bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond research: improved perinatal care through scale-up of a Moyo fetal heart rate monitor coupled with simulation training in northern Tanzania for helping babies breathe
Authors: Munyaw Yuda , Gidabayda Joshua , Yeconia Anita , Guga Godfrey , Mduma Esto , Mdoe Paschal
Published: April 2022

Background

The purpose of this project was to improve perinatal survival by introducing Moyo Fetal Heart Rate (FHR) Monitor coupled with neonatal resuscitation simulation training.

Methods

The implementation was done at three district hospitals. We assessed health care workers’ (HCW’s) skills and perinatal death trends during implementation. Baseline data were collected from the hospitals before implementation. Newborn resuscitation (NR) skills were assessed before and after simulation training. Assessment of perinatal outcomes was done over 2 years of implementation. We used descriptive analysis; a t-test (paired and independent two-sample) and a one-way Anova test to report the findings.

Results

A total of 107 HCW’s were trained on FHR monitoring using Moyo and NR knowledge and skills using NeoNatalie simulators. The knowledge increased post-training by 13.6% (p <  0.001). Skills score was increased by 25.5 and 38.2% for OSCE A and B respectively (p <  0.001). The overall fresh stillbirths rate dropped from 9 to 5 deaths per 1000 total births and early neonatal deaths at 7 days from 5 to 3 (p <  0.05) deaths per 1000 live births over 2 years of implementation.

Conclusion

There was a significant improvement of newborn resuscitation skills among HCW’s and neonatal survival at 2 years. Newborn resuscitation training coupling with Moyo FHR monitor has shown potential for improving perinatal survival. However, further evaluation is needed to explore the full potential of the package.
Relationship between TIA minus C0-7 angle and C2-7 SVA: analysis of 113 symptomatic patients
Authors: Yang Kai , Li Xiang-Yu , Wang Yu , Kong Chao , Lu Shi-Bao
Published: April 2022

Background

Measurement of T1 slope (T1S) can be difficult due to the anatomical positioning of the shoulders. And thoracic inlet angle (TIA) was a morphological parameter and not changed by the position. We proposed a new parameter, TIA minus C0-7 angle (TIA-C07), to evaluate C2-7 SVA in order to overcome the T1S imperfection.

Methods

This was a retrospective radiological analysis of symptomatic subjects. The following cervical parameters were measured: Cervical lordosis angle (CL), C0-7 angle (C0-7), occiput-C2 lordosis angle (O-C2), C2-7 sagittal vertical axis (C2–7 SVA), TIA and TIA-C07. The Pearson correlation test was calculated, and the stepwise multiple regression analysis was conducted to determine the best predictor for C2-7 SVA. A paired sample t test was used to compare the predicted and measured C2-7 SVA.

Results

The mean age of 113 patients was 60.02 ± 9.67. The average O-C2, CL, C0-7, TIA, TIA-C07 and C2-C7 SVA was 29.24 ± 8.48°, 13.67 ± 11.22°, 42.91 ± 11.44°, 76.07 ± 9.54°, 33.16 ± 13.18° and 21.34 ± 11.42 mm. The predictive formula was founded: C2-7 SVA = 2.80 + 0.56 * (TIA—C07) (R = 0.645, R2 = 0.416). There was no statistical difference between the predicted and the measured C2-7 SVA (t = 0.085, P = 0.933).

Conclusions

TIA and C0-7 mismatch may significantly impact cervical alignment, and a greater T1A-C07 was related to a greater degree of C2-7 SVA. TIA-C07 may be a more important predictor for C2-7 SVA.
The blood–brain barrier and the neurovascular unit in subarachnoid hemorrhage: molecular events and potential treatments
Authors: Solár Peter , Zamani Alemeh , Lakatosová Klaudia , Joukal Marek
Published: April 2022

The response of the blood–brain barrier (BBB) following a stroke, including subarachnoid hemorrhage (SAH), has been studied extensively. The main components of this reaction are endothelial cells, pericytes, and astrocytes that affect microglia, neurons, and vascular smooth muscle cells. SAH induces alterations in individual BBB cells, leading to brain homeostasis disruption. Recent experiments have uncovered many pathophysiological cascades affecting the BBB following SAH. Targeting some of these pathways is important for restoring brain function following SAH. BBB injury occurs immediately after SAH and has long-lasting consequences, but most changes in the pathophysiological cascades occur in the first few days following SAH. These changes determine the development of early brain injury as well as delayed cerebral ischemia. SAH-induced neuroprotection also plays an important role and weakens the negative impact of SAH. Supporting some of these beneficial cascades while attenuating the major pathophysiological pathways might be decisive in inhibiting the negative impact of bleeding in the subarachnoid space. In this review, we attempt a comprehensive overview of the current knowledge on the molecular and cellular changes in the BBB following SAH and their possible modulation by various drugs and substances.
Keeping our children safe: piloting a hospital-based home-visitation program in Israel
Authors: Shalev Ligat , Luder Anthony , Spitzer Sivan , Krupik Danna , Essa-Hadad Jumanah , Rudolf Mary C. J.
Published: April 2022

