bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative role of scintigraphy in sporting injuries in the new millennium
Authors: Wall Hans , Breit Robert , Burton Leticia , Frater Clayton , Bruce Warwick
Published: September 2023

Exercise for good health and as a prerequisite for most sporting endeavours is both an aspirational and necessary requirement at a time when obesity plagues much of the well-developed world. It has led to great advances in the science of exercise and a medical specialty devoted to sporting injuries. Epidemiology of sporting injury is crucial in this process in order to prevent injury and to focus attention on dangerous practices in some sports. The bone scan was historically considered a mainstay for the diagnosis of sporting injuries involving stress fractures, acute fractures and some soft tissue injuries. However, the role of scintigraphy has been supplanted by magnetic resonance imaging (MRI) in many of these settings, largely due to its high contrast resolution for soft tissues, spatial resolution of the relevant anatomy and the absence of radiation exposure. Nevertheless, there remains a valuable contribution from scintigraphy with the development of single photon emission computed tomography (SPECT) co-located with x-ray computed tomography (CT) in the same instrument. The place of scintigraphy in the evaluation of sporting injuries needs to be critically evaluated against the competing modalities of CT, MRI and high-resolution ultrasound. It is no longer appropriate or critically acceptable to examine scintigraphy in isolation from the other available imaging modalities.
Amorphous Macromers as Potential Organic Matrix in Dental Composites
Authors: Susila Anand , Balasubramanian Venkatesh
Published: September 2023

Objectives: Assess the thermal and hydrolytic stability of patented macromer- based dental polymer matrices and composites Methods: Polymer matrices and composites based on a patented material (IP:343192) containing hybrid amorphous macromers co-polymerized with one of the 4 different dimethacrylates was prepared and the thermal and photo-thermal behavior were assessed. Diffusivity resistance and cross-link density of polymers were assessed. Sorption (𝑆(𝑡), 𝑀𝑔%(𝑡) 𝖠 𝑆%(𝑡)and solubility (𝑆𝐿(𝑡) 𝖠 𝑆𝐿%(𝑡) of composites in chloroform (CHCl3), tetrahydrofuran (THF), carbon tetrachloride (CCL) and acetone (Ace) for varying durations (1h, 24h 1mo), and deionized water for 120h were determined. Results: Dual Tg were noticed for both the matrices and composites; matrices containing BisGMA (G) and UDMA (U) as the dimethacrylate co-polymer showed significantly lower𝑆𝐿(𝑡). Matrix containing TEGDMA (T) as the dimethacrylate co-polymer showed the least 𝑆(𝑡). Matrix containing BisEMA (E) had the highest cross-link density. photo-DSC of composites showed a Degree of Conversion of 97% at lower enthalpies (15-28J/g). None of the composites showed water solubility. All materials showed solubility in acetone with U being the least. Sorption and solubility in other organic solvents was lower and occurred only at longer immersion time. Conclusions: Amorphous hybrid macromer-based polymer matrices and composites show promising thermal and hydrolytic behavior.
Head and Neck Low Flow Vascular Lesions Treated with Corseting Technique
Authors: Nair Sanjiv , N Niveditha , Nair Advaith , R Prashanth
Published: September 2023

Head and neck vascular lesions management has been a great challenge to the surgeons due to catastrophic bleeding that obscures the visibility during the surgery. A proposed surgical technique called CORSET SUTURING for the treatment of non cutaneous low-flow vascular malformations in the head and neck region minimizes the blood loss and facial disfigurement. Corset sutures are placed to strangulate the lesion and restore the facial symmetry with the least amount of comorbidities. The aim of the present study is to describe the clinical characteristics of patients treated by corset suturing technique, material used and surgical morbidity, in order to contribute to a better understanding of this technique. Medical records and images of 15 patients treated by the same corset suturing protocol were retrieved and analysed. The indications, advantages and disadvantages, technique and complications observed are discussed. There was a significant reduction in the bulkiness of tumour mass noted and also a return of the regional facial outline was evident. In conclusion, corset suturing has an important role in management of diffuse low-flow vascular malformations of the head and neck as it is found to be a simple, cost-effective, less scarring and acceptable method, hence can be considered as an alternative to the other expensive methods such as embolization, with least surgical comorbidities.
Ethical Issues of Artificial Intelligence in Diabetes Mellitus
Authors: Sridhar Gumpeny , Lakshmi Gumpeny
Published: September 2023

Artificial intelligence (AI) has permeated various branches of clinical medicine, with promising applications in predictive, diagnostic and therapeutic areas. Digital innovations are increasingly useful in the management of non communicable diseases in the form of tracking applications, data collection systems (EMRs) and wearable sensors. Globally, diabetes mellitus is the most common and serious non communicable disease. There is a mismatch between the people with diabetes and the number of healthcare professionals needed to manage them. Therefore, artificial intelligence has the potential to play a significant role in addressing the unmet need. Majority of AI applications have been developed for the diabetes population. Ethical issues arising from the application can be carried over to its application in other areas of clinical medicine. Among diabetic population, artificial intelligence has been prominently employed in screening for diabetic retinopathy. Continuous glucose monitoring and insulin pumps are other areas of application. Data collection and sharing through AI media can ease the burden of poor doctor-patient ratio, and improve efficacy of treatment. Despite its advantages, and the fact that citizen juries have been found to be favourable towards the use of AI in research and treatment, certain drawbacks continue to exist. With the threat of data theft and breach of privacy, due diligence must be given to ethical and legal aspects to protect the patient. It is acknowledged that AI can facilitate the decision making process but not entirely replace a physician's role. With able governing laws, systems to protect safety, minimize bias and improve transparency, AI and precision medicine could help control the burden of disease.
The EFQM Model as an Exquisite Tool for the Analysis of Business Excellence and Its Use in the Healthcare Industry
Authors: Bukvič Vladimir
Published: September 2023

