bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms of vibration-induced structural myocardial remodeling
Authors: Vorobieva Victoria V. , Levchenkova Olga S. , Lenskaya Karina  V. , Shabanov Petr  D.
Published: March 2024

The review analyzes literature data on structural changes in the heart of patients with vibration disease, as detected by echocardiographic methods. Particularly, it highlights concentric remodeling of the left ventricle chambers and disturbances in diastolic function. The review also discusses a 1.2-fold decrease in heart structure intensity compared to healthy individuals (p 0.05). Furthermore, it examines changes in morphometric and bioenergetic parameters of cardiomyocytes under different experimental vibration modes (7 and 56 sessions at a frequency of 8 Hz), confirming the disruptions in the relationship between the spatial configuration of the heart cavities, contractile ability, and energy supply potential. Loss of cardiac myofibrils represents the transition from myocardial hypertrophy to decompensation, accompanied by an increase in degenerative (dystrophic) signs such as the loss of sarcomeres in cardiomyocytes. Understanding these pathological (morphological) processes requires consideration of various mediators that regulate cell metabolism, proliferation, growth, and survival, including stromal interaction molecule, calcium ATPase of the endo(sarco)plasmic reticulum, inositol-1,4,5-triphosphate receptor, protein that forms CRAC channels, and transient receptor potential canonical. The degradation system of the extracellular matrix, including matrix metalloproteinases and tissue inhibitors, plays a crucial role in structural cardiac remodeling. This system regulates the rate of mRNA synthesis on the DNA matrix by binding to specific DNA regions that control cardiac nutrition and plasticity. The review suggests that these findings can help explain some patterns of cardiac remodeling development in patients with vibration disease and determine the direction of pathogenetically based therapy. This therapy should consider not only the vibration-protective effect of drugs but also their ability to inhibit and regress myocardial remodeling.
Problem questions of prevention and precising control of diseases associated with hypoxia
Authors: Lyubimov Andrey V.
Published: March 2024

Cardiovascular diseases are the one of the main causes of death in the 21st century. Their rating is not expected to be decreased in the near future despite all the successes in the wide distribution and using of high-tech methods of treatment. This article is devoted to the problem of introducing fundamental recent discoveries into practical medicine as part of the development of preventive, personalized and precision medicine. The author considers not used mechanisms of endogenous adaptation, prevention and preclinical diagnosis of hypoxia-associated diseases in the clinic and concludes that introducing of a new marker of adaptation to visceral hypoxemia is perspective approach in therapy of the cardiovascular diseases.
Яркий изобретатель-новатор фармаколог Александр Ливиевич Ураков (к 70-летию со дня рождения)
Authors: Shabanov Petr D.
Published: March 2024

Яркий изобретатель-новатор фармаколог Александр Ливиевич Ураков (к 70-летию со дня рождения)
Problem of increased humidity in ice arenas and possible solutions
Authors: Neverov Evgeniy N. , Korotkiy Igor' A. , Kozaev Anton A. , Korotkih Pavel S. , Gushin Aleksey A.
Published: March 2024

This paper reviews the problem of high humidity in an ice arena in Sochi and ways of solving it. The authors consider the ventilation system structure and determine the causes of the high humidity—moisture in the water vapor forms and a cold surface of ice cools the surrounding space and objects. The consequences of this air state are fogging over the ice surface, namely, condensate formation, which exacerbates the quality of the ice rink, corrosion of steel and iron structures, and mold attack. In addition, the facility microclimate is uncomfortable for people to stay there. During this study, the authors identified several ways to achieve the necessary indoor air parameters. The first method is sorption dehumidification. This system can function at low temperatures and cope with extreme dampness, but it has significant costs. The second method, which is simpler and more effective, is assimilation. This method is based on the ability of warm air masses to hold a larger amount of water vapor than cold air masses. This method for improving the air parameters is more effective when required to modify an existing ventilation system. In this particular case, in the ice arena in Sochi, assimilation was the most effective method. Air coolers with a drift eliminator were installed in the existing ventilation system. The calculation of the selected heat exchangers was performed using ventilation equipment selection software (VESS).
Procedure for calculation and analysis of transcritical cycle CO2 with parallel compression and ejector
Authors: Talyzin Maksim S.
Published: March 2024

Attempts to reduce the negative impact on the environment have led, among other things, to the use of so-called natural refrigerants. One of which is SO2.
At food processing enterprises, this refrigerant is used in two main cycles - cascade and transcritical.
Along with the negative impact on the environment, it is also necessary to take into account the increase in the efficiency of refrigeration plants, which is especially important for transcritical cycles.
The purpose of the study was to develop a method for calculating and analyzing the transcritical cycle of SO2 with parallel compression and an ejector.
The calculation of the transcritical cycle is based on the fundamental laws of thermodynamics, the analysis method is based on the entropy-statistical method of thermodynamic analysis. Cycle calculation includes analysis of compression loss by system components.
Description of operation of transcritical cycle of SO2 with parallel compression and ejector with two temperature levels is given, procedure of calculation and analysis of losses in elements of refrigerating unit operating according to transcritical cycle of SO2 with parallel compression and ejector is given.
The use of this method allows you to identify the elements and processes with the greatest losses and take further measures to improve the efficiency of the refrigeration system.
Method for evaluating efficiency of refrigeration units based on compression cycle with economizer
Authors: Talyzin Maksim S.
Published: March 2024

