bluuebunny/crossref_metadata_2025 huggingface dataset:
Posterior fossa extradural hematoma - clinical presentation and outcome
Authors: Kaushal Yadav , Govind Lodha Krishna , Gaurav Jaiswal , Kumar Gupta Tarun , Bipinbhai Patel Pratik , Suresh Kumawat
Published: September 2023

Background: Posterior Fossa Extra Dural Hematoma (PFEDH) is a rare entity but certain crucial structures are supposed to be injured. Because of limited space in the posterior fossa, a clinical small volume of hematoma can deteriorate patients. Therefore timely diagnosis and prompt intervention are required.

Objective: This study is done to analyse factors like demographic profile, mode of injury, clinical features in relation to PFEDH and its management and how they influence the outcome.

Materials & methods: This is a retrospective analysis of patients who presented with PFEDH from July 2016 to July 2021 at RNT Medical College and M.B. group of Hospitals Udaipur, India. Patients were evaluated on the basis of demographic profile, mode of injuries, GCS on admission & discharge, and associated radiological findings.

Result: A total of 25 patients with PFEDH were included in this study. Amongst these, 18 (72%) were males, and10 (40%) were less than 18 years of age. On admission 19 (76%) had GCS 13-15.22 (88%) patients underwent surgery and 3 (12%) were planned for conservative management. At 6-month follow-up, 22 (88%) patients had good outcomes with GOS 3-5 and 1 was lost to follow up while 2 (8%) had poor outcomes with GOS 1-2.

Conclusion: GCS on admission is a good predictor of outcome. The volume of EDH was one of the key factors in deciding the line of management. PFEDH can sometimes be rapidly fatal due to expansion of hematoma and compression of posterior cranial fossa space which leads to brain stem compression therefore time management is the most important factor for a good outcome.
Diagnostic and prognostic role of magnetic resonance imaging in cases of moderate to severe traumatic brain injury
Authors: Pattankar Sanjeev , Sadashiva Nishanth , Dikshit Priyadarshi , Maurya Ved Prakash , Shukla Dhaval P. , Reddy V. Umamaheshwar , Mishra Rakesh , Agrawal Amit
Published: September 2023

Moderate to severe traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Timely diagnosis and accurate prognostication play a key role in informed clinical decision-making. Though magnetic resonance imaging (MRI) is a superior anatomical scan compared to computerized tomography (CT), the latter remains the current investigation of choice in the clinical setting of TBI due to some of the former’s inherent deficiencies in imaging bone/blood, limited access, cost, etc. Nevertheless, the fact that MRI is a valuable adjunct in evaluating the TBI patients with clinical findings disproportionate to the CT scan substantiates its possible complementary/supplementary diagnostic and prognostic role in TBI. MRI scan is ideally placed on demonstrating the shear/diffuse axonal injury (DAI), non-haemorrhagic intraparenchymal lesions, and brain stem lesions poorly delineated by a CT scan. The currently available literature demonstrates that DAI and caudal brainstem lesions are indicators of poorer outcomes. However, the prognostic value of MRI, in addition to that of CT, remains an area of active investigation. We have tried to present the evidence-based use of MRI in moderate to severe TBI. Advances in newer MRI sequences like susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), functional MRI (fMRI), and magnetic encephalography (MEG) have the potential to revolutionize the current role of MRI in TBI.
Post ventriculoperitoneal shunting S. Maltophilia Meningitis
Authors: Mittal Amol , Kumar Pankaj , Pandey Sharad , Gupta L.N.
Published: September 2023

Background: Leptomeningeal inflammation caused by S. Maltophilia is rare. It is inextricably linked with prior antimicrobial therapy, prolonged ICU stays and antecedent neurosurgical intervention.
Case description: We describe a case of a 5-year-old male child with posterior fossa medulloblastoma with obstructive hydrocephalus who underwent ventriculoperitoneal shunt followed by suboccipital midline craniotomy and later presented with S. Maltophilia meningitis.
Conclusion: The overall mortality in the cases reviewed was 17 per cent. Inherent resistance to a wide array of antimicrobial agents with a simultaneously increasing number of cases poses a therapeutic challenge. Trimethoprim/sulfamethoxazole is recommended as empirical and as a definitive treatment in patients with S. Maltophilia infection. The optimal duration of therapy for S. Maltophilia meningitis is similar to the treatment of gram-negative bacillary meningitis, which is usually 2 weeks after the culture has been negative.
Letter to the Editor
Authors: Grădinaru Stefan , Popa Andrei Adrian , Toader Corneliu
Published: September 2023

At the beginning of every spring, Cluj becomes for 3 days the main topic of discussion among students passionate about neurosurgery throughout Romania. The ''Neurosurgical Masterclass'' is the catalyst for young and enthusiastic students to learn the mysteries of the human brain and this year was organized the 10th edition of this interesting congress. The event succeeded in joining together 185 neurosurgery enthusiasts and 36 renowned speakers.
Factors associated with success of trial spinal cord stimulation in patients with chronic pain
Authors: Grande Eleonora , Ciavarro Marco , Cioni Beatrice , Tufo Tommaso
Published: September 2023