The author links together business analysis and business excellence as an ideal that all well- performing organisations wish to achieve while attaining and continuously maintaining superior levels of business performance, thus fulfilling and even exceeding the expectations of their stakeholders. He leans on the EFQM model and uses it as an excellent tool for analysing the business of an organisation throughout all the phases defined by traditional business analysis. This includes the observation of facts and identification of problems, which can be construed as defining the organisation’s strengths and areas for improvement. This entails setting up hypotheses and testing them by applying appropriate measures. After a short introduction, the author makes first a thorough literature review on business excellence in the last two decades with an emphasis on the EFQM Model. He focuses particularly on the assessment and critical attitude of individual researchers who have studied this topic. Further, the author presents the basic concepts and elements of the EFQM model of business excellence, with a particular emphasis on the RADAR matrix as a very useful instrument (management tool) for business excellence analysis. He also presents the use of the model for analysing and assessing the business excellence of organisations in the public sector, specifically in the healthcare industry (hospitals). He presents the key attributes (select healthcare aspects) that define the quality of healthcare services for its key participants, i.e., patients and the payers of these services. These attributes, namely technical performance, interpersonal relationships, amenities and access, patient preferences, efficiency and cost effectiveness, are then highlighted by select business excellence criteria, mainly referring to the stakeholders’ perception of the organisation in question and business performance indicators. The author rounds off his paper with a couple of recommendations regarding the identification of strengths and areas for continuous improvement, which he, as a leading assessor with many years’ experience, including in the healthcare industry, considers as the most important aspect of business excellence analysis.
Neutrophil/Lymphocyte Ratio (NLR) and Lym-phocyte/CRP ratio (LCR) are Reliable Pre-dictors of Adverse Out-comes in High-Altitude COVID-19 Patients
Authors: Aguilar Rosalinda , Luna Alfredo , Reyes Christian , Mata Maria , Gutierrez Willebaldo , Martinez Martin , Duenas Enrique , Soto Antonio , Franco Daniel , Calleja Gustavo , DeUrioste Natalia , Suazo Jose , Solorzano Amilcar , Sanchez Lida , Soliz Jorge
Published: September 2023

The neutrophil/lymphocyte ratio (NLR) and the lymphocyte/C-reactive protein ratio (LCR) are prognostic factors in inflammatory, cardiovascular, and oncological diseases. With the emergence of the COVID-19 pandemic, it has been recently shown that NLR and LCR are also useful for the prognosis of disease severity in patients infected with the SARS-CoV-2 virus at sea level. However, there are no studies demonstrating the reliability of NLR and LCR in high-altitude human populations (above 2,500 m). This is relevant because both the incidence and mortality from COVID-19 are decreased in high altitude. A possible explanation of this effect is a lower impact of this virus on the exaggerated inflammatory response induced by the viral infection. The aim of this study is to determine whether the NLR and LCR indices can be used as reliable predictive markers of COVID-19 severity in high-altitude permanent resident patients. Routine blood biochemistry and complete blood count were performed on 368 patients positive for the SARS-CoV-2 virus in Huaraz, Peru (3,050 m). Patients’ follow up was carried out until home discharge or fatal outcome. The results show that: 1) NLR values are higher in deceased patients admitted to the intensive care unit due to COVID-19; 2) NLR and LCR are reliable predictors of death in patients with COVID-19; and 3) NLR and LCR are reliable predictors of intensive care unit requirement in COVID-19 patients. We conclude that NLR and LCR are reliable biomarkers and prognostic factors of COVID-19 severity and can be used in high-altitude permanent resident patients.
Neoadjuvant and Adjuvant Therapy; Calculating Costs
Authors: Guirgis Helmy
Published: September 2023

Background: Neoadjuvant Nivolumab plus chemotherapy improved event-free survival in early resectable lung cancer. The target therapy Osimertinib is used as neoadjuvant, adjuvant and in advanced advanced/metastatic non-small lung cancer (a/m- NSCLC). The current clinical practice in a/m- NSCLC is to continue Osimertinib, if effective and safe. The estimated 3-year cost was $745,116, necessitating placement of $500,000 cap. The median immune check point inhibitors (ICI) 3-year cost of $404,388 was below the cap (Guirgis, ESMED, 2023). We aimed to quantify and compare ICI-and Osimertinib costs in earlier vs advanced stages in multiple solid tumors. Methods: Annual 2019-2020 costs of Osimertinib were calculated ad monthly optimal dose x 12. The ICI were calculated as dose x mg/m2 or per 80 kg x price x number of cycles. Results: The, 2-year Osimertinib cost in 1 st and 2 nd -line metastatic disease was $496,744, adjuvant 1-year $248,372 and neoadjuvant $31,046.
Potential Impact of Genetic-Code Mutations on Medicine and Health
Authors: Wong Tze-Fei , Xue Hong
Published: September 2023

