptable for impacted communities. If efficacious, ACCTiVATE may provide a scalable model to improve chronic health outcomes and telehealth equity among marginalized racial/ethnic populations experiencing structural and interpersonal access barriers.
Question/answer-sequences in contact tracing telephone calls in Flanders during the Covid-19 pandemic’
Authors: Slembrouck Stef , Timmerman Romeo , Vandenbroucke Mieke , Bafort Anne , Geuchte Sofie
Published: December 2024

Background: During the outbreak of COVID-19 in 2020, one of the critical strategies employed by governments around the world to contain the virus’s spread was contact tracing. In Belgium, contact tracing was mostly implemented through government-mandated call centres employing a mix of experienced and recently recruited telephone workers. As the collection of reliable information concerns a central goal of contact tracing interactions, the posing of questions by contact tracers becomes a highly consequential, yet challenging task to execute. Expansions which accompany questions may be useful as important vectors to manage the sensitivity of invasive questioning of index patients.

Objective: In this article, we zoom in on the multiple guises of how questions were posed by Flemish contact tracers in the period 2020-2021, with specific attention to the positioning of the contact tracers’ questions in adjacency pairs (expansions), and how this relates to the accomplishment of the goals of the contact tracing call (including obtaining relevant and truthful answers and managing the intrusive and sensitive aspects of questioning behaviour).

Methods: A corpus of 100 contact tracing calls conducted in Dutch between a contact tracer and index patient was gathered between late 2020 and early 2021. A quantitative analysis was conducted on the transcribed interactions to identify the type of expansion applied by contact tracers (pre-expansions, insert expansions and post- expansions) and the interactional meaning accomplished in the expansion (e.g., motivation for asking a question, apology for the intrusion, an explanation of a term used, etc.).

Results: Our results show that contact tracers mostly expand after an answer has been received, rather than anticipate the need to frame a question-answer sequence or guide the index patient enroute from question to answer. Most prevalent as pre-expansions are question announcements and recall of what was said earlier. In the case of insert expansion, the most prevalent interactional accomplishments are clarifications or time management signals. In the case of post- expansions, the prevalent types are backchannel, question clarifications and repetitions of the index patient’s answer as a form of acknowledgement or display of information processing.
Rapid Triage of Radiation Exposure Using a 4-Gene Real Time PCR Test
Authors: Terbrueggen Robert , Dixon Samuel , Guyon Timothy , Jacobs Aviva
Published: December 2024

The ability to distinguish the concerned public from the significantly exposed is of critical importance for mounting an effective response to a mass scale nuclear incident. Here we describe the development and performance of a radiation biodosimetry blood test with a sensitivity of 99.0% and specificity of 96.5% for the qualitative determination of irradiated vs non-irradiated. Similar performance is observed in human and non- human primate (rhesus macaque) blood samples for in vivo total body irradiation as well as ex vivo blood irradiation. The test is based on the relative expression of 3 radiation responsive mRNA biomarkers relative to a normalizer mRNA using a pre-established cut-off. Blood samples must be collected into an RNA stabilizing blood collection device and sample testing is compatible with the real time PCR infrastructure used worldwide for COVID-19 pandemic response.
The effect of diode laser on the shear bond strength of one step self adhesive systems to human dentin: An in vitro study
Authors: Chaudhury Arjama , Thomas George , Jose Sunil , Joseph Sona , Krishna Manju , G Saicharan
Published: December 2024

Adhesives are integral to modern restorative dentistry for enhanced functional and esthetic outcomes. The use of lasers for improved bonding is on the rise and there is a need to understand the effect of lasers on adhesives.

The study aims to evaluate the effect of diode laser irradiation on one-step self-etch adhesive before their polymerization on the shear bond strength between resin cement and dentin.

Thirty extracted human teeth were collected and the buccal surface was grounded till dentin was exposed. A window of 3mm x 3mm was made on all the specimens that served as test sites and were randomly allocated to three groups (n = 10); Group 1: G-Premio bond without laser irradiation followed by photopolymerization; Group 2: G-Premio bond with laser irradiation without photopolymerization, and Group 3: G-Premio bond with laser irradiation followed by photopolymerization. The Shear Bond Strength (SBS) was determined using a Universal Testing Machine. One-way ANOVA followed by post hoc Tukey test was used with a level of significance at P ≤ 0.05.

SBS was significantly highest among Group 3 followed by Group 1 and the least SBS was found in Group 2 (P < 0.001). A post hoc test revealed significant differences between all three groups (P < 0.001).