The transition to the so-called “digital economy” requires the development of automation tools, and, therefore, algorithms based on which it will be possible to create intelligent control systems.
At the same time, do not forget that the control and monitoring tools themselves are not an end in themselves. Automation must solve certain problems, relying on a data collection system (monitoring system). One of these tasks is energy saving. Since the share of electricity costs for refrigeration equipment is a significant part of the country’s energy balance, energy conservation issues are paid a lot of attention at the state level (Federal Law No. 261-FZ “On Energy Saving and Energy Efficiency and on Amending Certain Legislative Acts of the Russian Federation”).
Existing systems for monitoring the operating parameters of a refrigeration plant are often used only to detect emergencies and alarm them, however, an intelligent analysis system can be built on the basis of recorded data to optimize the operation of the refrigeration plant in real time.
This article describes the methodology for assessing the energy efficiency of refrigeration plants operating on a cycle with an economizer and allowing to evaluate both at the design stage and during the operation of the refrigeration plant, and allows to obtain a distribution of losses by elements and processes of the refrigeration plant.
lateSearching for the most energy-efficient composition of a mixture of dimethyl ether and carbon dioxide as an air conditioning system refrigerantr
Authors: Zharov Anton A. , Kazakova Anastasiya A. , Grigoryan Mikael A. , Kovalchuk Nikita A.
Published: March 2024

BACKGROUND: Carbon dioxide can be an alternative refrigerant for vapor compression refrigeration systems, particularly air conditioning systems (ACSs). However, its use suffers from the increased pressure in the refrigeration circuit. To solve this, for its reduction, a mixture of CO2 with a substance that has significantly lower pressures under the same conditions can be developed, for example, dimethyl ether (DME), which has zero GWP and ODP, is inexpensive and readily available. The study of DME, in particular, was conducted by the Department E4 “Refrigeration and Cryogenic Engineering, Air Conditioning and Life Support Systems” of N.E. Bauman Moscow State Technical University. DME is moderately toxic and flammable.
AIM: This study aims to investigate the possible use of a mixture of DME and carbon dioxide for energy-efficient application in ACSs using commercially available compressors for R410A.
METHODS: Comparative calculation analysis of the characteristics of a simple one-stage vapor compression cycle was performed using R410A and a mixture of DME and CO2 using the calculation packages Mathcad 15, Aspen HYSYS v. 10, SOLKANE8, and REFPROP.
RESULTS: 1. The cycle on pure DME is the most effective in terms of the coefficient of performance: ε = 5.63 at an ambient air temperature of 26°C, ε = 3.07 at 40°C. 2. It is necessary to consider the influence of temperature glides, the average value of which ranges from 10°C to 30°C depending on the concentration of components. 3. At DME/CO2 ratios of 40/60% and 60/40% (in mole fraction), the discharge pressure corresponds to the discharge pressure in the R410A cycle, with 39.62 bar at an ambient temperature of 26°C and 37 bar at 40°C, respectively.
CONCLUSIONS: An environmentally friendly mixture of DME and CO2 with low GWP and zero ODP is developed. An increase in the percentage of DME in the mixture increases the coefficient of performance and reduces the pressure range, and at the same time, significant temperature glides arise, which affects the installation efficiency, namely, the transition to a cycle with a receiver tank, i.e., with a recuperative heat exchanger between the fluorinated refrigerant flow leaving the evaporator and the fluorinated refrigerant flow leaving the condenser. The developed mixture is less efficient than the R410A refrigerant in terms of the coefficient of performance and discharge pressure. However, it is possible to further consider a mixture of DME and CO2 with concentrations of 40% and 60%, respectively, as a replacement for the R410 refrigerant because there is a correspondence of discharge pressures for serial compressors (about 40 bar); however, it is necessary to keep in mind the flammability risk of the mixture.
laterAnalysis of the energy efficiency of an environmental control system of a passenger aircraft by using the entropy-statistical method
Authors: Tishchenko Igor V. , Abalakin Sergey A. , Merkulov Vladislav I. , Zharov Anton A. , Borisenko Artem V.
Published: March 2024

BACKGROUND: Aviation designers are striving to increase fuel efficiency of aircraft, including by increasing the efficiency of aircraft environmental control systems by reducing losses in its components.
AIM: This study performs an entropy-statistical analysis of the environmental control system of a passenger aircraft assesses efficiency losses in the units included in it.
MATERIALS AND METHODS: A static mathematical model of an environmental control system with moisture content control was developed to calculate the system parameters in various operating modes, for which an entropy-statistical analysis was performed.
RESULTS: Using entropy-statistical analysis, the main units of the system were examined, their influence on the overall efficiency of the environmental control system was assessed, and the advantages of the given method of entropy-statistical analysis for such systems were outlined. The mathematical model was developed using the Matlab Simulink software package.
CONCLUSIONS: A static mathematical model of an environmental control system with a three-wheel air cycle machine unit and a “loop” high-pressure dehumidification system was developed. An entropy-statistical analysis of the system was performed. The influence of the units included in the system on the efficiency of the system as a whole was assessed.
Histological Visualization of Glyceraldehyde-Derived Glycation with Glucose using Ultrasound Microscopy
Authors: Miura Katsutoshi , Iwashita Toshihide
Published: March 2024