The genetic code encoding amino acid sequences in ribosomal translation consists of an alphabet of 61 triplet codons for 20 amino acids and three chain termination signals. Basically the same universal code is employed by all organisms from the Last Universal Common Ancestor (LUCA)-proximal Methanobacter kandleri (Mka) to humans. This universal code, which has remained invariant for all living species, enables the transplantation of protein-coding genes between different species without loss of function, and constrains the chemical diversity of the encoded amino acids. Over the initial decades following the discovery of the code, its invariance coupled with the lack of any information regarding its origin have led to the view that the code might represent an inexplicable ‘frozen accident’ in the history of life. However, with the formulation of the coevolution theory of the genetic code and its multifaceted supporting evidence, this view has become untenable. Instead, the encoded amino acids are known to comprise two different classes: ten Class 1 amino acids available on prebiotic Earth were incorporated into the protocells as they evolved into life forms, while the ten Class 2 amino acids were produced by early life through biosynthesis. Thus, the later entry of the Class 2 amino acids identified them as end products of cellular evolution, which suggests the plausibility of continuing alterations of the encoded amino acids after an eons-long pause. Accordingly, attempts were made by our group to replace Trp by 4-fluroTrp (4FTrp) from the proteome of Bacillus subtilis. The targeted replacement obtained proved the inherent mutability of the code, and this has stimulated the development of a wide range of mutated codes through a variety of approaches. Hundreds of genetic code mutants have now been successfully isolated from microbes to animals, transforming the code from an immutable construct to a highly malleable molecular device. The effects of such new codes on medicine and health range from treatments for a variety of diseases to the alleviation of food crisis arising from the degradation of the environment and devastation due to natural disasters.
Environmental Isolate Developing Antibiotic Resistance by Complementation
Authors: Ridgeway Mary , Fink Ashley , Mitchell David
Published: September 2023

Antibiotic resistance is a growing concern within the scientific community. With few new antibiotics being introduced and an increasing number of resistant microbes, routine bacterial infections are becoming more difficult to treat in clinics and hospitals. The purpose of this study is to compare the ability of two environmental isolates – Staphylococcus aureus (S. aureus) and Exiguobacterium undae (E. undae) to grow in solutions of increasing concentrations of tetracycline and ciprofloxacin. After the bacteria showed grow in the solutions, antibiotic susceptibility was tested by examining zones of inhibition on Trypticase Soy Agar (TSA) plates. Our results indicate both isolates were initially susceptible to each antibiotic. The isolates were grown individually and mixed to determine if the isolates could gain resistance to the antibiotics in either environment. Our results demonstrate that E. undae could grow and become resistant in mixed cultures when grown in the presence of S. aureus reflecting the ability of S. aureus to complement microbial growth. Along with the ability of S. aureus to complement the growth of E. undae, it was also able to develop resistance to both ciprofloxacin and tetracycline through repetitive exposure.
Comparison of homeopathic medicines composed of Taraxacum officinale and Lycopodium clavatum for treating cellular hepatocarcinoma
Authors: Valle Ana , Carvalho Aloiso , Rahme Samir , Araujo Andressa , Malard Patricia , Brunel Hilana
Published: September 2023

Homeopathy has been increasingly standing out for its proven clinical benefits and for providing a course of treatment with fewer side effects to patients, thus promoting a better quality of life for them. Homeopathic therapy can be used in different contexts and is an additional alternative for treating cancer patients in Integrative Medicine. Within this context, hepatocellular carcinoma has a high mortality rate and, in most cases, is diagnosed in advanced cases. Therefore, this study evaluated the in vitro efficacy of the association of the homeopathic medicines Taraxacum officinale and Lycopodium clavatum against HepG2 cells. For this purpose, cells were grown in 75 cm² flasks and then plated in 96-well plates. The treatment with Taraxacum D4 + Taraxacum D8 + Taraxacum D12 and Taraxacum D5 + Lycopodium D6 at concentrations of 20, 40, and 60 µL/mL was added to each well. After 48 hours of incubation in an oven at 37ºC, 5% CO2, cells were subjected to the cell viability test by MTT. A decrease in viability was observed compared to the control group (cells without treatment). In addition, the medicine Taraxacum officinale was more effective in decreasing cell viability than the other medicines in the three conditions tested. In conclusion, the homeopathic medicine Taraxacum D4 + Taraxacum D8 + Taraxacum D12, in accord of potencies, is promising against hepatocellular carcinoma cells and can be used to aid in the treatment of this type of cancer.
Characterization of Pomological and Physicochemical Properties of Zivzik and Pervari Pomegranate Genotypes Grown in Siirt Province
Authors: SAKAR Ebru , VARDİN Hasan , KARAASLAN Mehmet , ODABAŞIOĞLU Mehmet İlhan
Published: September 2023