Objective: Spinal cord stimulation (SCS) is a widely employed technique in treating chronic pain, however, it still fails in significantly reducing pain in one-out-of-three cases. Poor consensus exists on the most predictive factors of SCS outcomes. Although psychological criteria such as emotional stability are recommended for this treatment, it is not well understood if the perception of patients’ own health may impact the SCS success. Therefore, we retrospectively examine factors associated with the patient's subjective conditions, to investigate their relationship with SCS success.
Methods: Before the implantation of an SCS trial per routine clinical decision-making, and independently from the implanted devices, patients treated in our clinical practice underwent an extensive evaluation of pain, disability, depression and the overall quality of life. In those patients with successful SCS trials, the pain level was also evaluated at the end of the trial period. Regression analyses were performed to investigate factors predicting successful trial stimulation.
Results: Successful trial stimulation was effective in 15 patients (75%). Perceived disability, pain and general health resulted as independent predictive factors on SCS trial outcome. Further investigation showed perceived disability (i.e. Oswestry Disability Index) as a crucial factor, and ROC curve analysis identifies a cut-off of 38 as a predictive score of success.
Conclusions: Although preliminary, these findings suggest that standardized scales examining the overall patients’ perceived health status, particularly the disability index may help shed light on predicting SCS trial success. Thus, it is argued the potential application of self-administered scales in SCS patients’ selection in routine clinical practice.
Intradiploic meningioma
Authors: Singh Neha , Singh Deepak , Singh Rakesh
Published: September 2023

Intradiploic meningioma is a rare subtype of primary intraosseous meningiomas. The convexity and the skull base are the two primary locations for intraosseous meningiomas. They usually present as a painless expansile mass without any neurological findings. Intradipoic meningiomas are seldom correctly diagnosed preoperatively and are usually mistaken for primary bone tumours. CT scan head with bone windows and contrast-enhanced MRI brain should be done for diagnosis and evaluation. Intraosseous meningioma should be considered in the differential diagnosis of patients presenting with osteoblastic or osteolytic skull lesions as the treatment of choice is resection, which is potentially curative.
Coexistence of ipsilateral ulnar and median nerve entrapment
Authors: Kandemir Turan , Ercan Serdar , Ataizi Zeki Serdar
Published: September 2023

Objective: Carpal tunnel syndrome (CTS) and Cubital tunnel syndrome (CuTS) are the median nerve compressions under the carpal ligament and ulnar nerve at the wrist, the most common peripheral nerve entrapment of the upper extremity. The fatty tissue due to the high body mass index (BMI) differs the severity of the entrapment symptoms. The study aims to evaluate the association between BMI and symptoms of CTS and CuTS by analyzing the patients whose entrapments are at the same extremity and onset at the same time.
Method: The patients were divided into two groups according to the neuropathy sit (CTS and CuTS) and four subgroups according to the BMI (Overweight, grade 1 obese, grade 2 obese, and morbidly obese). All patients were followed up with EMG and performance scale before and after surgical treatment.
Results: A total of 31 patients were included in the study. The mean BMI of the patients was 29.63 kg/m2. The average BMI of male patients was 29.02 kg/m2, while the average BMI of female patients was 30.3 kg/m2.
Conclusion: In contrast to the previous hypotheses that claim the high body mass index increases the severity of CTS but reduces the formation of CuTS, our study revealed that body mass index was not related to the severity of symptoms.
Commentary
Authors: Abdulla Ebtesam , Al-Aradi Bassam , Rahman Sabrina , Moshiur Md
Published: September 2023

This commentary discusses the effect of misuse of intravenous sedation regimens in lowering the systemic blood pressure in mechanically ventilated neurosurgical patients in the intensive care unit.
Preliminary results of minimally invasive stereotaxic surgery of intraparenchymal hematomas at the Hospital of Mali (23 cases)
Authors: Dama Mahamadou , Diallo Oumar , Coulibaly Oumar , Sissoko Daouda , Coulibaly Theodore Maxim , Tembine Kalba , Coulibaly Thomas , Liu Fengqiang , Mohamed Cisse El Hassimi , Kanikomo Drissa
Published: September 2023

Introduction: Spontaneous intracerebral haemorrhage (ICH) is a rupture of blood vessels in the brain parenchyma, in the absence of any underlying structural vascular lesion. It’s destructive and associated with a high mortality rate. There is a specific threshold of hematoma evacuation to impact mortality or functional outcome in ICH even the curative effect of minimally invasive hematoma removal for cerebral haemorrhage has not been fully recognized worldwide. We aim to evaluate surgical performance on hematoma volume and functional outcomes of patients.
Methods: This study is a retrospective and observational clinical study. A total of 30 ICH patients were treated in the Department of neurosurgery at the Hospital of Mali from December 2019 to November 2020. Minimal invasive puncture hematoma removal was performed in all the patients. The modified Rankin scale (mRS) was used to assess functional outcomes at 6 months and one year of surgery. Was considered poor functional outcome mRS >3. The percentages (%) of the count data were assessed by Fisher’s exact test by SPSS 23.0 software was used.
Results: A total of 23 ICH patients met the inclusion criteria, the mean was 47,78 years. Among the risk factors, the HTA is present in 91,3% of patients. The evacuation was satisfactory in 91.30% of cases.
Conclusion: This first study of minimally invasive stereotaxic for ICH evacuation must be followed up and encouraged. Even if the results are satisfactory, a double-blind study is required in the largest sample.
Influence of clinical and neurophysiological parameters on the function outcome of the facial nerve after vestibular schwannoma surgery
Authors: Radanović Dražen , Ilić Rosanda , Bogdanović Ivan , Živković Bojana , Pajić Srbislav , Nikolić Magdalena , Bogosavljević Đurđina
Published: September 2023