Background: Reducing sugars and reactive aldehydes, such as glyceraldehyde (GA), non-enzymatically react with proteins to form advanced glycation end-products (AGEs). GA is produced in the glycolysis pathway, and GA-derived AGEs play an essential role in the pathogenesis of angiopathy associated with hyperglycemia in patients with diabetes. Aims: Several studies have reported on chemical alterations in glycation. However, histological confirmation of these biochemical changes has been relatively rare. This study aimed to visualize glyceraldehyde-induced glycation and evaluate the severity of glycation using attenuation of sound (AOS) values. Given that glycation promotes cross-links between proteins and sugars, the energy loss of sound that passes through them increases. We hypothesized that AOS alteration would reflect the glycation state of the tissues and cells. Methods: Fresh frozen sections or fresh cells were briefly fixed in ethanol and soaked in GA with different glucose concentrations. Thereafter, AOS images were obtained via scanning acoustic microscopy over time, and tissue and cellular glycation induced by GA with glucose was evaluated using AOS values. Results: AOS images were able to visualize GA-induced glycation over time. Compared to GA alone, glucose supplements concentration-dependently accelerated glycation. The arterial smooth muscle, collagen, and intima were apt to accept glycation, whereas the mucosa was unaffected. Conclusion: The comparability and digital nature of AOS images make them suitable for statistical analysis of glycation. Higher glucose concentrations promoted a greater increase in the AOS values of the sections and cells. Moreover, the increase in AOS values varied according to organs and cells, which supports the difference in affected organs among patients with diabetes mellitus. Our findings suggest that a longer hyperglycemic state promotes greater glycation.
Safety and Efficacy of Hydrus and I-Stent inject combined with Phacoemulsification in Primary Open Angle Glaucoma Patients: 2 year follow up study
Authors: Sharma Bhavesh , Khan Habib , Sinha Aprajita , Chakrabarti Monali , Sharma Tarun
Published: March 2024

Aims: To compare the safety and efficacy of phacoemulsification combined with two individual kinds of trabecular bypass micro-stent device insertion. This study compares Phacoemulsification with Hydrus stent versus phacoemulsification combined with I-Stent inject W in patients with medically uncontrolled primary open-angle glaucoma (POAG). Material and Methods: A retrospective comparative case series. Results: Eighty eyes of 75 patients with 2 years completed follow-up after combined phacoemulsification with trabecular by-pass stent (s) were included. Forty eyes of 37 patients had Hydrus stent (Hydrus Group-PH) and the other 40 eyes of 38 patients had I-stent inject W (I-stent Group-Pi) insertion combined with phacoemulsification and intraocular lens implantation. Patient demographics and preoperative characteristics of the two groups studied are comparable. A post-operative decrease of 20 percentage or more in the IOP was achieved in 33 eyes (82.5%) in PH group and 30 eyes (75%) in Pi group (p=0.57). The Hydrus group (PH) had a post-operative reduction in the mean number of medications in 22 eyes (55%) in comparison to 18 eyes (45%) in the I-stent group (Pi). Second stage trabeculectomy was avoided in 31 eyes (77.5%) in the Hydrus group and 27 eyes (67.5%). There was no significant difference in rate of complications between two groups. Conclusion: Both Hydrus stent and I-stent inject W combined with phacoemulsification and intra-ocular lens implantation, are efficacious and safe for treating patients with medically uncontrolled mild and moderate primary open-angle glaucoma (POAG). The reduction in the mean IOP and in the mean number of post-operative glaucoma medications was higher for the patients in Hydrus stent group than in I-stent inject W group.
Preparation, and antibacterial activity of chitosan derivative containing double quaternary ammonium salt and hydantoin structures
Authors: Hu Yiting , Xie Xiaojiang , He Jingwei , Liu Fang
Published: March 2024

Chitosan quaternary ammonium salt antibacterial agents with a single structure have the drawbacks of slow bactericidal speed and poor bactericidal effect, which cannot meet the practical usage requirements. To address the problem, in this study, we designed and synthesized a novel chitosan derivative containing double quaternary ammonium salt and chloride hydantoin structures (QCS-CA-DEADH-Cl) by using chitosan, 5,5-dimethyl hydantoin, methyl iodide, and 2-Dimethylaminoethyl chloride hydrochloride as the main raw materials, and then used as antibacterial agent. The structure of QCS-CA-DEADH-Cl was characterized by Fourier transform infrared spectra, X-ray photoelectron spectroscopy, Thermogravimetric, and Scanning electron microscopy. The antibacterial activity of QCS-CA-DEADH-Cl, and the renewability and stability of N-Cl structure in QCS-CA-DEADH-Cl were explored. The results indicated that the N-Cl structure of QCS-CA-DEADH-Cl has strong renewability and storage stability. Moreover, the synergistic effect of quaternary ammonium salt structure and N-Cl structure endowed QCS-CA-DEADH-Cl with excellent antibacterial activity. This work does not only provide a new perspective for the preparation of novel chitosan antibacterial agents but also contributes to expanding the comprehensive utilization of biomass resources.
Assessment of the progression of public investment in cataract surgery in Brazil
Authors: ROSSI Silvana , DAMIÃO Amanda , COSTA Samuel , HORTA Guilherme , KARA-JUNIOR Newton
Published: March 2024