Background

Unintentional childhood injuries are a leading cause of morbidity and mortality worldwide. Attempts to prevent child home injuries have rarely been implemented in hospital settings which present an important opportunity for intervention. The SHABI (‘Keeping our Children Safe; SHomrim Al BetIchut Yeladenu’) program recruits at-risk families presenting with child injury to the Emergency Department. Medical/nursing students conduct two home visits and provide safety equipment and guidance. The objective of this study was to investigate the impact of SHABI on participating families’ home-safety.

Methods

The pilot was conducted between May 2019 and March 2020 in northern Israel, an area with high child injury rates. Eligibility included families with preschool children who incurred a home injury. Home-safety was assessed by observation through the ‘Beterem’ checklist. Parents' views, knowledge, awareness of dangers and report of home injuries were assessed at the start of each visit.

Results

352 of 773 eligible families agreed to be contacted. 135 participated, 98 completed both home visits. Significant improvement in home-safety items was observed 4 months after the first visit (14 [IQR12-16]) vs. (17 [IQR15-19]; p < 0.001), accompanied by an overall increase in home safety (Mean ± SD 71.9% ± 9.5% vs. 87.1% ± 8.6%; p < 0.001). 64% reported greater awareness of dangers, 60% affirmed home was safer, and 70% valued the equipment. No difference was found in the prevalence of injuries (14 of 98 families prior and 8 after the visit; p = 0.17). Home visitors reported benefiting from the experience of working with disadvantaged families.

Conclusion

The program, which included recruitment in a hospital emergency setting and use of healthcare students as home visitors, was successfully implemented and accompanied by significant improvement in home safety with a non-significant trend of child injury decrease.
Sertoli cell and spermatogonial development in pigs
Authors: Zheng Yi , Gao Qiang , Li Tianjiao , Liu Ruifang , Cheng Zechao , Guo Ming , Xiao Jinhong , Wu De , Zeng Wenxian
Published: April 2022

Background

Spermatogenesis is an intricate developmental process during which undifferentiated spermatogonia, containing spermatogonial stem cells (SSCs), undergo self-renewal and differentiation to generate eventually mature spermatozoa. Spermatogenesis occurs in seminiferous tubules within the testis, and the seminiferous tubules harbor Sertoli and germ cells. Sertoli cells are an essential somatic cell type within the microenvironment that support and steer male germ cell development, whereas spermatogonia are the primitive male germ cells at the onset of spermatogenesis. While the developmental progression of Sertoli cells and spermatogonia has been well established in mice, much less is known in other mammalian species including pigs.

Results

To acquire knowledge of Sertoli cell and spermatogonial development in pigs, here we collected as many as nine ages of Duroc porcine testes from the neonate to sexual maturity, i.e., testes from 7-, 30-, 50-, 70-, 90-, 110-, 130-, 150- and 210-day-old boars, and performed histological and immunohistochemical analyses on testis sections. We first examined the development of spermatogenic cells and seminiferous tubules in porcine testes. Then, by immunofluorescence staining for marker proteins (AMH, SOX9, DBA, UCHL1, VASA, KIT, Ki67 and/or PCNA), we delved into the proliferative activity and development of Sertoli cells and of spermatogonial subtypes (pro-, undifferentiated and differentiating spermatogonia). Besides, by immunostaining for β-catenin and ZO-1, we studied the establishment of the blood-testis barrier in porcine testes.

Conclusions

In this longitudinal study, we have systematically investigated the elaborate Sertoli cell and spermatogonial developmental patterns in pigs from the neonate to sexual maturity that have so far remained largely unknown. The findings not only extend the knowledge about spermatogenesis and testicular development in pigs, but also lay the theoretical groundwork for porcine breeding and rearing.
Eye movements and eating disorders: protocol for an exploratory experimental study examining the relationship in young-adult women with subclinical symptomatology
Authors: Navas-León Sergio , Sánchez-Martín Milagrosa , Tajadura-Jiménez Ana , De Coster Lize , Borda-Más Mercedes , Morales Luis
Published: April 2022

Background

Recent research indicates that patients with anorexia (AN) show specific eye movement abnormalities such as shorter prosaccade latencies, more saccade inhibition errors, and increased rate of saccadic intrusions compared to participants without AN. However, it remains unknown whether these abnormal eye movement patterns, which may serve as potential biomarkers and endophenotypes for an early diagnosis and preventive clinical treatments, start to manifest also in people with subclinical eating disorders (ED) symptomatology. Therefore, we propose a protocol for an exploratory experimental study to investigate whether participants with subclinical ED symptomatology and control participants differ in their performance on several eye movement tasks.