Introduction: Vestibular schwannomas are benign neoplasms of the nerve seath, and they represent the third most common endocranial tumour, following the meningioma and the pituitary adenomas. The primary symptoms of vestibular schwannomas are hearing loss, tinnitus as well as a balance disorder. The therapy of vestibular schwannoma consists of observation, surgery and radiosurgery. The majority of patients who are good candidates for surgery are already affected by significant hearing impairment, thus one of the primary goals of the surgery is the preservation of facial nerve function.
Aim: To analyze the outcome of facial nerve function one-year post-surgery using clinical and neuropsychological parameters.
Material and methods: This study analyzed the patient's clinical status on admission along with the neuroradiological characteristics of tumours and the neurophysiological intraoperative parameters and their effect on the facial nerve function in the early postoperative period as well as one year after the surgery using the House–Brackmann scale.
Results: A total of 30 patients who underwent surgery from January 1st 2015 to December 31st 2018 at the Clinical Centre of Serbia, Neurosurgery Clinic for vestibular schwannomas were examined. The median age of the patients was 51 years. Hearing loss was present in all patients. Sensitivity drop in the innervation region of n. trigeminus was present in 7 (23.3%) patients, as was tinnitus. Cerebellar symptomatology (76%) was present in the highest percentage of patients.
Conclusion: We can conclude that the most important aspects of the facial nerve function are the preoperative state of the facial nerve and the electrophysiological parameters. Although the radical procedure of surgery led to an immediate postoperative outcome, it was not significant for the ultimate outcome of treatment. Thus, radical surgery may be considered to carry the same risk of definitive impairment of the facial nerve function, just like a combination treatment with subtotal resection and stereotaxic radiosurgery.
Intramedullary cavernoma
Authors: Dianka Mamadou Bata , Abdoulkader Guedi Farida , Houssein Omar Djama , Omar Houssein Goumaneh , Omar Ali Filsan
Published: September 2023

The cavernoma is a vascular malformation made of well-circumscribed agglomeration of pseudo-capillaries. Bone marrow localization is rare and accounts for about 5% of spinal cord vascular lesions. Clinical symptomatology is marked by progressive bone marrow compression syndrome. The diagnosis is strongly evoked in magnetic resonance imaging and confirmed by histology. The management is essentially surgical.
We report a case of bone marrow cavernoma in a 38-year-old man seen in consultation, paraplegic for 2 weeks. The spinal cord MRI revealed a lesion opposite D11, evoking a cavernoma. The patient was operated on with total removal of the lesion; histology confirmed the diagnosis of cavernoma. The immediate post-operative follow-up was marked by the partial recovery of the deficit. We discuss, through this clinical case, the clinical, radiological and especially therapeutic aspects of the medullary cavernoma.
The curious case of commitment to religion and prayer in extreme long term survival anaplastic astrocytoma patient
Authors: Tasić Goran , Nikolić Igor , Rasulić Lukas , Janićijević Aleksandar , Aleksić Vuk
Published: September 2023

Anaplastic astrocytoma WHO (World Health Organization) grade 3 represents about 7% of all primary brain tumours in the adult population. The standard treatment protocol involves safe surgical resection, chemotherapy and radiotherapy. Advances in therapeutic protocols have been noted over the past few decades, but the prognoses are still poor with a median survival of 31 months.

We present a case of a male patient who is alive 25 years after the initial diagnosis and treatment of anaplastic astrocytoma WHO grade 3. The patient was operated and reoperated two times due to local tumour recurrence in the first two years after the initial diagnosis. After the last operation, the patient abandoned medical therapy and started praying. The patient is still alive without any clinical or radiological signs of tumour recurrence.
Global neurosurgery: the need of the hour for developing countries
Authors: Khizar Ahtesham , Zahid Soha
Published: September 2023

Global neurosurgery is relatively a new sub-discipline of global surgery. It is an area of study, research, practice, and advocacy that focuses on enhancing health outcomes and promoting health equity for all individuals around the world who are afflicted by neurosurgical disorders or require neurosurgical care. Low- and middle-income countries (LMICs) around the world have not benefited from advances in neurosurgery; most have little or no neurosurgical capacity in their entire country. The need of the hour is that a global problem necessitates a global response with a common vision and objectives.
Endoscopic endonasal transsphenoidal surgery for pituitary adenomas
Authors: Sertdemir Mahmut , Erdi Mehmet Fatih
Published: September 2023