Aim: This study aimed to evaluate the progression of public investments in cataract surgery in Brazil and its correlation with the growth of the elderly population and the gross domestic product (GDP) between 2010 and 2021. Methods: This descritive, retrospective study analyzed data from public databases recording surgical procedures and the amounts invested per surgery to treat senile cataracts, performed per year and by region by the Unified Health System in 2010 and 2021. Results: The number of cataract surgeries performed by Brazil’s public health system increased by 79.77%, from 356,088 in 2010 to 640,408 in 2021, while the population aged >60 years increased by 50.08%. The increase in the number of surgeries resulted from greater public investments in the area (an increase of 26.61% in corrected values), which was consistent with the increase in the GDP during the period (30.88% in corrected values). Conclusions: The progression of public investments in cataract surgery from 2010 to 2021 was similar to the increase in GDP of Brazil. Moreover, the increase in the number of surgeries performed by the public health system offset the increase and aging of the population and also reduced the proportion of accumulated cases of cataract-related blindness. However, the improvement was not homogeneous, demonstrating the need to adopt public policies based on regional epidemiological evidence.
Psoriasis as a Risk Factor for Skin Cancer: An International, Propensity-Matched Retrospective Cohort Study
Authors: Malick Hamza , Cho Seo , C. Lauck Kyle , Firdaus Aaisha , Kivelevitch Dario
Published: March 2024

Psoriasis, a chronic immune-mediated skin disorder impacting millions globally, is increasingly recognized for its links to various disease processes. As our understanding of immune dysregulation in psoriasis progresses, acknowledging the pivotal role of dysregulated T-cells in the pathogenic development of the persistent inflammatory state becomes crucial. This immune dysregulation and the resulting prevalent inflammatory state have raised concerns about psoriasis potentially serving as a significant comorbidity in cancer development among patients. To contribute to this discussion, we conducted a global retrospective cohort study with propensity score matching (PSM) using the TriNetX Analytics platform. The study aimed to investigate whether patients diagnosed with psoriasis face an elevated risk in the development of cutaneous malignancies, encompassing both melanoma and non-melanoma skin cancers. Our findings confirmed a noteworthy concern, revealing a significantly increased risk of developing cutaneous neoplasms in individuals with psoriasis. In conclusion, our study underscores the importance of heightened awareness and the necessity for routine skin cancer screenings in this unique patient population. The observed association between psoriasis and an increased risk of cutaneous neoplasms highlights the need for proactive medical interventions and emphasizes the potential impact of psoriasis as a comorbidity in the context of cancer development.
The Relevance of World Health Organization Surgical Safety Checklist to Spinal Surgery
Authors: Munigangaiah Sudarshan , Davies-Jones Gareth
Published: March 2024

Across the 193 member states of the World Health Organization (WHO) an estimated 234 million operations were conducted worldwide in 2008 (1 per every 25 human beings on the planet). These numbers have continued to increase to 312.9 million by 2016. Surgical errors involving the wrong site, wrong procedure or wrong patient occur at a rate of 1 in 112,000. This equates to 2,000 estimated ‘never events’ every year with a significant associated physical and psychological burden on patients and surgeons and financial and reputational burden on health organisations involved in litigation for such errors. The WHO Surgical Safety Checklist (WHOSSC), produced in 2009 is now synonymous with safety in the operating theatre. This checklist imposes a process of scrutiny at the key steps of the patients journey through theatre. The key details scrutinised have been shown to improve patient outcomes and theatre efficiency. Several studies have looked at adapted checklists specific to different specialties and it is becoming clearer that whilst the overall benefit of the original checklist is undeniable, in some speciality areas a more deliberate and nuanced application of the checklist to address specific problems could be of value. As a specialism, spinal surgery differs from others with a significant risk of a perioperative complication leading to harm and morbidity, permanent disability or even death. Iatrogenic spinal cord injury requires high-level resources and prolonged, sometimes lifelong rehabilitation. Other complications include cerebrospinal fluid leak, blood loss, new neurologic deficit, hardware failure, proximal junctional failure, pseudarthrosis, and surgical site infection. Wrong level spinal surgery (WLSS) is a complication specific to spinal surgery and studies have reported WLSS effecting 50-68% of spinal surgeons at some point in their career. The risks of these complications can be mitigated by factors, some of which are included in the WHOSSC and others with are lacking. This scoping review looks at how surgical checklists; both the original and modified versions have and could be used to address the surgical safety challenges specific to spinal surgery.
Combination of Transcranial Direct Current Stimulation and Action Imitation Training in Post- Stroke Aphasia Rehabilitation: Implications from a Single Case Study.
Authors: Varini Matteo , Zettin Marina , Gai Marta , Dimitri Danilo
Published: March 2024