Methods

The sample will be recruited through convenience sampling. The Eating Disorder Examination Questionnaire will be administered as a screening tool to split the sample into participants with subclinical ED symptomatology and control participants. A fixation task, prosaccade/antisaccade task, and memory-guided task will be administered to both groups. Additionally, we will measure anxiety and premorbid intelligence as confounding variables. Means comparison, exploratory Pearson's correlations and discriminant analysis will be performed.

Discussion

This study will be the first to elucidate the presence of specific eye movement abnormalities in participants with subclinical ED symptomatology. The results may open opportunities for developing novel diagnostic tools/therapies being helpful to the EDs research community and allied fields.
Towns and trails drive carnivore movement behaviour, resource selection, and connectivity
Authors: Whittington Jesse , Hebblewhite Mark , Baron Robin W. , Ford Adam T. , Paczkowski John
Published: April 2022

Background

Global increases in human activity threaten connectivity of animal habitat and populations. Protection and restoration of wildlife habitat and movement corridors require robust models to forecast the effects of human activity on movement behaviour, resource selection, and connectivity. Recent research suggests that animal resource selection and responses to human activity depend on their behavioural movement state, with increased tolerance for human activity in fast states of movement. Yet, few studies have incorporated state-dependent movement behaviour into analyses of Merriam connectivity, that is individual-based metrics of connectivity that incorporate landscape structure and movement behaviour.

Methods

We assessed the cumulative effects of anthropogenic development on multiple movement processes including movement behaviour, resource selection, and Merriam connectivity. We simulated movement paths using hidden Markov movement models and step selection functions to estimate habitat use and connectivity for three landscape scenarios: reference conditions with no anthropogenic development, current conditions, and future conditions with a simulated expansion of towns and recreational trails. Our analysis used 20 years of grizzly bear (Ursus arctos) and gray wolf (Canis lupus) movement data collected in and around Banff National Park, Canada.

Results

Carnivores increased their speed of travel near towns and areas of high trail and road density, presumably to avoid encounters with people. They exhibited stronger avoidance of anthropogenic development when foraging and resting compared to travelling and during the day compared to night. Wolves exhibited stronger avoidance of anthropogenic development than grizzly bears. Current development reduced the amount of high-quality habitat between two mountain towns by more than 35%. Habitat degradation constrained movement routes around towns and was most pronounced for foraging and resting behaviour. Current anthropogenic development reduced connectivity from reference conditions an average of 85%. Habitat quality and connectivity further declined under a future development scenario.

Conclusions

Our results highlight the cumulative effects of anthropogenic development on carnivore movement behaviour, habitat use, and connectivity. Our strong behaviour-specific responses to human activity suggest that conservation initiatives should consider how proposed developments and restoration actions would affect where animals travel and how they use the landscape.
A tumor suppressor role for EZH2 in diffuse midline glioma pathogenesis
Authors: Dhar Swati , Gadd Samantha , Patel Priyam , Vaynshteyn Jake , Raju G. Praveen , Hashizume Rintaro , Brat Daniel J. , Becher Oren J.
Published: April 2022

Pediatric high-grade gliomas, specifically diffuse midline gliomas, account for only 20% of clinical cases but are 100% fatal. A majority of the DMG cases are characterized by the signature K27M mutation in histone H3. The H3K27M mutation opposes the function of enhancer of zeste homolog 2 (EZH2), the methyltransferase enzyme of the polycomb repressor complex 2. However, the role of EZH2 in DMG pathogenesis is unclear. In this study, we demonstrate a tumor suppressor function for EZH2 using Ezh2 loss- and gain-of-function studies in H3WT DMG mouse models. Genetic ablation of Ezh2 increased cell proliferation and tumor grade while expression of an Ezh2 gain-of-function mutation significantly reduced tumor incidence and increased tumor latency. Transcriptomic analysis revealed that Ezh2 deletion upregulates an inflammatory response with upregulation of immunoproteasome genes such as Psmb8, Psmb9, and Psmb10. Ezh2 gain-of-function resulted in enrichment of the oxidative phosphorylation/mitochondrial metabolic pathway namely the isocitrate dehydrogenase Idh1/2/3 genes. Pharmacological inhibition of EZH2 augmented neural progenitor cell proliferation, supporting the tumor suppressive role of EZH2. In vivo 7-day treatment of H3K27M DMG tumor bearing mice with an EZH2 inhibitor, Tazemetostat, did not alter proliferation or significantly impact survival. Together our results suggest that EZH2 has a tumor suppressor function in DMG and warrants caution in clinical translation of EZH2 inhibitors to treat patients with DMG.
Trophic niche separation of two non-spinose planktonic foraminifers Neogloboquadrina dutertrei and Pulleniatina obliquiloculata
Authors: Toue Ryuji , Fujita Kazuhiko , Tsuchiya Masashi , Chikaraishi Yoshito , Sasaki Yoko , Ohkouchi Naohiko
Published: April 2022