Commercial pomegranate cultivation in Siirt province is concentrated in Şirvan and Pervari districts. Although Zivzik pomegranate variety is a registered pomegranate variety, it is not well known outside the region where it is grown (Zivzik, Sarıdana, Kapılı and Pirinçli villages). Pervari pomegranate is grown in the regions between Bitlis stream, Hizan and Pervari. In this study, pomological and physicochemical characteristics of different sized fruits of Zivzik (n=8) and Pervari (n=10) pomegranate genotypes collected from different locations in Siirt province were investigated. The pomological characteristics examined were fruit weight, aril yield, 100 aril weight, fruit width-length, aril width-length, rind (peel) skin and aril colour, juice yield, juice density and colour. The physicochemical properties analysed were total soluble solids, total acid, pH, ascorbic acid, total sugar, reducing sugar, total phenolic substance, anthocyanin, antioxidant capacity (DPPH), moisture and ash content. It was found that the most abundant organic acid in Zivzik and Pervari pomegranates was citric acid (3.34-4.67 g/L) and malic acid was found more in Zivzik pomegranate (1.76 g/L). Zivzik pomegranate was found to be richer in terms of the amount of phenolic compounds. Quercetin and caffeic acid are the most abundant phenolic compounds in the fruit of both varieties.
Clinical profile and sensory pattern in lateral medullary syndrome
Authors: K. Shraddha Kedlaya , P. Lenin Sankar , Veeramani Ravikumar
Published: September 2023

Background: Lateral Medullary syndrome is an acute ischemic stroke syndrome characterised by occlusion of the vertebral artery/posterior inferior cerebellar artery. The study aimed to describe the sensory pattern and clinical profile of patients admitted with lateral medullary syndrome.
Methods: This cross-sectional descriptive study was done in the neurology department at Thanjavur Government Medical College, Tamil Nadu. Twenty patients with acute stroke clinically suspected of lateral medullary syndrome were taken into this study for one year. Magnetic Resonance Imaging (MRI) of the brain with an MR Angiogram was done to confirm clinical suspicion of Lateral medullary syndrome. They were examined in detail for clinical profile and sensory pattern, and relevant investigations were done.
Results: Among the 20 LMS patients, 85% were males, and the mean age of occurrence was 53.2 years. All of them had acute infarcts in the lateral medulla. Hypertension, diabetes mellitus and dyslipidemia were the most common systemic risk factors. The most common sensory pattern observed was classical, with loss of sensation in the ipsilateral face and contralateral body in 45% of patients. The most common clinical presentation was walking instability, bulbar symptoms, and a longer hospital stay. The second most common pattern was only sensory impairment in the ipsilateral face, seen in 30%. Their clinical presentation was unsteadiness while walking, with no bulbar symptoms, shorter hospital stays, and better recovery.
Conclusions: LMS is an acute stroke syndrome common in males, often after 50 years, with hypertension, diabetes, and dyslipidemia as systemic risk factors.
A cross-sectional study to document socio-demographic profile and disease profile of dermatosis in pediatric age group
Authors: Jadav Naresh B. , Vaghela Nital N. , Patel Komal B. , Patel Yogesh U. , Parmar Brijesh V. , Umarigar Dipak D.
Published: September 2023

Background: Skin diseases are considered a major health problem in the pediatric age group and are sometimes associated with significant morbidity. Among them, dermatosis is one of the most common skin diseases in India, affecting the skin and hair. Early diagnosis and treatment are essential for pediatric patients to prevent long-term persistence or disability caused by the disease. Although some manifestations are physiological and require no treatment, different age groups have different sets of clinical dermatoses, with dermatitis being the most common among all age groups. Studying the proportions of various clinical presentations of different types of dermatosis helps in the proper diagnosis and management of patients. This study was conducted to document the socio-demographic profile and disease profile of various forms of pediatric dermatosis.
Methods: A cross-sectional study was conducted from April 2017 to March 2019 among 401 pediatric patients at a tertiary-level hospital.
Results: Out of the 401 participants, approximately two-thirds were male, and more than half (53.1%) were 5-11 years old. Among the dermatoses groups, the most common were dermatitis (20.4%), nutritional (15%), pigmentary (13.6%), and others.
Conclusions: All forms were predominantly seen among males, except in a few dermatitis types like papulosquamous, hair, pigmentary, bullous, and keratinizing disorders, where females were more prone than males.
Propensity of use of neuromuscular blocking agents among Indian anaesthesiologists: A questionnaire-based survey
Authors: Hodarkar Shubha , Jain Anil Kumar
Published: September 2023

This survey aimed to understand the use of neuromuscular blockers (NMBs) with respect to neuromuscular monitoring, reversal of residual neuromuscular block, and incidence of adverse events among Indian anaesthesiologists.

A 40-item questionnaire was sent to 250 anaesthesiologists across India via email and their responses were statistically analysed.

The response rate was 50%. To facilitate tracheal intubation, 81.0% respondents preferred cisatracurium, 72.2% preferred atracurium, 43.7% preferred vecuronium, 58.7% preferred rocuronium, and 70.6% preferred succinylcholine. Safety and recovery time are the most important criteria for an ideal NMB. About 84% respondents expressed concerns about the adverse effects of NMBs, especially recovery of neuromuscular function (31.1%) and hemodynamic effects (26.4%). The train-of-four (TOF) ratio for residual paralysis was not checked by 57% respondents. Reversal agents were used by >2/3 respondents; however, 86.5% used them after cisatracurium was used. Concerns about adverse effects of anticholinesterase/antimuscarinic agents were expressed by 63.4% respondents, while 85% expressed the need for availability of sugammadex in India. Almost two-thirds opined that conventional nerve stimulators and quantitative TOF monitors should be available in the operating room.