Background. One of the most used non-invasive brain stimulation (NIBS) techniques in aphasia rehabilitation is Anodal Transcranial Direct Current Stimulation (A-tDCS). Its application is supported by the fact that brain plasticity, when facilitated by language intervention, can be improved by non-invasive brain stimulation. The effects of neuromodulation combined with various language and communication therapies have led to promising results in the rehabilitation of patients presenting with acquired aphasia. An Action Observation Therapy such as IMITAF seems to contribute to improvements in language skills, mainly in naming. This experimental clinical protocol aims to investigate the rehabilitative potential of A-tDCS on perilesional areas, combined with computerized neuropsychological training. Method. Participant: Mr. V., 66-year old right-handed male, Italian native speaker. The patient suffered an ischemic stroke due to left carotid artery dissection which resulted in right hemiparesis, mixed transcortical aphasia, characterized by non-fluent speech and dysarthric and disfluent speech. Treatment: The subject underwent unipolar montage stimulation, with anode placed in F5 and intra-cephalic reference on Fp2. For safety reasons, a stimulation intensity of 1.5 mA was applied for 20 minutes once a day in combination with IMITAF level I, which required the subject to repeat bisyllabic words. Procedure: The stimulation protocol lasted a total of 4 weeks and was divided into 2 different modes. Clinical Training: 40-minute treatments (no.10 sessions) and involved the combined administration of a-tDCS (20-minute online mode) and 40-minute training. Home-Based Training: 40-minutes trainig carried out at the patient’s home, via PC (no. 8 sessions). Results. Mr. V. completed the protocol treatment sessions without reporting any adverse effects, such as scalp redness, tingling or headache. The results showed an improvement in the auditory/visual comprehension of words/sentences after A-tDCS and Action Observation Therapy, which has maintained one month after treatment. Conclusions. Together with IMTAF neuropsychological training, the constant and repeated use of A-tDCS, on the perilesional areas, contributed to improvements in language skills thus promoting an overall recovery of communicative skills in an individual with chronic post-stroke non-fluent aphasia.
Hypoxia-Inducible Factor mediates the Release of Natriuretic Peptides
Authors: Arjamaa Olli
Published: March 2024

Background: The physiology of natriuretic peptides is insufficiently known. The function of mechanical heart alone, mediated by large and rapid volume overloads, has been suggested to be the key operator in the synthesis and release of natriuretic peptides from the endocrine heart. Researchers have concluded that terrestrial mammals, including humans, have a powerful endocrine system that responds to the mechanical stress of the heart by causing instantaneous diuresis and natriuresis. Although one of the most important and valid paradigms in cardiology is that mechanical load increases the oxygen consumption of heart, the investigation of the relationship between mechanical load and oxygen metabolism has been neglected in the studies on circulating natriuretic peptides. Purpose: To develop a comprehensive conceptual model explaining how the oxygen metabolism plays a central role in the biology of natriuretic peptides. Conclusions: All cells including cardiac myocytes, share an oxygen sensing pathway which is regulated through a nuclear transcription factor, the Hypoxia-Inducible Factor. When the oxygen concentration is normal Hypoxia-Inducible Factor is rapidly oxidized, whereas in hypoxic conditions, Hypoxia-Inducible Factor starts to accumulate and trigger downhill the expression of hundreds of genes such as the genes for A-type and B-type natriuretic peptide. As a result of diuresis, natriuresis, and plasma shift from intravascular space to extravascular space, circulating natriuretic peptides cause volume contraction and hemoconcentration contributing to the transport of oxygen into tissues and organs. Implications: Understanding the biology of natriuretic peptides in cardiac diseases would increase the usefulness of plasma measurement of natriuretic peptides.
Racial Disparities in Telemedicine Uptake during the COVID-19 Pandemic among Patients with Hematologic Malignancies in the United States
Authors: Neparidze Natalia , W. Lau Krystal , Wang Xiaoliang , Huntington Scott , Jamy Omer , S. Calip Gregory , Shah Harsh , M. Stephens Deborah , Miksad Rebecca , Parikh Ravi , Takvorian Samuel , Goyal Gaurav , Seymour Erlene
Published: March 2024

Background: The COVID-19 pandemic impacted healthcare visit trends, transitioning care to utilize telemedicine. We aimed to investigate if the uptake in telemedicine during pandemic was equitable across racial groups for patients with hematologic malignancies. Methods: Using the nationwide Flatiron Health electronic health record (EHR)-derived de-identified database we analyzed patients with diagnosis of acute myelogenous leukemia (AML), diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL) or multiple myeloma (MM). Patients were categorized into treatment types within lines of therapy: outpatient (oral therapy and outpatient infusions combined with oral therapy) vs. inpatient treatments (chemotherapy, cellular therapy). Monthly visit rates were calculated as the number of visits (telemedicine or in-person [in-clinic treatment administration, vitals, and/or labs]) per active patient per 30-day standardized month. We used time-series forecasting methods on pre-pandemic monthly visit rate data (March 2016 - February 2020) to estimate projected counterfactual monthly visit rates between March 2020 - February 2021.Telemedicine uptake was descriptively analyzed over time (t). Results: We included 18,924 active patients (2,394 Black and 16,530 White) and 884,504 visits (117,673 Black and 766,831 White). 4,053 AML, 3,468 diffuse large B cell lymphoma, 1,943 follicular lymphoma, 2,151 mantle cell lymphoma, 5,926 chronic lymphocytic leukemia and 7,752 myeloma patients. Black patients had no significant reductions in in-person visit rates throughout the pandemic period compared to the projected rates. Conversely, White patients experienced an 18% (95% PI 9.9% - 25%) lower rate of in-person visits for outpatient therapy during the early pandemic (March - May 2020) (actual monthly visit rate 1.61; projected visit rate 2.0 [95% CI 1.8-2.2]). Telemedicine uptake was significantly higher for White patients compared with Black patients for all diseases and treatment categories between March 2020-February 2021 (t = 9.5, p < 0.01), AML inpatient (t = 2.4, p = 0.04), MM outpatient (Figure 3C) (t = 6.0, p < 0.01) and MM inpatient treatment categories (Figure 3D) (t = 2.3, p = 0.04). Conclusions: White patients had significantly higher telemedicine uptake compared with Black patients for all treatment categories. These findings challenge healthcare systems to direct efforts toward reducing the gap in healthcare access.
Improved Management of sickle cell pain crisis in a Pediatric Emergency Department through Use of Intranasal Fentanyl.
Authors: Agarwal Pallavi , Burns James , Smith Erlyn
Published: March 2024