Based on laboratory observations, planktonic foraminifers are omnivorous, feeding zooplankton and phytoplankton. Spinose species tend toward greater dependence on zooplankton prey than on phytoplankton prey, while non-spinose species are more adapted to herbivorous diets. However, the trophic activity of planktonic foraminifers in the natural environment and their trophic positions in the marine food web have not yet been fully understood. The trophic position (TP) of two non-spinose species, Neogloboquadrina dutertrei and Pulleniatina obliquiloculata, was determined by differences in the nitrogen isotopic composition between two amino acids (glutamic acid and phenylalanine). Results show that TP values of N. dutertrei were ~ 2.4, indicating dependence on omnivorous (mixed herbivorous and carnivorous) diets, while those of P. obliquiloculata were ~ 2.1, indicating dependence on herbivorous diets. Together with previous laboratory observations, these TP values suggest that N. dutertrei is a detritivore or scavenger, while P. obliquiloculata is generally a herbivore. This trophic niche separation likely allows these two planktonic foraminiferal species to live within a similar depth zone in the open water column and provides a clue for understanding causes of spatial and temporal changes in their relative abundances in living and sediment assemblages.
Modulating Tumour Hypoxia in Prostate Cancer Through Exercise: The Impact of Redox Signalling on Radiosensitivity
Authors: Brown Malcolm , Rébillard Amélie , Hart Nicolas H. , O’Connor Dominic , Prue Gillian , O’Sullivan Joe M. , Jain Suneil
Published: April 2022

Prostate cancer is a complex disease affecting millions of men globally. Radiotherapy (RT) is a common treatment modality although treatment efficacy is dependent upon several features within the tumour microenvironment (TME), especially hypoxia. A hypoxic TME heightens radioresistance and thus disease recurrence and treatment failure continues to pose important challenges. However, the TME evolves under the influence of factors in systemic circulation and cellular crosstalk, underscoring its potential to be acutely and therapeutically modified. Early preclinical evidence suggests exercise may affect tumour growth and some of the benefits drawn, could act to radiosensitise tumours to treatment. Intracellular perturbations in skeletal muscle reactive oxygen species (ROS) stimulate the production of numerous factors that can exert autocrine, paracrine, and endocrine effects on the prostate. However, findings supporting this notion are limited and the associated mechanisms are poorly understood. In light of this preclinical evidence, we propose systemic changes in redox signalling with exercise activate redox-sensitive factors within the TME and improve tumour hypoxia and treatment outcomes, when combined with RT. To this end, we suggest a connection between exercise, ROS and tumour growth kinetics, highlighting the potential of exercise to sensitise tumour cells to RT, and improve treatment efficacy.
Are dopamine agonists still the first-choice treatment for prolactinoma in the era of endoscopy? A systematic review and meta-analysis
Authors: Cai Xiangming , Zhu Junhao , Yang Jin , Tang Chao , Cong Zixiang , Ma Chiyuan
Published: April 2022

Background

For prolactinoma patients, dopamine agonists (DAs) are indicated as the first-line treatment and surgery is an adjunctive choice. However, with the development of surgical technique and equipment, the effect of surgery has improved. The aim of this study was to assess the efficacy and safety of surgery versus DAs in patients with different types of prolactinomas.

Methods

A systematic search of literature using Web of Science, PubMed, Cochrane Library, and Clinical Trial databases was conducted until July 12, 2019. Prolactinoma patients treated with DAs (bromocriptine or cabergoline) or surgery (microscopic or endoscopic surgery) were included. Outcomes included the biochemical cure rate, recurrence rate, prolactin level, improvement rates of symptoms, and incidence rates of complications. A random-effects model was used to pool the extracted data. Qualitative comparisons were conducted instead of quantitative comparison.