Endoscopic endonasal transsphenoidal surgery (EETS) is a widely accepted technique for the surgical resection of pituitary tumours. In this report, we present our single-centre experience with EETS for pituitary adenomas, mainly focusing on its efficacy and postoperative complications. Among 100 patients who underwent EETS, 57 (57%) were female and 43 were (43%) male. The mean age of the patients was 51.55 ± 13.51 years. Nonfunctional adenoma was found in 61 (61%) patients, acromegaly was found in 29 (29%) patients, Cushing’s disease in six (6%), and prolactinoma was found in four (4%) patients. On average, a 75.8% decrease in the postoperative tumour volume was observed in nonfunctional adenomas. Surgical cure was achieved in 51.7% of patients with acromegaly, 50% of those with Cushing’s disease, and 25% of those with prolactinoma.  The most common postoperative complication was found to be cerebrospinal fluid fistula.
Penetrating thoracic spine injury causing haemothorax
Authors: Rowndzy Injam Ibrahim S. , Rashid Hoshanc Sdeeq , Ismail Mustafa , Saleh Saleh Abdulkareem , Shaker Noor Mohammed , Muthana Ahmed , Ahmed Mohammed Mohsen , Rahem Najat Hassan , Hoz Samer S.
Published: September 2023

Background. Penetrating spine injuries can cause catastrophic complications to the patient, and it demands immense medical care to minimize the insult. Mainly, it occurs in the military field; however, it has become more prevalent among civilians due to gun availability. The thoracic spine is the most affected part, followed by the cervical and lumbar spine.  
Case report. A 15-year-old teenage boy had a penetrating injury to the thoracic (T10) vertebrae due to a missile bullet that resulted in bilateral lower limb weakness and required him to undergo decompressive laminectomy. During surgery, a missed hemothorax was discovered incidentally.
Conclusion. To the best of the author's knowledge, this case of penetrating thoracic spine injury due to a missile bullet associated with missed hemothorax has not been previously reported. This paper discusses the importance of early detection and treatment of injuries associated with penetrating spine trauma to improve patient survival and disability.
Management of brain aneurysm neck-avulsion during clipping surgery
Authors: Al-Ageely Teeba A. , Ismail Mustafa , Alsaadi Salima B. , Salim Fatima F. , Kareem Zahraa M. , Talib Sura H. , Jaafer Huda , Hoz Samer S.
Published: September 2023

Background. Intra-operative rupture (IOR) of intracranial aneurysms is a critical event affecting the operation course and the patient’s outcome. However, A rupture induced by an avulsion in the aneurysmal neck is exceedingly challenging, as sealing the neck tear by clip application might result in ischemic injury due to parent vessel occlusion. Here we reviewed the literature regarding the intraoperative avulsion of the aneurysmal neck with an illustrative case to provide explanations of its surgical management intricacies.
Methods. A Midline PubMed literature review was performed using the following keywords; (Aneurysm) AND (neck) AND (surgery or clipping) AND (tear OR avulsion). Fifty-three results were found initially. After excluding non-human subject studies, and non-English studies, two independent researchers examined the title and the abstract for the cases of neck tear or avulsion with its management.
Results. Fourteen articles were found to be included in this study. The average age of the cases is around 57 years. The percentages of females in the review were 62% (8/13), and among the males, 38% (5/13). Regarding the locations, PcomA and AcomA were both 23% (3/13) of the cases; other locations include ACA, 15%, and MCA, 15%. The surgical techniques that opted from the literature include the cotton clip method, clip wrapping, parallel clipping and micro-suturing
Conclusion. IOR due to aneurysmal neck avulsion is a devastating surgical complication, and its management may differ according to the extent of the rupture. Choosing the most convenient technique depends on the surgeon’s knowledge and experience.
West syndrome and multiple sclerosis association
Authors: Si Ahmed Hakim , Lilia Megherbi , Smail Daoudi
Published: September 2023

Introduction. West syndrome is a rare and severe infantile epileptic encephalopathy, beginning around the age of six months, characterized by a classic electro-clinical triad. This is a pathology totally different from multiple sclerosis (MS) which is a demyelinating disease of the central nervous system caused, affecting young adults, especially females. The association of these two pathologies has never been described.
Observation. We report here an exceptional presentation of MS in a 14-year-old girl with a history of West syndrome. She had normal development until the age of six months, when she began to have flexion spasms. The diagnosis of West syndrome was made with a normal MRI. The infantile spasms disappeared after treatment with vigabatrin and adrenocorticotropic hormone (ACTH). It had generally progressed to Lennox Gastaut encephalopathy, with delayed psychomotor development and epileptic sequelae. At 14, she presented with left hemiparesis within a few days. A cerebral MRI showed multiple nodular hyperintensities of the supra and infratentorial white matter, with the presence of an active lesion, fulfilling the diagnostic criteria for multiple sclerosis. CSF analysis was normal. Anti-AQP4, anti-MOG, anti-NMDA and anti-GABA (AB) antibodies were absent in the blood. Antibodies against HIV and viral hepatitis were. Biotinidase activity and autoimmunity tests were correct. The patient received high doses of methylprednisolone IV (1g/day) for three days with remarkable clinical improvement after 15 days.
Discussion. MS is a complex and heterogeneous central nervous system (CNS) demyelinating disease. It is not uncommon for epilepsy to be the first symptom of multiple sclerosis. Seizures, on the other hand, are more common after disease progression. Although the disease is characterized by inflammatory lesions of the white matter, various neuropathological and radiological studies have shown that the disease also affects the grey matter. Several studies have shown that seizures are three to six times more common in MS patients than in the general population. Even though MS can start with epilepsy and a seizure may be the only symptom of a relapse of MS, it is still not known whether the two diseases coexist or whether MS predisposes to seizures.
Conclusion. The association of these two totally different pathologies can lead us to say that the mechanism of multiple sclerosis may begin in childhood and that the clinical signs appear in adulthood.
Prospective study of selective intra-arterial cerebral infusion and intra-operative local application of carboplatin for recurrent glioblastoma multiformis
Authors: Hamid Tareq Abdul Ghani , Mahmoud Ibrahim Abdul Wahab , Awad Ibrahim Ali , Youssef Amer Talal Ahmed , Zakaria Wael K.
Published: September 2023

Background. High-grade glioma is the commonest primary malignant brain tumour in adults. Intra-arterially selectively infused chemotherapeutic agents into the tumour bulk is being widely trialled recently with promising results.