Introduction: National Heart, Lung, and Blood Institute recommends giving the first dose of opioids within 30 minutes of presentation to the emergency department for sickle cell disease patients with moderate to severe vaso-occlusive crisis. Intranasal fentanyl has been used extensively and shown to reduce time to the first dose of analgesic, improve pain scores at 20 minutes, and increase the odds of getting discharged from the emergency department. Material and methods: For phase one of the project, baseline data was collected. The new pain algorithm was introduced at the start of the second phase, which involved giving intranasal fentanyl as the first analgesic for vaso-occlusive crisis in the emergency department. After the intervention, the second analysis compared outcomes with phase one. Wilcoxon-Mann-Whitney tests were used for comparing data between phase one and phase two and Wilcoxon signed-rank tests (paired version) were used for comparing pain scores before and after analgesic. Results: Visits at phase two had significantly lower hospitalization rate [phase one 53.5% vs. phase two 34.2%(p value 0.005)], more fentanyl use [phase one 1.5% vs. phase two 50.6% (p< 0.001)], less patient-controlled-analgesia (PCA) opioid use after admission [phase one 13.0% vs. phase two 2.53% (p= 0.016)], higher compliance with outpatient visits [phase one 61.3% vs. phase two 98.7% (p < 0.001)], shorter length of hospital stay [phase one 117.6 ± 112.7 hours vs. phase two 68.3 ± 47.2 hours (p-value 0.01)], decrease in the time to first analgesic after coming to the emergency department (phase one 78.2 ± 131.2 minutes vs. phase two 38.3 ± 31.2 minutes (p 0.85)], and decrease in the mean pain score after first medication in the emergency department [phase one 5.48 ± 3.12 vs. phase two 4.46 ± 2.88 (p value 0.021)] Conclusion: Intranasal fentanyl led to more effective and timely management of vaso-occlusive crisis with improvement in clinical outcomes compared to standard management.
Role of self-efficacy, knowledge sharing, mediated adaptability and external environment change as moderators of readiness for change
Authors: Rismansyah  , Adam Mohamad , Badia Perizade , Yuliani Yuliani
Published: March 2024

It is vital for higher education to improve its ability to anticipate and implement long-lasting change. Private higher education institutions are currently facing challenges in governance that hinder their ability to upgrade their accreditation grade to "excellent ".  The involvement of institutional management is a key factor in enabling these institutions to compete on a national and international level. Research methodology uses confirmatory factor analysis to test the hypotheses developed while structural equation modeling is employed as the equation model. The sample population comprised 16 private tertiary institutions in South Sumatra, Indonesia. The study focused on the heads of study programs resulting in a total of 195 respondents.  The results indicated that self-efficacy and knowledge sharing did not have a direct impact on readiness for change whereas adaptability exhibited a direct influence. The study demonstrated that adaptability acts as a mediator between self-efficacy and knowledge sharing towards readiness for change. The final model test results confirmed adaptability as a mediating variable. Additionally, the study revealed that external environmental change did not moderate the relationship between adaptability and readiness for change. Changes of a high calibre that promote a sustained digital education transformation are necessary due to the real-world effects on Indonesia's higher education system. The ability to adapt and embrace new technology is very important factors for higher education performance to face readiness for change in private higher education, especially in management units.
Comparison of the Effect of Temperature and Different Culture Media on the Possibility of Growth of Salmonella Typhimurium (ATCC: 14028)
Authors: Eslami Nazila , Anzabi Younes , NourAzar Mir Alireza
Published: March 2024

Background and Aims: Gastrointestinal infection with Salmonella serotypes, especially Typhimurium, is common worldwide. One of the important points regarding the isolation of Salmonella is its similarity with other microbial flora, which makes it difficult to isolate it. Therefore, it is very important to choose the correct separation method. This study aimed to compare the growth rate of Salmonella in different cultural environments and the effect of temperature and enrichment on it.
Materials and Methods:  24 out of 36 Ross breed broilers were infected with the bacteria to obtain stool samples containing Salmonella Typhimurium. One McFarland dilution was given to chickens for experimental infection. After the confirmation of the infection, the culture was started in days for 7 consecutive days. From 2 media enriched with Tetrathionate broth and Selenite Cysteine broth and 3 selective culture media, Xylose lysine Deoxycholate agar, Brilliant Green agar, and McConkey agar for culture were used. All cultures were examined at 2 temperatures of 37°C and 42°C in terms of growth rate. The Kappa test was used for data analysis.
Results: The results showed no difference between tetrathionate and selenite cyane enrichment media (k=0.81). Agreement between Xylose Lysine Deoxycholate and McConkey (k=0.33), agreement between Xylose Lysine Deoxycholate and Brilliant Green (k=0.57), and agreement between Brilliant Green and McConkey (k=0.80), were obtained. The agreement between 37°C and 43°C was < 0.1.
Conclusion: According to the results obtained, using an Xylose Lysine Deoxycholate culture medium and incubation at 42°C are recommended to isolate Salmonella Typhimurium from fecal samples.
Immunologic Factors and Genomic Considerations in Recurrent Pregnancy Loss: A Review
Authors: Montazeri Fateme , Tajamolian Masoud , Hosseini Elham Sadat , Hoseini Seyed Mehdi
Published: March 2024