Results

DAs were better than surgery in terms of the biochemical cure rate (0.78 versus 0.66), but surgery had a much lower recurrence rate (0.19 versus 0.57). Full advantages were not demonstrated in improvement rates of symptoms and incidence rates of complications with both treatment options. In microprolactinoma patients, the biochemical cure rate of endoscopic surgery was equal to the average cure rate of DAs (0.86 versus 0.86) and it surpassed the biochemical cure rate of bromocriptine (0.86 versus 0.76). In macroprolactinoma patients, endoscopic surgery was slightly higher than bromocriptine (0.66 versus 0.64) in terms of the biochemical cure rate.

Conclusion

For patients with clear indications or contraindications for surgery, choosing surgery or DAs accordingly is unequivocal. However, for patients with clinical equipoise, such as surgery, especially endoscopic surgery, in microprolactinoma and macroprolactinoma patients, we suggest that neurosurgeons and endocrinologists conduct high-quality clinical trials to address the clinical equipoise quantitatively.
A Pilot Feasibility Study of Digital Health Coaching for Men With Prostate Cancer
Authors: Handley Nathan R. , Wen Kuang-Yi , Gomaa Sameh , Brassil Kelly , Shimada Ayako , Leiby Benjamin , Jackson Lindsey , McMorris Michael , Calvaresi Anne , Dicker Adam P.
Published: April 2022

PURPOSE:

Prostate cancer is the most common cancer among men in the United States. The majority of prostate cancer treatment occurs in the ambulatory setting, and patients and their caregivers take on significant responsibility for monitoring and managing treatment and disease-related toxicity. Digital health coaching has shown promise as a tool to positively influence outcomes. We completed a single-arm pilot study to assess the feasibility of digital health coaching in men with prostate cancer.

METHODS:

Men with a history of prostate cancer requiring treatment in the past 2 years were eligible for inclusion. Participants engaged in a 12-week health coaching program, consisting of a combination of at least one telephone call and up to four digital nudges (defined as content delivered via text, e-mail, or app on the basis of the participant's preference) per week. Prostate cancer–specific content addressed one of the following topics each week: fatigue, pain management, healthy eating, exercise, managing incontinence, sexual health, managing stress and anxiety, financial toxicity, goal setting during treatment, managing side effects, communicating with the health care team, and medication adherence. Services were provided at no cost to the participant.

RESULTS:

A hundred patients were consented for the study, and 88 enrolled. The feasibility threshold of 60% was met with 63 of the 88 enrolled individuals completing the 3-month program (proportion = 71.6%; 90% CI, 62.6 to 79.4; P = .016).

CONCLUSION:

Digital health coaching for men with prostate cancer is feasible. These findings support further evaluation of digital health coaching for men with prostate cancer in larger randomized controlled trials.
Autoimmune-Associated Seizures
Authors: Gillinder Lisa , Britton Jeffrey
Published: April 2022

PURPOSE OF REVIEW

This article focuses on the seizure manifestations and presentations of autoimmune-associated epilepsy and acute symptomatic seizures in autoimmune encephalitis. It discusses the specificity of the various central nervous system autoantibodies and clarifies when their presence can be considered indicative of an immune etiology. Finally, current recommendations regarding patient selection for autoimmune antibody evaluation are reviewed, and an approach to immunotherapy is provided.

RECENT FINDINGS

Although autoimmune seizures are caused by a heterogeneous group of autoantibodies, key features reported in the literature should alert clinicians to the possible diagnosis. In particular, seizure characteristics including frequency, timing, duration, and symptomatology can provide vital clues to help differentiate autoimmune-associated seizures from other causes of epilepsy. Diagnostic certainty also requires an understanding and integration of the spectrum of clinical and paraclinical presentations, and several scoring systems have been developed that may be useful to aid the identification of autoimmune seizures.

Seizures due to autoimmune etiology are increasingly encountered in clinical practice. It is critical that clinicians recognize immune seizure etiologies early in their course given they are often responsive to immunotherapy but are usually resistant to antiseizure medications. Currently, however, it is unfortunately not uncommon for autoimmune-associated seizure disorders to remain undiagnosed, resulting in missed opportunities to administer effective therapies. Efforts to better understand autoimmune seizure manifestations and treatment strategies are ongoing.
Update on Antiseizure Medications 2022
Authors: Abou-Khalil Bassel W.
Published: April 2022

EDITOR’S NOTEABSTRACT

The article “Update on Antiseizure Medications 2022” by Dr Abou-Khalil was first published in the February 2016 Epilepsy issue of Continuum: Lifelong Learning in Neurology as “Antiepileptic Drugs,” and at the request of the Editor-in-Chief was updated by Dr Abou-Khalil for the 2019 issue and again for this issue.