Methods. This is a prospective study designed between November 2015 and November 2019. Thirty patients were diagnosed with recurrent histo-pathologically proven GBM after one surgery at least and followed by standard radiotherapy and temodal. Patients aged between 37-76 years, 18 males and 12 females were subdivided into group A of 21 patients who underwent intra-arterial delivery of carboplatinand group B of 9 patients who underwent re-surgical resection and local application of carboplatin.

Results. The mean age of the included cases was 55.4 years (range, 37-76 years). Selective intra-arterial injection was performed in 21 cases (70%), while the remaining 9 cases (30%) had local application of carboplatin in the tumour bed. Post-treatment vomiting was reported in 7 cases (23.3%). Significant and partial responses were achieved in 2 cases for each (6.7%). Time to tumour progression had a mean of 19.03 weeks (range, 3 – 30 weeks). After receiving carboplatin, the study cases had a mean survival of 26.5 weeks (range, 6 – 70 weeks). Intra-arterial injection had significantly better results compared to local tumour bed infiltration (p = 0.01).

Conclusion. Although recurrent glioblastoma multiformis has poor survival, intra-arterial delivery of carboplatin may have a slight positive impact on patient survival. The procedure however is relatively safe with manageable complications.
EXPRESSION OF NUCLEOTIDE EXCISION REPAIR PROTEIN ERCC1 IN TUMOR TISSUE AS A PROGNOSTIC FACTOR IN COLORECTAL CANCER
Authors: Bogomolova Irina Aleksandrovna , Dolgova Dinara Rishatovna , Antoneeva Inna Ivanovna , Parmenova Ekaterina Gennad'evna , Myagdieva Il'seya Rinatovna , Urevskiy Mark Alekseevich
Published: September 2023

At present, biomarkers of tumor resistance to platinum drugs in colorectal cancer are of much concern. Relapses and metastases occur in 35 % of patients with colorectal cancer (stages I–III) after adjuvant polychemotherapy with platinum-based anticancer drugs within the first 5 years. Resistance to platinum-based drugs is determined by a number of factors, including increased DNA repair capacity.
The aim of the study is to evaluate the prognostic role of ERCC1 expression in tumor tissue in colorectal cancer.
Materials and Methods. The authors studied the expression of the nucleotide excision repair protein ERCC1 in tumor tissue as a prognostic marker for adjuvant chemotherapy FOLFOX/XELOX in patients with colorectal cancer (stages II–IV). The correlation between ERCC1 expression in tumor tissue and chemotherapy effectiveness, clinical stage, age, survival, differentiation, and EGFR pathway mutations (NRAS, KRAS, BRAF) was assessed.
Results. ERCC1 expression was detected in 46.9 % of tumor tissue samples and in 88.9 % of resection line tissue samples. In patients with ERCC1 overexpression, the median survival was significantly lower than in patients with low ERCC1 expression. In tumors with NRAS and BRAF mutations, no ERCC1 expression was observed. No differences were determined in patient according to the disease stage, tumor differentiation, and mutations.
Cancer tumors is an independent predictor of FOLFOX/XELOX chemotherapy resistance.
DIAGNOSTIC VALUE OF NITROGEN METABOLISM DISORDERS IN NON-ALCOHOLIC FATTY LIVER DISEASE IN COMORBID PATIENTS WITH METABOLIC SYNDROME AND STRATIFICATION OF DISEASE STAGES
Authors: Aryamkina Ol'ga Leonidovna , Biek Al'fred Yulaevich , Saitov Aziz Ruslanovich
Published: September 2023

The aim of the study is to determine the significance of hyperammonemia for the diagnosis of non-alcoholic fatty liver disease (NAFLD) in patients with metabolically associated comorbid pathology.
Materials and Methods. A single-stage cohort randomized study was conducted to examine NAFLD in patients with metabolically associated pathology – type 2 diabetes, obesity, hypertension, coronary artery disease, and dyslipidemia. The study included 96 patients, who were divided into 3 groups: patients with steatotic liver disease (n=33), patients with non-alcoholic steatohepatitis (n=47) and patients with newly diagnosed liver cirrhosis (n=16). For NAFLD diagnosis, non-invasive methods were also applied (APRI, FIB4, NAFLD fibrosis score). To diagnose hepatocellular insufficiency, the authors evaluated ammonia level in capillary blood. Statistical processing was carried out by parametric and nonparametric methods, correlation and cluster analysis (Statistica 10.0). We also calculated odds ratio.
Results. Metabolic syndrome in patients aged 64.2±0.85 (64.9 % females and 35.1 % males, Charleson comorbidity index 4.57±0.12) was represented by type 2 diabetes (100 %), insulin-treated diabetes (2/3 of patients), hypertension (1/3 of patients, stage 3 of NAFLD), obesity (87.5 %), coronary heart disease (90.6 %), steatotic liver disease (34.4 %), non-alcoholic steatohepatitis (49 %) and asymptomatic liver cirrhosis (16,6 %). According to NFS results, stage F3–F4 fibrosis was diagnosed in 52.1 % of patients, F2 fibrosis in 47.9 %; hyperammonemia was found in 91.7 % (up to 111.1±4.86 (101.3–120.7) µmol/l). Hyperammonemia developed from steatosis to non-alcoholic steatohepatitis and liver cirrhosis and correlated with the stage of liver fibrosis, hepatitis activity, and metabolic syndrome key criteria. NFS calculator and hyperammonemia diagnosis made it possible to stratify the stages of non-alcoholic fatty liver disease.
Le problème de la souffrance gratuite selon Yūsuf al-Başīr
Authors: Vajda Georges
Published: September 2023