The survey showed that safety and recovery time are the most important parameters in selecting an NMB. Cisatracurium was the most widely used NMB for tracheal intubation because of its safety, duration of action, less anaphylactic reactions, and fewer hemodynamic fluctuations. The use of TOF for monitoring was low. While reversal agents were used by >2/3 respondents, many respondents used them after cisatracurium was used as an NMB.
Anesthesia management of superobese pregnant patient under spinal anesthesia in cesarean section
Authors: Mehta Sumedha , Dongare Dhanshree , Sadafule Namrata Natraj , Pawar Kirti Surendra
Published: September 2023

Morbidly obese parturient requires specialized anesthetic care for safe labour and delivery. Regional anesthesia is considered safer than general anesthesia for cesarean section in super morbid obese parturient. We present this case to discuss anesthetic challenges associated with regional anesthesia and our approach in successful management of cesarean section in super morbid obese parturient.
Lidocaine-induced anaphylactic shock – A case report
Authors: Reddy Sathya Narayana , Govind Amal , Teja Surya , Dudi Saroj
Published: September 2023

IgE-mediated hypersensitivity reactions (HRs) to local anaesthetics are extremely uncommon. One of the most widely used local anaesthetics for minor dental and other surgical procedures is lidocaine. The incidence of anaphylactic reaction by Inj. Lidocaine among global population is <1%. The first anaphylactic reaction reported in 1902. A 69-year-old female patient shifted to community hospital emergency department. She presented with complaints of vertigo, anxiety, tachypnoea, hypoxia, and sudden onset of breathlessness. History revealed on administration of Inj. Lidocaine a local anaesthesia to her before knee surgery developed above-mentioned symptoms after 15 minutes. After receiving her from OT patient vitals observed as pulse rate-97bpm, GRBS-140mg/dl, blood pressure-170/70mmHg, spo95% with 0. On emergency basis treated her with anti-histamines (Inj. Chlorpheniramine), steroids (Inj. Hydrocortisone-400mg, Inj.solumedrol-1gm), oxygen support of 7 to 8 lit/min, after 4 days she recovered completely and discharged. We used a scale (Naranjo scale) to evaluate the severity of the adverse drug reaction as per scale, score was five that indicates probability of happening adverse reaction. We conclude the case as anaphylactic reaction to lidocaine could have been cause of the event. It is important to collect patients complete past medical history and their allergic history. Also by giving importance to drug sensitivity testing at least to the list of drugs that are reported to show allergic reactions or anaphylactic reactions in post marketing surveillance. Optimised management protocols can save both the patient life and dilemma faced by physicians.
A case report on anaesthetic challenges in Patau syndrome: Navigating craniofacial and cardiac defects
Authors: Shukla Pragya , Singh Abha , Rath Amrita , Prakash Shashi , Bhaskar Sanjay
Published: September 2023

The anaesthetic management of paediatric patients with Patau syndrome presents unique challenges, particularly when combined with craniofacial and cardiac defects and limited airway resources. This case report highlights our experience in managing a syndromic child with a difficult airway in a resource-constrained environment. The inability to secure the airway adequately can pose significant perioperative risks. In this case, we successfully utilized an oesophageal bougie as an alternative technique to secure the airway. This report emphasizes the importance of adapting to limited resources and employing innovative approaches to ensure optimal patient care in challenging situations.
Discrimination in Grading: Evidence from Immigrants in Ecuador
Authors: Drouet Arias Marcelo , Duryea Suzanne , Marotta Luana , Rangel Marcos , Rodríguez Guillén Lucina
Published: September 2023

This article investigates whether discrimination taking the form of biased assessment of students by teachers is prevalent within Ecuadorian schools serving immigrants. Robust evidence is drawn from unique data pertaining to high-school students and educators. After holding constant performance in blindly scored tests of proficiency, we find that teacher-assigned Mathematics and Language grades suffer from well cardinal and ordinal grading biases against children from immigrant households. We show that these results are robust with respect to the omission of socio-emotional traits that are valued by teachers. Heterogeneity analyses indicate key differences by the gender of the students and perceptions of teacher engagement.
The local political regime: aspects of Moscow polity
Authors: Chergeiko Georgy
Published: September 2023

The article discusses the theoretical and methodological foundations of modern political regimes. The evolution of political and regime issues is reflected from the standpoint of the views of researchers reflecting in the 21st century. The crisis of the transit approach is shown, which inevitably led to a rethinking of democracy. The analysis focuses on local modes, which have two basic forms of expression: regional and urban, in relation to large urbanized spaces (megacities). As a result of the application of regional transformation criteria to the political sphere, it is concluded that since 2010, Moscow polity has experienced power-political restructuring in the format of a «pact of elites» and not scenarios of «struggle according to the rules», «war of all against all», «winner gets everything». 
The use of the methodology of B. Ferman, in relation to the city (Moscow) political regime of 2010, allows us to conclude that the «control regime» explains more the specifics of metropolitan polity than the features of the «coordination regime».
Transposition of the regional identity of young people moved to a megalopolis
Authors: Chebanova Daria
Published: September 2023