PURPOSE OF REVIEW

This article is an update from the article on antiepileptic drug therapy (now referred to as antiseizure medication therapy) published in the two previous Continuum issues on epilepsy and is intended to cover the vast majority of agents currently available to the neurologist in the management of patients with epilepsy.

Treatment of epilepsy starts with antiseizure medication monotherapy. Knowledge of the spectrum of efficacy, clinical pharmacology, and modes of use for individual antiseizure medications is essential for optimal treatment for epilepsy. This article addresses antiseizure medications individually, focusing on key pharmacokinetic characteristics, indications, and modes of use.

RECENT FINDINGS

Since the most recent version of this article was published, two new antiseizure medications, cenobamate and fenfluramine, have been approved by the US Food and Drug Administration (FDA), and the indications of some approved medications have been expanded.

Older antiseizure medications are effective but have tolerability and pharmacokinetic disadvantages. Several newer antiseizure medications have undergone comparative trials demonstrating efficacy equal to and tolerability at least equal to or better than older antiseizure medications as first-line therapy for focal epilepsy. The list includes lamotrigine, oxcarbazepine, levetiracetam, topiramate, zonisamide, and lacosamide. Pregabalin was found to be less effective than lamotrigine. Lacosamide, pregabalin, and eslicarbazepine have undergone successful trials of conversion to monotherapy for focal epilepsy. Other newer antiseizure medications with a variety of mechanisms of action are suitable for adjunctive therapy. Antiseizure medications marketed since 2016 have benefited from the FDA policy allowing a drug’s efficacy as adjunctive therapy in adults to be extrapolated to efficacy in monotherapy. In addition, efficacy in adults can be extrapolated for efficacy in children 4 years of age and older. Both extrapolations require data demonstrating that an antiseizure medication has equivalent pharmacokinetics between its original approved use and its extrapolated use. Rational antiseizure medication combinations should avoid antiseizure medications with unfavorable pharmacokinetic interactions or pharmacodynamic interactions related to mechanism of action.

Knowledge of antiseizure medication pharmacokinetics, efficacy, and tolerability profiles facilitates the choice of appropriate antiseizure medication therapy for patients with epilepsy.
EEG Essentials
Authors: Tatum William O.
Published: April 2022

PURPOSE OF REVIEW

EEG is the best study for evaluating the electrophysiologic function of the brain. The relevance of EEG is based on an accurate interpretation of the recording. Understanding the neuroscientific basis for EEG is essential. The basis for recording and interpreting EEG is both brain site–specific and technique-dependent to detect and represent a complex series of waveforms. Separating normal from abnormal EEG lies at the foundation of essential interpretative skills.

RECENT FINDINGS

Seizures and epilepsy are the primary targets for clinical use of EEG in diagnosis, seizure classification, and management. Interictal epileptiform discharges on EEG support a clinical diagnosis of seizures, but only when an electrographic seizure is recorded is the diagnosis confirmed. New variations of normal waveforms, benign variants, and artifacts can mimic epileptiform patterns and are potential pitfalls for misinterpretation for inexperienced interpreters. A plethora of medical conditions involve nonepileptiform and epileptiform abnormalities on EEG along the continuum of people who appear healthy to those who are critically ill. Emerging trends in long-term EEG monitoring to diagnose, classify, quantify, and characterize patients with seizures have unveiled epilepsy syndromes in patients and expanded medical and surgical options for treatment. Advances in terminology and application of continuous EEG help unify neurologists in the diagnosis of nonconvulsive seizures and status epilepticus in patients with encephalopathy and prognosticate recovery from serious neurologic injury involving the brain.

After 100 years, EEG has retained a key role in the neurologist’s toolkit as a safe, widely available, versatile, portable test of neurophysiology, and it is likely to remain at the forefront for patients with neurologic diseases. Interpreting EEG is based on qualitative review, and therefore, the accuracy of reporting is based on the interpreter’s training, experience, and exposure to many new and older waveforms.
Translational Potential of High-Resistance Inspiratory Muscle Strength Training
Authors: Craighead Daniel H. , Freeberg Kaitlin A. , Maurer Grace S. , Myers Valerie H. , Seals Douglas R.
Published: April 2022

Age-associated cardiovascular (CV) dysfunction increases the risk for CV diseases. Aerobic exercise training can improve CV function, but only a minority of adults meet aerobic exercise guidelines. High-resistance inspiratory muscle strength training is a time-efficient lifestyle intervention that may promote adherence and improve CV function. However, further investigation is needed to translate inspiratory muscle strength training into the public health domain.
Contrasting foliar and soil nutrients responses to drought induced crown dieback in a Quercus brantii forest
Authors: Hosseini Ahmad , Hosseini Seyed Mohsen
Published: April 2022