En sectateur Adèle de la théologie mu'tazilite, mais sachant simplifier et adapter à ses croyances juives les données complexes et excessivement copieuses fournies par ses sources, le docteur karaïte Yūsuf al-başīr consacra quatre chapitres (XXIII à XXVI) de son traité général de théologie (Muhtawī) à l'exposition du problème de la souffrance en apparence imméritée, «compensée» dans l'au-delà par le Dieu juste. La traduction commentée de trois de ces chapitres (le quatrième ayant été étudié ailleurs) est suivie d'une présentation de textes juifs et musulmans de l'époque (dont un de Yūsuf lui-même), propres à l'illustrer, ainsi que d'extraits d'ouvrages karaïtes postérieurs, en partie inédits, concernant le thème doctrinal en question.
Les Juifs vénitiens de Constantinople et leur communauté du XIIIe au milieu du XVe siècle
Authors: Jacoby David
Published: September 2023

On trouve à Constantinople des Juifs vénitiens dès la seconde moitié du XIIIe siècle. L'existence de leur quartier particulier ou Judaicha n'est toutefois attestée qu'à partir de 1343. La nature des institutions qui régissaient leur communauté ressort de la documentation vénitienne relative à la première moitié du XVe siècle. Conformément à la politique qu'elle poursuivait dans l'ensemble de son empire, Venise n'intervint qu'à titre exceptionnel dans la vie de sa Judaicha de Constantinople. Au début du XVe siècle, les bailes de la Commune dans la capitale byzantine édictèrent une série de mesures visant à mettre fin à l'emprise de l'oligarchie au pouvoir et à assainir les finances de la communauté. L'intervention des autorités vénitiennes se manifestait également dans le domaine du droit privé, le tribunal rabbinique étant dénué des moyens nécessaires pour mettre à exécution les sentences prononcées. Par conséquent, la rédaction d'actes en latin et en dialecte vénitien s'imposait. La tolérance manifestée par Venise à l'égard des traditions religieuses et juridiques de ses sujets juifs, souvent attestée, s'alliait à l'exploitation fiscale de ces derniers.
Le problème de l'assistance bienveillante de Dieu, du «mieux» et de la nécessité de la Loi révélée selon Yûsuf al-Basîr. Traduction et commentaire du Kitâb al-Muhtawî (chapitres XXXIV-XXXVI)
Authors: Vajda Georges
Published: September 2023

La justice absolue de Dieu, l'un des piliers de la théologie des Mu'tazi-lites, adaptée par Yüsuf al-BasIr dans la mesure où elle était concilia¬ ble avec les croyances fondamentales du Judaïsme, exige que le Créateur mette l'homme, libre de ses décisions quant à la foi religieuse et à la conduite morale, en mesure de faire son salut, finalité de sa création, mais réalisable seulement par la docilité à la volonté divine se mani¬ festant dans la Loi révélée. Cette mise en mesure est le lutf, assistance bienveillante, non pas contrainte exercée à l'égard du bénéficiaire. Elle implique, dans la perspective mu'tazilite, l'imposition de devoirs, «l'assujettissement » à une règle de vie qui vient préciser la loi de la raison inscrite dans la constitution native de l'être humain ou tout au moins objet du consentement universel. L'action secourable, qui s'impose, elle, à Dieu en vertu de Sa justice, comporte-t-elle toutefois l'obligation d'accomplir toujours le maximum concevable de bien ? Seule une fraction des Mu'tazilites l'affirme, alors que cette thèse est critiquée et rejetée par la majorité de l'école dont le théologien karaïte reprend en la simplifiant l'argumentation.
Mourad Farag and His Book, The Karaites and the Rabbanites
Authors: Nemoy Leon
Published: September 2023

The modern history of Karaism and Karaites is one of the most neglected corners in the whole field of Jewish and Near Eastern studies. Particularly in the 20th century, unrecorded history is bound to become permanently lost history, an eventuality surely to be regretted.