G-Premio bond irradiated with a diode laser followed by photo-polymerization exhibited the highest SBS.
Exploring maxillary molar root morphology: A case of extra palatal canal
Authors: Anuhya Samala , Reddy Jayaprada , Imran Shaik , Punna Rajani
Published: December 2024

: A fundamental requirement for successful endodontic treatment is understanding the tooth's root canal anatomy. The pulp chamber represents the most intricate part of the tooth. Effective treatment depends on accurately diagnosing and identifying all canals, performing thorough cleaning and shaping, and completing a three-dimensional (3D) filling while preserving the natural structure of the root canal system.

: A 35-year-old male patient presented with apical periodontitis in relation to maxillary first molar. Radiographic examination revealed widening of periodontal ligament. Following local anaesthesia via PSA nerve block and infiltration, rubber dam isolation was done. An access cavity was created, and upon locating the canal orifices, an additional, separate palatal canal was identified. Cone Beam Computed Tomography (CBCT) was advised to confirm. Using a microscope, the MB2 orifice was carefully exposed by troughing along the groove between the MB1 and palatal canals with long-shank burs and a DG-16 explorer. All five canals were meticulously cleaned and shaped with NiTi rotary files, followed by 3D obturation.

The significance of identifying anatomical changes, such as the extra-palatal canal in maxillary first molars with MB2, is highlighted in this case report. Endodontic results are improved by successful management using precise procedures and modern imaging, highlighting the importance of careful evaluation in complex cases.
Optimizing nutritional strategies to enhance metabolism and physiotherapy outcomes: A comprehensive review
Authors: Kauser Mohammed Sheeba
Published: December 2024

The integration of nutritional strategies into physiotherapy has gained significant attention as a means to enhance patient outcomes by improving metabolic health and recovery. This review aims to synthesize current research on how nutrition can be optimized to support metabolic processes and complement physiotherapy practices, ultimately leading to better functional and rehabilitative outcomes.

Nutrition plays a crucial role in regulating metabolic rate and energy balance. Key macronutrients—proteins, carbohydrates, and fats—each contribute differently to metabolic processes, influencing muscle synthesis, energy availability, and overall metabolic rate. A key focus of this review is the interplay between nutrition and exercise in the context of physiotherapy. Nutritional strategies that align with exercise regimens can significantly boost rehabilitation efforts. We explore how nutrient timing, hydration, and dietary adjustments can be tailored to support exercise goals and enhance the efficacy of physiotherapy treatments.

Translating nutritional science into clinical practice involves developing actionable guidelines for integrating dietary recommendations with physiotherapy. This section provides practical advice for healthcare professionals on how to incorporate nutritional assessments and interventions into physiotherapy plans. We highlight successful case studies and propose strategies for personalized nutrition plans that complement individual physiotherapy goals.

Despite advancements, there are still gaps in understanding the full impact of nutrition on physiotherapy outcomes. We identify areas where further research is needed, including longitudinal studies and trials that investigate long-term effects of nutritional interventions on metabolic health and rehabilitation. Future research directions aim to refine dietary recommendations and enhance evidence-based practices.

Optimizing nutritional strategies can significantly enhance metabolism and improve the effectiveness of physiotherapy. This review underscores the importance of a holistic approach that combines nutritional and physical therapies to achieve superior patient outcomes. By integrating comprehensive dietary strategies with physiotherapy practices, healthcare providers can offer more effective, personalized care to support recovery and overall health.
ANÁLISE COMPARATIVA NA QUANTIFICAÇÃO DE BETALAÍNAS: IMPLICAÇÕES PARA APLICAÇÕES NA INDÚSTRIA DE ALIMENTOS E BENEFÍCIOS À SAÚDE
Authors: MIRANDA DO NASCIMENTO NATALIA , Barana Ana Cláudia
Published: December 2024

Natural colorants, such as betalains, are crucial in food coloring and valued for their nutritional and therapeutic properties. However, their precise analysis is challenging due to the sensitivity and instability of these substances. Red beetroot, rich in betalains, is widely consumed and associated with various health benefits. There are different analytical methods for quantifying betalains, each with its advantages and limitations. This article conducted a literature review on betalains and applied analytical methodologies based on Nilsson's (1970) and Stintzing and Carle's (2008) absorption spectrophotometry. The results of the laboratory assays were compared using Tukey's test at 5% significance level, showing that both methods can effectively quantify betalains but may exhibit significant differences in betalain fractions. Betacyanins did not show significant differences, while betaxanthin and betalain fractions exhibited slight differences. Therefore, the choice between methods should consider the sample nature, the analysis objective, and the available technical limitations. In summary, ongoing research in betalain analysis is essential to develop and improve analytical methods that meet the specific needs of different samples, ensuring accurate and reliable quantification of these compounds.
Biochemical and clinical characteristics of creatine deficiency syndromes.
Authors: Sykut-Cegielska Jolanta , Gradowska Wanda , Mercimek-Mahmutoglu Saadet , Stöckler-Ipsiroglu Sylvia
Published: December 2024