Evidence has shown that drought-induced crown dieback has significant interaction with soil-plant water and nutrients relationships, but there isn’t sufficient knowledge of the water and nutrients connections in declining Persian oak (Quercus brantii) trees. To investigate the relationships between crown dieback and leaf nutrients concentrations, leaf water content, soil nutrients concentrations and soil mois­ture, one of the dieback affected stands was selected. This stand was located in Shalam forested area in northern Ilam province, west of Iran. Persian oak trees were evaluated using a crown dieback classification and divided into four classes with four replicates based on the severity of crown dieback. Sampling from leaves of trees and soil was implemented randomly in four sides of tree crown in August. Trees with mod­erate to severe declining showed reduced leaf water content (WC) and reduced relative leaf water content (RWC). Leaf N and P concentration of declining trees was significantly (p-value <0.05) more than that of healthy trees. The leaf K concentration of declining trees was significantly (p-value <0.10) more than that of the healthy. The leaf N:P amounts of oak trees was statistically different among crown dieback classes. But no significant differences was observed between the healthy and declining trees in terms of soil N, P, K, Ca and Mg concentrations and soil moisture. It was concluded that drought has effects on the nutrients status in the leaves of Persian oak trees and their changing in the declining trees is for resistance to drought condition, improving water use efficiency and possibly performance of vital activities.
Psychological and Neuropsychological complications of patients with Covid - 19, after their hospitalization in Intensive Care Units
Authors: Biagkis Nicholaos , Anthopoulou Irene , Kapadochos Theodore
Published: April 2022

The globally recognized COVID-19 pandemic has brought about unprecedented and unexpected upheavals in science data. The consequences of SARS-CoV-2 are evident in public health and primarily in almost every human system. Due to the extent of the damage that it sometimes causes to the body, it is possible that patients need to be treated in an Intensive Care Unit.
In particular, during the hospitalization not only organic problems were observed, but also psychological, neuropsychological and neuropsychiatric disorders, which are caused by the nature of the virus. Important findings show that the mental health effects of the virus are not limited to the time frame of hospitalization in the ICU but remain after discharge.
Post-intensive care syndrome, post-traumatic stress disorder and fatigue are some of the most important persistent effects, so their in-depth understanding is considered necessary.
Adaptation and Validation of Diabetes Knowledge Questionnaire (DKQ- 24 item) within Greek Population
Authors: Chrysi Maria , Vaidakis Dennis , Kapritsou Maria , Gamvrouli Maria
Published: April 2022

Background: The Michigan Diabetes Research and Training Centre develop, during the 80s, the Diabetes Knowledge Questionnaire in order to determine the level of diabetes knowledge. Providing insights both to researchers and health professionals as an aid to intervening and improving diabetes self-management.
Aim: The aim of this study was to translate, adapt and validate the Diabetes Knowledge Questionnaire (DKQ) to Greek Language.
Method and Material: The 24-item DKQ was administrated to a preselected sample of 40 patients with type 2 diabetes. The validation study was conducted from February to March 2020, in the diabetes clinic of a major Greek general hospital. The questionnaire was transcribed in Greek using “forward–backward” translation by two independent translators. Individuals’ demographic data were recorded. The data is expressed as mean ± SD, in significant level 0.05.
Results: DKQ Cronbach’s alpha had an adequate value. The intraclass correlation coefficient for average measures was significant, based on the 95% confident interval. Gender, profession and educational level did not correlate with the total score of the DKQ, individual’s age though was correlated.
Conclusions: The Greek version of the DKQ is a reliable and credible instrument for assessing the level of diabetes knowledge in Greece.
Status of self-esteem in medical students at a college in Kathmandu: A descriptive cross-sectional study
Authors: Shrestha Bikal , Yadav Stuti , Dhakal Subodh , Ghimire Pooja , Shrestha Yubika , Singh Rathaure Ela
Published: April 2022

Background: Self-esteem is vital to living a happy, confident and content life. Medical students experience various forms of stress due to academic, financial and social pressures which could affect their levels of self-esteem. This study aims to study the status of self-esteem among undergraduates of a medical college at Tribhuvan University, Nepal.

Methods: After receiving the ethical approval from the Institutional Review Committee (IRC) of NAIHS; we conducted a descriptive cross-sectional study among the first- to fifth-year medical students from December 2020 to April 2021. 190 were selected for the study using a stratified random sampling technique. This study used the Rosenberg self-esteem scale to measure self–esteem of the participants. A Google Forms questionnaire was sent to the participants via email. Then, the data obtained were entered in the Google sheet and later analyzed using SPSS 27. A Chi-square test was used to identify potential differences in self-esteem scores among different variables. A p-value of < 0.05 was considered statistically significant. 