The present paper attempts to rescue from oblivion a recent member of the Cairene Karaite community. Mourad Farag (1867-1955), born in a family of goldsmiths, became a successful attorney at law, but devoted much of his leisure to Jewish studies and became a self-taught scholar in this field. He published a long series of works in Hebrew grammar, comparative Hebrew and Arabic philol¬ ogy, Karaite law, Biblical exegesis, and kindred subjects, as well as copious Arabic and Hebrew poetry. The paper examines in particular detail his work entitled The Karaites and the Rabbanites, in which he goes into great detail in examining the differences between the two camps, as well as the history of the Karaites and their literary activity. His intention throughout is to avoid intolerance and recriminations and to promote mutual understanding, and he is equally opposed to extremism on either the Karaite or the Rabbanite side. If occasionally he bases his conclusions on insufficient evi¬ dence, this is probably due to his lack of access to, or inability to read fluently, the pertinent Rabbanite sources in the original. On the other hand, in some aspects, for example in his concern for the rights of women, he is clearly under the influence of modern Western thought. An important product of modern Karaite literature ; neither work nor author should be permitted to lapse into oblivion.
Artistic horizons of Natalia Belik-Zolotareva
Authors: Yanko Yurii
Published: September 2023

Statement of the problem. The creative personality of N. A. Belik-Zolotarova, choral conductoris known not only in Slobozhanshchyna but also throughout Ukraine. Kotlyarevsky, winner of the I. Slatin Municipal Prize (2004) and the Person of the Year 2004 rating, is well known not only in Slobozhanshchyna but throughout Ukraine. Her work in choral art has long been respected by the music community. The author of this article personally observed all stages of the formation and development of the creative phenomenon of Natalia Belik-Zolotareva. The analysis of recent research and publications has no special scientific study of N.A. Belik-Zolotarova’s life and work. There are a number of responses, reviews, and journalistic publications that to some extent cover her personality. There is one single article «Harmony of Life and Work» by V. Palkin dedicated to the multifaceted devotion of N. A. Belik-Zolotareva. The study also relies on the works of the artist herself. The main objective is implementation of determination of N. A. BelikZolotareva’s creative activity as a bright figure of the modern national musical culture and to identify the constants of her creative and performing outlook and artistic thinking. The scientific novelty of the article lies in the comprehension of the creative figure and the disclosure of the essence of Natalia Belik-Zolotareva’s performing acme. The research methodology is based on the use of a typological approach to the integrity of the conductor’s personality in professional activity and empirical research of individual psychological characteristics of N. Belik-Zolotareva’s creative personality. The results of the study are based on the understanding of the concept of personality as a reflection of the social nature of a person, on the consideration of him or her as an individual and a subject of society. The article examines the factors that influenced the formation and development of N. Belik-Zolotareva, identifying a set of properties that contributed to the manifestation of her individuality. Conclusions. The phenomenon of N. A. Belik-Zolotareva’s creative personality is revealed at the genetic and mental, psychological and personal, general social and life-creative levels. As a result of the analysis of the artist’s creative activity, it is established that the bright creative personality of N. BelikZolotareva is manifested in the breadth of worldview guidelines, the variety of artistic preferences, and reliance on spiritual and social constants.
Performance stylistics of piano program pieces by Chinese composers (Wang Jianzhong “Red lilies bloomed on the mountain”)
Authors: Song Meixuan
Published: September 2023

Background. The article examines the piano piece «Red Lilies Bloomed on the Mountain» by the Chinese composer Wang Jiangzhong. The general characteristics of the genre of the program piece, the imagery, symbolism or folklore of the names of piano works are considered, which help to specify the figurative content with the help of verbal decoding, bringing the performer and the listener closer to the figurative and emotional essence of Chinese national instrumental creativity. Objectives. In order to identify the universal mechanism of piano interpretation of program pieces by Chinese composers, the specific features and specificity of Chinese national artistic thinking are analyzed, which is reflected in the performing style, which includes the understanding of the figurative sphere, issues of a technological nature, and the stylistic authenticity of the performance. Methods. The research methodology requires a systematic musicological approach to the study of the selected musical material, which, in turn, led to the use of such methods as: historical-typological, musical-aesthetic, genre-stylistic, interpretological, comparative. Results. If the pianist fully understands the character of the piece and the main ideas of Chinese philosophy, then this knowledge will tend to direct the performance of any piece to the creative process. The psychological aspect of performance requirements consists of two aspects: – determination and confidence of mood, firmness in one’s convictions and ideals, which are reflected in the music of the play thanks to certain musical techniques and compositional techniques; – the natural mobility and lightness of the melody, the overall consistency of its sound, as well as the harmonious combination of such musical characteristics as the smoothness and contrast of the sound. The requirements for the aesthetic component of the work are aimed mainly at researching the national uniqueness of the work, reflecting its beauty and symbolic content, as well as at a detailed analysis of the synthesis of national and Western musical traditions. Existing attempts at music notation in san-ban rhythms should be classified as the most general instructions for performers, especially those who do not have sufficient experience in the field of musical self-expression in the traditions of Chinese music. Conclusions. The performer must also focus on such aspects as: awareness of various philosophical ideas that directly affect both the symbolic content and imagery of Chinese music itself, and the creative process associated with its reproduction and performance on stage; the importance of understanding the title of the work, its historical and cultural context; the need for an accurate sense of latitudinal relationships in the theme and texture of the work, feeling the sound ideal of authentic sounding with the inner ear.
Digital competence of the university student. A systematic and bibliographic update
Authors: Marrero-Sánchez Odalys , Vergara-Romero Arnaldo
Published: September 2023

Society has experienced an essential technological revolution in recent decades, generating significant repercussions in the educational field, especially in higher education. This technological evolution demands the development of digital skills that allow us to face problems and situations in this environment.