The purpose of this work was to interpret through the prism of the importance for the construction of a new identity of young people of the factors of transposition of regional identity when moving to a metropolis. The goal was achieved through the use of the methodological framework of transcendental phenomenology and the method of textual and structural analysis. The main stages for this study were: building a theoretical framework using the conceptual apparatus of I. Goffman and his theatrical metaphor to determine the boundaries of the study; collection of empirical material by the method of in-depth phenomenological interview (15 interviews were taken in total); reduction and further analysis of empirical material, in which both the factors of regional identity separately and the interaction between them were considered, which made it possible to identify the hierarchy between the elements of regional identity. The main result of this research work was the assumption that for the studied group in the context of the modern world, regional identity is gradually transformed into a “thin”, more individualized and based on less strong and rigid ties. In addition, a conclusion was made about the complex relationship between the social and physical factors of the regional self, which both turn out to be significant for channeling the process of transposing regional identity, but from different positions within the structure itself.
On one view of Eurasianism: doctrine of personality (personology) and proof of the existence of Eurasia by S. Wiederker
Authors: Shekhovtsova Ekaterina
Published: September 2023

The article addresses to the doctrine of personality in the philosophy of classical Eurasianism, which Stefan Wiederkehr analizes in one of the paragraphs of his book “Eurasian Movement. Science and Politics in the Russian Emigration of the Interwar Period and in Post-Soviet Russia”. In the study of Eurasianism XX and XXI centuries, the author presents Eurasianism as a speech act, pursuing a political goal in a particular historical context. The topic of Eurasianism and literature, as well as the religious aspect, which is key in the philosophy of classical Eurasianism, are left out of the study. In matters relating to "personology", the author assesses the idea of the classics of the Eurasian movement about the "multinational" or "collective" personality, as Russian philosophers of the early 20th century see Russia-Eurasia.
Odkrywać na nowo znaczenie i wartość małżeństwa. Przemówienie papieża Franciszka do Roty Rzymskiej z 27 stycznia 2023 roku
Authors: Góralski Wojciech
Published: September 2023

Doroczne przemówienie do Roty Rzymskiej wygłoszone 27 stycznia 2023 r. na otwarcie nowego roku sądowego Franciszek poświęcił wartości i znaczeniu małżeństwa w życiu Kościoła. Ukazując pochodzenie tego wyłącznego i nierozerwalnego związku mężczyzny i kobiety z ustanowienia Bożego, podkreślił, że rodzina (oparta na małżeństwie) jest „drogą Kościoła”. Ta fascynująca wspólnota całego życia, nawet niesakramentalna, jest prawdziwym darem Boga. Ojciec Święty zwraca uwagę na potrzebę pielęgnowania miłości małżeńskiej, która wymaga ciągłego oczyszczania i dojrzewania. Znaczące jest akcentowanie przez Franciszka konieczności ciągłego odkrywania trwałości małżeństwa jako „węzła”, który  nie powinien kojarzyć się jakimkolwiek narzuceniem lub ciężarem, jest bowiem ,,więzią miłości”. Następca Benedykta XVI kładzie wreszcie nacisk na konieczność rozwijania  duszpasterstwa przedmałżeńskiego i duszpasterstwa rodzin, co powinno pomagać nupturientom oraz małżonkom w dojrzewaniu ich wzajemnej miłości, przy czym niezbędna jest tutaj pomoc poradnictwa  psychologicznego.
Bioética y el derecho al acceso a los cuidados de salud
Authors: Garrafa Volnei
Published: September 2023

El acceso a los cuidados de salud es un derecho universal de todo ser humano y no debe ser reducido a un objeto de consumo disponible solo para las personas con capacidad económica de adquirirlo. Desde el referencial teórico de la Declaración Universal sobre Bioética y Derechos Humanos de la Unesco, en primer lugar, se discute la razón de elegir los derechos humanos como base para el trabajo; en segundo lugar, se presenta la equidad como un principio indispensable en el debate para reforzar la comprensión de que las personas y las poblaciones desiguales deben ser tratadas de manera desigual y compensatoria, con el objetivo de buscar la igualdad basada en el reconocimiento humanitario del derecho de cada individuo en función de sus necesidades y diferencias. En tercer lugar, el texto aborda el complejo problema de priorizar la asignación de recursos escasos para garantizar el acceso a la atención médica para la mayor cantidad posible de personas. En resumen, el artículo pretende mostrar que el acceso a la atención médica para todas las personas, independientemente de su nivel de ingresos, debe ser considerado como un derecho humano universal que, además de las responsabilidades gubernamentales y del sector privado en apoyar programas inclusivos, debe reconocer también la legitimidad de la lucha de los movimientos sociales en defensa de mejores condiciones de vida y salud para todas las personas sin distinción.
Description of extraintestinal pathogenic Escherichia coli based on phylogenetic grouping, virulence factors, and antimicrobial susceptibility
Authors: Montes-Robledo Alfredo , Buelvas-Montes Yaleyvis , Baldiris-Avila Rosa
Published: September 2023