Recurrent pregnancy loss (RPL), which is also known as repeated miscarriage, affects around 2-3% of women who are trying to conceive. While some factors contributing to RPL have been identified, the cause of almost half of all cases remains unknown. Immunological factors have been proposed as one of the potential causes of such miscarriages. However, it is hard to track the common factors leading to RPL since the individual genomic identity of aborted fetuses is different in a family like other siblings. The immunological factors involved in the pathogenesis of miscarriage generally result from either the function of the maternal immune system attributable to her genomic background or the fetal origination established by both maternal and paternal genomic backgrounds that constitute the fetal genome.
Protein S Deficiency with Two Novel PROS1 Gene Variants
Authors: Soleymani Niloofar , Rezvany Mohammad Reza , Shams Mahmood , Dorgalaleh Akbar , Tabibian Shadi , Zaker Farhad
Published: March 2024

Background and Aims: Protein S (PS) is a vitamin K-dependent glycoprotein synthesized by endothelial and somatic cells that acts as an anticoagulant in its free form and an inhibitor of the complement system in its bound form. Deficiency of PS is a congenital thrombophilia that can have significant clinical consequences. This study aimed to report the clinical and genetic characterization of four Iranian patients with PS deficiency.
Materials and Methods: In this study, we investigated the genetic basis of PS deficiency in four Iranian patients from three unrelated families, including two females and two males with a mean age of 32.5(± 25.73) years. Whole blood was collected to measure PS total antigen levels and isolated genomic DNA, which was then amplified using polymerase chain reaction to direct sequencing of the PROS1 gene with the Sanger method. Each novel variation was subjected to in silico analysis.
Results: Two novel variants in the PROS1 gene were identified: c.-196 C > G in exon 1 and c.198A > C in exon 2. In this setting, both variants were present in a heterozygous state in patient C1 and a homozygous state in patient C2. In addition, a silico analysis was conducted to assess the impact of the identified variants, showing that the c.198A > C variant was likely detrimental and the c.198A > C variant was likely pathogenic.
Conclusion: The results highlight the heterogeneity of PS deficiency and the need for further investigation to identify additional mutations and understand the genetic basis of this condition in the Iranian population.
Evaluation of Serum Levels of Anti-Helicobacter pylori IgG and IgA by ELISA Method in Patients with Gastric Ulcer in Chalous, Iran
Authors: Taravat Arezoo , Bashi Zadeh Fakhar Haniyeh , Shaghai Babak , Rouhollah Fatameh
Published: March 2024

Background: Considering the role of Helicobacter pylori in various diseases such as chronic gastritis, gastric ulcer and malignancies, this study was performed to evaluate the level of antiHelicobacter pylori antibodies in the serum of the population of Chalous and then its relationship with demographic characteristics.
Methods: A descriptive study was conducted in the department of Microbiology in a tertiary care teaching hospital during December 2019 to May 2021. All hospitalized patients with diarrhea, who had a history of exposure to antibiotic drugs and all patients with IBD were included in the study. Stool samples were collected from all patients with diarrhea who have been on antibiotic or anticancer drug during last 6weeks or previously diagnosed case. Patient’s demographic features and clinical details were collected from medical records.
Results: About 78% of people had IgA positive titer and about 48% had IgG positive titer. Serum IgA level in patients with bloating (P = 0.005) and in patients with nausea (P = 0.016) was statistically significant. Also, in patients studied there was a significant relationship between bloating (p = > 0.001), nausea (0.013) was seen with a serum IgG level .
Conclusion: Due to the high percentage of positive titers of anti-Helicobacter pylori antibodies, especially IgA in the sample population, it seems that the follow-up of positive serological titers will help to prevent and control the prevalence of Helicobacter pylori infection.
Incidence of Clostridium difficile in Patients with Antibiotic Associated Diarrhea
Authors: Babu P Iswarya , Valsan Chithra , M Ardra , Paul John
Published: March 2024