In this sense, Higher Education Institutions (HEIs) have attached great importance to the training in digital skills of university students in their academic policies. Digital competence implies the knowledge, abilities, skills, and attitudes necessary to access, analyze, evaluate, reflect critically, create, and communicate in four key areas: technological, informational, multimedia, and communicative.

The objective of this article is to analyze documents related to the digital competencies of university students. To achieve this, a descriptive bibliometric study was carried out. Among the conclusions, the need to strengthen the training in digital skills of university students is highlighted so that they can take advantage of the communication tools available in the knowledge society.
Architectural conservation of the rock-hewn churches of Lalibela, Ethiopia: A study on preservation and socio-economic conservation
Authors: Richard F. Nonyelum , Golkarian Sh.
Published: September 2023

The 11 monolithic structures that makeup Ethiopia's Rock-Hewn structures in Lalibela were painstakingly cut out of solid rock in the 12th century. Currently, these churches are facing various issues of deterioration such as exposure to natural and human-caused harms. This article critically evaluates the architectural conservation initiatives made to preserve these amazing buildings, which are often recognized as some of the most astounding architectural accomplishments in history. It carefully examines the preservation techniques used, highlighting their cultural relevance and the inherent values crucial for maintaining the Lalibela rock-hewn churches. Through the socio-economical aspects, it draws attention to the lack of funding and lack of technical requirements. Also, sustainable conservation activities develop a sense of ownership and bring awareness to the value of protecting cultural heritage. The report suggests methods for strengthening capability and creating a special conservation fund. The study uses a qualitative research methodology focusing on in-depth case studies from Lalibela, other rock-cut structures, and published academic works. As a result, this research offers valuable suggestions to encourage efficient conservation techniques. Finally, these observations contribute to a greater comprehension of the challenges in preserving the world's architectural legacies by providing helpful references for analogous sites facing similar conservation challenges.
Negativizing emotive coloronyms: A Kazakhstan-US Ethno-Psycholinguistic comparison
Authors: Bulegenova Indira B. , Karabulatova Irina S. , Kenzhetayeva Gulzira K. , Beysembaeva Gulshat Z. , Shakaman Yrysgul B.
Published: September 2023

Neurotargeting prioritizes emotions in understanding collective unconscious and individual behavior. Comparative emotive linguistics reveals cross-cultural emotional expression variations. Despite extensive emotion research, gaps remain due to differing response norms. Psychology understands emotions well, but lacks universal classification, hindering linguistic description. Confusion between emotion and emotive obscures psychophysiological and verbal distinctions. Nonverbal emotives, reflecting emotions, require analysis of generation and expression mechanisms.

This study examines color's role in conveying negative emotions in Kazakh writer A. Nurpeisov's "Blood and Sweat" and American writer T. Dreiser's "Trilogy of Desire." Authors use linguistic and nonverbal methods to portray emotions. Hypothesis: color as emotive state designation functions with "permissible-unacceptable" and "good-bad" evaluations, evident in shaping emotional reality perception. Analyzing coloristic negative emotives uncovers ethno-cultural metaphorical models, connecting emotive coloronyms with basic emotional concepts. Findings aid standardizing cognitive mechanisms for understanding mental experiences and comparative emotive linguistic terminology.
Hydro-mechanical powertrain for timber transport vehicles: technological relationship with the impact on the soil and plant environment
Authors: Sokol Pavel , Bozhko Aleksandr , Novikova Tatyana , Rabko Siarhei
Published: September 2023

Reducing the negative impact on the forest soil and vegetation environment of wheeled propellers of biaxial articulated forest transport vehicles, along with changing the parameters of the propellers themselves, can be effectively carried out by redistributing the power flow in the hydromechanical transmission. In order to ensure high traction performance and cross-country capability through single obstacles (root systems) in the conditions of a cutting area, it is necessary to take into account the rational parameters of the components and assemblies of the hydromechanical transmission based on new scientifically sound technical solutions. A review of the designs of hydromechanical transmissions of domestic and foreign-made forest transport vehicles revealed their advantages and disadvantages that affect the effectiveness of their use in the conditions of forest exploitation. The primary transportation of trees, which occupies a significant volume during logging, is effectively handled by forest transport vehicles with high energy saturation. The use of a promising torque converter design as part of a hydromechanical transmission unit for the separate drive of the drive axles of wheeled articulated timber vehicles will compensate for the effect of external forces and reactions to the wheel mover, as well as minimize the phenomenon of power circulation in a closed loop "wheel mover – bearing surface", which will contribute to an increase in traction performance. The technological relationship from the use of different powertrain designs is characterized by moderate differentiation (p < 0.05) according to the criteria of impact on the soil environment, based on the use of the median method in the statistical analysis of similarities and differences. Future research will answer the following questions: how will the level of loss of useful power in the hydromechanical transmission of a wheeled forest transport vehicle equipped with a new torque converter change in conditions of constantly changing external influences? How and how closely will the transmission parameters with the new torque converter affect the performance and patency of the forest transport vehicle, taking into account the characteristics of the soil and plant environment?