Background and Objectives: Extraintestinal pathogenic Escherichia coli (ExPEC) is a recently recognized and highly diverse pathotype of E. coli. Its significance as a pathogen has increased due to the emergence of hypervirulent and multi- drug-resistant (MDR) strains. The aim of this study was to characterize ExPEC isolates from humans based on their phylo- genetic group, virulence factor profile, and antimicrobial susceptibility.
Materials and Methods: The isolates were collected from patients with extraintestinal infections caused by E. coli, includ- ing urinary tract infections, bacteremia, and surgical site infections. The E. coli phylogenetic groups were determined using multiplex PCR. Additionally, the isolates were evaluated for their biofilm-forming abilities, susceptibility to antimicrobial agents, and presence of virulence genes.
Results: In this study, the isolates were classified into four phylogenetic groups: A (48.3%), B2 (25.8%), D (19.35%), and B1 (6.45%). All isolates exhibited at least one of the ten analyzed virulence factors. However, there was no direct evidence linking a specific phylogenetic group to a particular virulence factor. Nevertheless, the presence of the fimH, fyuA, ompT, traT, and kpsMTII virulence genes was correlated with the production of strong biofilms, multidrug resistance (MDR), and the production of alpha hemolysin.
Conclusion: This study provides a description of the phylogenetic groups in ExPEC and their potential association with virulence factor profiles and antimicrobial susceptibility.
Cell wall disruption, membrane damage, and decrease in the expression of Yrp1 virulence factor in Yersinia ruckeri by propolis ethanol extract
Authors: Sheydai Fardin , Tukmechi Amir
Published: September 2023

Background and Objectives: Instead of antibiotics, propolis is a promising alternative for treating bacterial diseases. The aim of this study was to evaluate the effect of propolis ethanol extract (PEE) on Yersinia ruckeri (Y. ruckeri), a fish pathogen, by examining its impact on the cell wall, cytoplasmic membrane, and gene expression.
Materials and Methods: The effect of propolis on the bacterial cell wall, membrane, and DNA using scanning electron mi- croscopy (SEM) was investigated. Its effect on the NAD+/NADH ratio, reactive oxygen species (ROS) production, as well as the expression of a virulence factor (yrp1) was also determined.
Results: It was demonstrated that PEE has multiple antibacterial mechanisms against Y. ruckeri involving cell wall damage, membrane lysis, and a decrease in gene expression.
Conclusion: The obtained results indicated that the mode of propolis actio against Y. ruckeri is both structural and function- al, while others showed propolis only could inactivate bacteria in a structural way.
Non-thermal plasma radiation-induced changes in antibiotic susceptibility and protein profile of Staphylococcus aureus
Authors: Rabbani-Esfahani Mehrdad , Ghaderi Lida , Shali Parisa , Ghassempour Alireza , Hosseini Seyed Iman , Aliahmadi Atousa
Published: September 2023

Background and Objectives: Plasma radiation is a widely used technique for sterilization or decontamination in various industries, as well as in some healthcare settings such as dentistry. The primary aim of this study was to assess the potential of plasma radiation to create a new population of Staphylococcus aureus cells with distinct characteristics that could lead to novel healthcare challenges.
Materials and Methods: A homemade non-thermal plasma apparatus was applied and the effects of plasma treatment  on S. aureus ATCC25923 was assessed. Plasma radiation was applied under controlled conditions to ensure that some bacterial cells remained viable. The treatment was repeated 10 times, with each round followed by a recovery phase to collect any surviving bacterial cells. To assess the potential changes in the bacterial population, we examined the antibiotic susceptibility pattern, micro-structural characteristics using scanning electron microscopy (SEM), and total protein profile using the ma- trix-assisted laser desorption ionization-time of flight (MALDI-TOF) technique.
Results: The experimental results revealed slight variations in the antibiotic susceptibility patterns of certain cell wall agents (imipenem, cephalothin, and cefepime), as well as in the MALDI-TOF spectra. However, no changes were observed in the SEM images.
Conclusion: The insufficient application of non-thermal plasma in bacterial decontamination may lead to physiological changes that could enrich or select certain subpopulations of S. aureus.
Attitudes Toward Menstrual Suppression Among Cyclic and Continuous Contraceptive Vaginal Ring Users in Kenya
Authors: Walker Kristina Wilbekin , Mugo Nelly , Ngure Kenneth , Gakuo Stephen , Casmir Edinah , Wiener Howard , Long Dustin , Shrestha Sadeep , Marrazzo Jeanne
Published: September 2023

Objective: Multipurpose prevention technologies (MPTs) are developmental dual-purpose options that would provide women with a contraceptive as well as a prevention modality aimed at sexually transmitted infections. The contraceptive vaginal ring (CVR) has many properties that makes it an ideal MPT candidate. The objective of this study is to understand women’s attitudes towards menstrual suppression, a potential side effect of using a CVR, and how to address these attitudes for MPT vaginal rings in development.
Materials and methods: We analyzed data derived from a subset of cohort study participants (n=45) in Thika, Kenya between January 2016- December 2018. The primary study enrolled 121 women 18-40 years with bacterial vaginosis and randomized them to cyclic or continuous CVR use for eight months. During the 6-month follow-up, a questionnaire eliciting attitudes towards menstrual suppression was administered. Responses to the menstrual suppression questionnaire between participants in the cyclic and continuous CVR use groups were compared. Likert-scale responses were summed to create a menstrual suppression attitude summary score, and a hierarchical cluster analysis was conducted to identify similarities in response patterns among all participants.
Results: Totally 81.8% of continuous CVR users believed that one was less likely to get pregnant after using hormonal medication to suppress menses, compared to 47.8% of cyclic CVR users (P=0.02), and were more worried it would cause long-term health effects (86.4% vs 60.9%, p = 0.05). The menstrual suppression attitude summary score ranged from 8 to 42, with lower scores indicating negative attitudes. The summary score identified three distinct clusters. When asked if menstrual suppression effects long-term health; 100% of Cluster 3 was worried compared to 80.8% of Cluster 2 and 46.2% of Cluster 1 (p = 0.03). The average summary score among Cluster 3 (Mean = 14.8, SD = 4.6) was lower (p < 0.001) and women were more worried about discomfort during sex (p=0.05) as well as their sexual partners feeling the ring (p=0.02).
Conclusion: Women are more likely to have negative attitudes if they believe menstrual suppression hinders future reproductive health. Education on cycle control and fertility could mitigate negative attitudes and improve uptake of CVRs.
Knowledge, Attitude and Practices Among Mothers of Infants Regarding Breastfeeding
Authors: Manjapallikkunnel Shema Raj , Nalinakumari Kesavan Nair Anjana , Sujatha Chintha
Published: September 2023