Background: This study was performed to determine the magnitude of Clostridioides difficile infection (CDI) in a tertiary care hospital in patients with antibiotic associated diarrhea (AAD) and to study the risk factors associated with this disease.
Methods: A descriptive study was conducted in the department of Microbiology in a tertiary care hospital during December 2019 to May 2021. Stool samples were collected from patients with signs and symptoms of AAD who had been consuming antibiotic or anticancer drugs durng six weeks before the sampling. The samples were subjected to C. difficile glutamate dehydrogenase (GDH) enzyme and CD toxin A & B detection by Enzyme Linked Fluorescent Assay (ELFA). Patient’s demographic features and clinical details were noted and statistically correlated with the test results
Results: Among the total 70 samples tested 20 (28%) were positive for GDH alone and 12 (17%) were positive for both GDH and CD toxin A and B. Fluoroquinolones was a significant risk factor in the study. Sepsis and colitis was found to have significant association with C.difficile infection in our study. The crude mortality rate was 17%.
Conclusion: Prompt and precise diagnosis and knowledge about the risk factors of CDI helps in effective management and prevention of CDI.
Prevalence of Streptococcus agalactiae in Urinary Tract Infections of Pregnant Women
Authors: Saghabashi Ahdiyeh , Rostami Khadijeh , Allameh Maryam , Khaledi Mansoor , Afkhami Hamed , Fathi Javad , Parvizi Rahmatullah , Esmkhani Mohammad , Dezfuli Aram Asareh Zadegan , Shahriary Shamin , Mahjoor Mohamad
Published: March 2024

Background: Urinary tract infection is the most common bacterial infection in children and adults, especially females. Among urinary tract infection caused by bacteria, Streptococcus agalactiae can cause periodic, temporary, or persistent infection in women. The aim of this study was to evaluate the prevalence of S. agalactiae isolated from urine samples in pregnant women referred to Qom hospitals, Iran.
Methods: In this descriptive study, 1264 pregnant women suspected for urinary tract infection were assessed. Midstream urine specimens collected from pregnant individuals in Ali-ibn-AbiTaleb hospital medical laboratory were passaged on blood agar media. Streptococcus agalactiae was detected using phenotype-based tests. Then, antibiotic susceptibility tests were conducted using the disc diffusion method according to CLSI protocols.
Results: Out of 1264 pregnant patients, 17.64% were diagnosed with beta-hemolytic Streptococcus, and 13.37% were diagnosed with S. agalactiae. The highest rates of antibiotic resistance were found for Clindamycin and Erythromycin. In place, the lowest resistance rate was detected for Nitrofurantoin. The prevalence of resistance to Penicillin was about 33%.
Conclusion: Regarding the results of this research, it would be better to perform urine culture tests before week 34 of pregnancy and the last weeks of pregnancy. Also, our results showed that Penicillin can be replaced by alternative antibiotics before week 34 of pregnancy to prevent further S. agalactiae antibiotic resistance.
Lucilia sericata Maggot Extract: A Promising Tool against Biofilms of Antimicrobial Resistant Strains of Staphylococcus aureus and Pseudomonas aeruginosa
Authors: Rashid Sara , Momeni-Moghaddam Madjid , Ghavidel Zahra
Published: March 2024

Background: This study explores the impact of Lucilia sericata maggots on the development and eradication of biofilms created by the pathogenic bacteria, Staphylococcus aureus and Pseudomonas aeruginosa.
Methods: We assessed the influence of Lucilia sericata maggot extract on the viability of planktonic bacteria, the formation and disruption of biofilms, bacterial metabolic activity. Also the effect of simultaneous ES-antibiotic treatment in biofilm elimination was investigated. Additionally, the expression levels of genes associated with biofilm formation, namely LasI, psLA, agrA, and icaD was studied.
Results: The results showed that ES can reduce the viability of planktonic S. aureus, significantly. Furthermore, ES of larvae fed on S. aureus-infected meat displayed the most substantial inhibition of biofilm formation (62.11% and 75.04% inhibition for S. aureus and P. aeruginosa, respectively). A similar trend was observed in biofilm destruction, with values of 56.67% and 68.50% inhibition for S. aureus and P. aeruginosa, respectively. The simultaneous application of ES of larvae that fed on S. aureus-infected meat and the minimum inhibitory concentration (MIC) of gentamicin resulted in 100% inhibition of biofilm formation by S. aureus. Notably, the group treated with ES of larvae fed on S. aureus-infected meat exhibited the most significant reduction in metabolic activity, with values of 95.03% and 68.25% for S. aureus and P. aeruginosa, respectively. The expression of LAsI and pslA genes in P. aeruginosa and the expression of agrA and icaD genes in S. aureus has decreased
Conclusion: The findings of this study demonstrate that maggot extract has not only impacted the formation, but also eliminated the biofilms of S. aureus and P. aeruginosa.
Teachers’ Perception Towards Inclusive Education
Authors: Manguilimotan Ramil P. , G. Padillo Gengen , C. Sanchez Jaquelyn , O. Elaba Jean Rea , M. Albos Cheryl , G. Capuno Reylan , C. Espina Raymond , D. Peteros Emerson
Published: March 2024

This study aimed to assess the perception of teachers handling inclusive education at the identified public elementary schools in Loon South District, Bohol Province, for the school year 2022–2023 as the basis for instructional skills enhancement plans. The respondents comprised three clusters of grades one to six teachers handling inclusive classes. The respondents were selected using universal sampling and treated using inferential and descriptive statistics. Results showed that most respondents aged 44-53 were female, married, with master units, specialized in general education, and taught for 8-14 years. Moreover, the level of perception of the respondents towards inclusive education was very positive. It was also found that there was no significant difference between respondents’ profile and their perceptions of inclusive education. Therefore, results showed that respondents were very optimistic about handling inclusive classes. It is recommended that the instructional enhancement plans be implemented for a more positive learning experience when dealing with inclusive classes.