Creatine deficiency syndromes are a newly described group of inborn errors of creatine synthesis (arginine:glycine amidinotransferase (AGAT) deficiency and guanidinoacetate methyltransferase (GAMT) deficiency) and of creatine transport (creatine transporter (CRTR) deficiency). The common clinical feature of creatine deficiency syndromes is mental retardation and epilepsy suggesting main involvement of cerebral gray matter. The typical biochemical abnormality of creatine deficiency syndromes is cerebral creatine deficiency, which is demonstrated by in vivo proton magnetic resonance spectroscopy. Measurement of guanidinoacetate in body fluids may discriminate between the GAMT (high concentration), AGAT (low concentration) and CRTR (normal concentration) deficiencies. Further biochemical characteristics include changes in creatine and creatinine concentrations in body fluids. GAMT and AGAT deficiency are treatable by oral creatine supplementation, while patients with CRTR deficiency do not respond to this type of treatment. The creatine deficiency syndromes are underdiagnosed, so their possibility should be considered in all children affected by unexplained mental retardation, seizures and speech delay.
Non-random base composition in codons of mitochondrial cytochrome b gene in vertebrates.
Authors: Prusak Beata , Grzybowski Tomasz
Published: December 2024

Cytochrome b is the central catalytic subunit of the quinol:cytochrome c oxidoreductase of complex III of the mitochondrial oxidative phosphorylation system and is essential to the viability of most eukaryotic cells. Partial cytochrome b gene sequences of 14 species representing mammals, birds, reptiles and amphibians are presented here including some species typical for Poland. For the analysed species a comparative analysis of the natural variation in the gene was performed. This information has been used to discuss some aspects of gene sequence - protein function relationships. Review of relevant literature indicates that similar comparisons have been made only for basic mammalian species. Moreover, there is little information about the Polish-specific species. We observed that there is a strong non-random distribution of nucleotides in the cytochrome b sequence in all tested species with the highest differences at the third codon position. This is also the codon position of the strongest compositional bias. Some tested species, representing distant systematic groups, showed unique base composition differing from the others. The quail, frog, python and elk prefer C over A in the light DNA strand. Species belonging to the artiodactyls stand out from the remaining ones and contain fewer pyrimidines. The observed overall rate of amino acid identity is about 61%. The region covering Q(o) center as well as histidines 82 and 96 (heme ligands) are totally conserved in all tested species. Additionally, the applied method and the sequences can also be used for diagnostic species identification by veterinary and conservation agencies.
Contribution of protein kinase A and protein kinase C signalling pathways to the regulation of HSD11B2 expression and proliferation of MCF-7 cells.
Authors: Rubiś Błazej , Grodecka-Gazdecka Sylwia , Lecybył Remigiusz , Ociepa Marta , Krozowski Zygmunt , Trzeciak Wiesław H
Published: December 2024

Contribution of the protein kinase A (PKA) and protein kinase C (PKC) signalling pathways to the regulation of 11beta-hydroxysteroid dehydrogenase type II (HSD11B2) gene expression was investigated in human breast cancer cell line MCF-7. Treatment of the cells with an adenylyl cyclase activator, forskolin, known to stimulate the PKA pathway, resulted in an increase in HSD11B2 mRNA content. Semi-quantitative RT-PCR revealed attenuation of the effect of forskolin by phorbol ester, tetradecanoyl phorbol acetate (TPA), an activator of the PKC pathway. It was also demonstrated that specific inhibitors significantly reduced the effect of activators of the two pathways. Stimulation of the PKA pathway did not affect, whereas stimulation of the PKC pathway significantly reduced MCF-7 cell proliferation in a time-dependent manner. A cell growth inhibitor, dexamethasone, at high concentrations, caused a 40% decrease in proliferation of MCF-7 cells and this effect was abolished under conditions of increased HSD11B2 expression. It was concluded that in MCF-7 cells, stimulation of the PKA signal transduction pathway results in the induction of HSD11B2 expression and that this effect is markedly reduced by activation of the PKC pathway. Activation of the PKC pathway also resulted in inhibition of cell proliferation, while activation of the PKA pathway abolished the antiproliferative effect of dexamethasone. These effects might be due to oxidation of dexamethasone by the PKA-inducible HSD11B2.