Objective: This study aims at understanding the level of knowledge, attitude, and practice of breastfeeding among mothers and the factors associated with good knowledge about breastfeeding.
Materials and methods: A cross-sectional study among 251 mothers of infants admitted in the pediatric wards of SAT Hospital, Thiruvananthapuram was conducted during November-December 2019. The mothers of infants born between 37 and 42 weeks of gestation and without major birth defects were included in the study. The data were entered into an MS Excel sheet and analyzed using Statistical Package of Social Sciences version 26.0. Significance of association was tested using Chi-square test and multivariate analysis was done using binary logistic regression test.
Results: The mean age of the participants was 26.25 (SD 4) years. On multivariable analysis, higher education and older age were found to be significantly associated with good knowledge. Independent sample T-Test results show that there was a statistically significant difference between the mean age of mothers with good knowledge (26.4(±4), 25.14(±3.7)), p-0.015 and statistically significant association was found between the mean attitude scores (34.07(5.58)) with current breastfeeding practices (p=0.002). Chi-square test shows that exclusive breastfeeding was significantly associated with the mother’s age (p=0.006); 64.2% of women practicing exclusive breastfeeding were less than 25 years of age. This study also demonstrated a significant association between the initiation of breastfeeding within an hour and exclusive breastfeeding (p=0.003).
Conclusion: This study shows that mothers with higher age and higher educational qualifications were significantly associated with good knowledge about breastfeeding. Even though mothers have good knowledge, nearly half the mothers only exclusively breastfeed their infants for six months. Improving the educational qualification of women and increasing awareness about the benefits of breastfeeding among young women will promote breastfeeding practices.
Effect of Carob Supplement on Spermogram Parameters and Sexual Function of Infertile Men Referred to the Infertility Center, Hamadan, Iran, 2019: A Randomized controlled trial
Authors: Pilehvari Shamim , Bahar Tayebeh Gharakhani , Masoumi Seyedeh Zahra , Kazemi Farideh , Moradkhani Shirin , Haghi Alireza Rastgoo , Maleki Parvin
Published: September 2023

Objective: The purpose of this study is comparison of carob with placebo in the treatment of male infertility.
Materials and methods: This study was performed as a clinical trial with two-group pretest-posttest design. Each group consisted of 30 members. The first group received 1.5 grams of carob per day, and the second group received placebo treatments. Treatment lasted for 12 weeks. Semen analysis as well as testosterone, prolactin, (LH), (FSH) and (TSH) were performed before and after drug treatment in two groups. Sexual function was assessed in the groups in two stages before and after the intervention using the standard International Index of Erectile Function. P-value less than 0.05 was considered statistically significant. Statistical analysis of data was performed using SPSS 16.
Results: The participants’ mean age was 34.83 ±6.22 in the placebo and 33.67 ±5.82 years in the Carob group. The results showed in the carob group compared to the placebo group, the rate of normal sperm counts increased by 17% and also the normal level of testosterone was 40% higher than the abnormal levels of the placebo group and these differences were statistically significant (P <0.05). And in most areas of sexual function, the mean scores after the intervention were higher than before (P> 0.05).
Conclusion: It is recommended to use carob supplements to improve spermogram parameters and male sex hormones.
The Underlying Factors for Postpartum Depression Severity in Iran: A Single-Center Study
Authors: Shabani Azadeh , Farahbakhsh Mahshid , Meybodi Azadeh Mazaheri , Faghih Nafiseh , Haddadi Mohammad
Published: September 2023

Objective: Postpartum depression (PPD) is a common mental disorder among women and it can cause negative consequences for them, children, and families; however, accurate statistics and underlying factors on PPD and its severity are not available in Iran.
Materials and methods: In this cross-sectional study, 200 women referred to an academic hospital for normal vaginal delivery, which had a full-term and single pregnancy and had passed between 6 weeks and 6 months of delivery, were selected by convenience sampling methods. The Edinburgh Depression Inventory and the checklist for demographic information of mothers were completed.
Results: The prevalence of postpartum depression was 11.0% and 68.2% of mothers had a mild type. 31.8% had a history of depression. There was a significant relationship between the severity of postpartum depression in women with a previous history of depression (P = 0.012). Between postpartum depression and maternal age (P = 0.115), body mass index at delivery (P = 0.571), number of pregnancies (P = 0.693), number of deliveries (P = 0.446), number of abortions (P = 0.424), willing or unwilling pregnancy (P = 0.451), neonatal sex (P = 0.533), history of neonatal hospitalization (P = 0.725), previous history disease (P = 0.725) was no statistical association.
Conclusion: The prevalence of PPD was approximately 11%, and there was a significant association between postpartum depression severity and a history of depression Physicians and policymakers should consider early screening for PPD, especially among women with previous depression.