Results: This study included a total of 180 participants, among which, 18.9% (13.19% to 24.61%; at 95% CI) students showed low self -esteem. 74.4% (68.02% to 80.78%; at 95% CI) students had normal self-esteem and 6.7% (3.05% to 10.35%; at 95% CI) students had high self-esteem. The mean self-esteem score was 19.19 (15.01 to 23.37; at 95% CI). Female participants suffered more than males from low self-esteem, and third-year students had the highest percentage of low self-esteem (30.77%).

Conclusion: The majority (74.4%) of medical students had normal self-esteem. However, 18.9% students had low self-esteem, among which, third-year students suffered the most (30.77%). Likewise, females exhibited higher prevalence of low self-esteem compared to males. Interventions to boost the level of self-esteem should be carried out to help medical students become confident and efficient doctors.
The association between FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a among chronic granulocytic leukemia patients treated with imatinib mesylate
Authors: Wardhani Shinta Oktya , Susianti Hani , Rahayu Puji , Yueniwati Yuyun Prabowowati , Fajar Jonny Karunia
Published: April 2022

Background: The gene FOXO3a has been elucidated to govern the development of chronic granulocytic leukemia (CGL). Moreover, it has been suggested that the levels of FOXO3a in circulation are affected by the FOXO3a rs4946936 gene polymorphism. However, no study has assessed the correlation between the FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a. The objective of this study was to assess the association between the FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a in CGL patients treated with imatinib mesylate. 

Methods: A cross-sectional study was conducted from February 2019 to February 2020. The genotyping of FOXO3a rs4946936 gene polymorphism was conducted using PCR-RFLP, and the levels of FOXO3a were assessed using ELISA. The association between the FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a were assessed using multiple logistic regression. 

Results: A total of 60 CGL patients were assessed in our study. Among them, the CC, CT, and TT genotypes of the FOXO3a rs4946936 gene polymorphism were 35.0%, 48.3%, and 16.7% respectively. Our calculation revealed that elevated levels of FOXO3a were found in CGL patients with the CC genotype of the FOXO3a rs4946936 gene polymorphism. While we failed to clarify the association between either the CT or the TT genotype of FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a. 

Conclusion: Our study identifies that the CC genotype of the FOXO3a rs4946936 gene polymorphism affects the elevated levels of FOXO3a in CGL patients treated with imatinib mesylate.
Thyroid cancer incidence in the United Arab Emirates: a retrospective study on association with age and gender
Authors: Almansoori Asma , Busch Hauke , Bendardaf Riyad , Hamoudi Rifat
Published: April 2022

Background: Thyroid cancer is the ninth most common malignancy worldwide, but the third most common malignancy in the United Arab Emirates (UAE). To our knowledge, this is the first UAE nationwide study aimed at presenting incidence rates of thyroid cancer at the national level of UAE based upon data from the national cancer registry and GLOBOCAN.

Methods: Between 2011 and 2017, a total of 2036 thyroid cancer cases from UAE patients were registered, of which 75.3% were female and 24.7% male patients.

Results: The results showed 6.6% increase in thyroid cancer cases in the UAE from 2011 to 2017 (p < 0.001) with a rise of approximately 400 cases per year from 2011 to 2040. Age standardized rate calculations showed increase in prevalence from 1.18 in 2011 to 4.32 in 2017 but decreases in incidence from 1.05 in 2011 to 0.15 in 2017. This trend is confirmed by the predictive model showing increase in incidence from 0.15 in 2017 to 0.64 by 2040. Gender was shown to be significantly associated with thyroid cancer. The female to male ratio was significantly higher in Emirati patients (4.86:1) (p < 0.001) than expat patients (2.47:1) (p < 0.01). Interestingly, expat patients contributed to the majority of thyroid cancer cases despite having lower female to male ratio. The age at diagnosis was significantly associated with thyroid cancer (p = 0.03) with the highest frequency diagnosed at 35-39 years of age. Globally, data from the predictive model showed that Asia had the highest rate of increase per year and UAE the lowest.

Conclusions: The slight increase in thyroid cancer prevalence and incidence, together with the different female to male ratio and diagnosis at younger age warrants further investigation at the molecular level from UAE thyroid cancer patients to elucidate the molecular basis of thyroid cancer.
Overview of logical bases and microcircuits in the construction of a combination device taking into account reliability
Authors: Makarenko F. , Yagodkin A. , Zolnikov Konstantin , Denisova Ol'ga , Poluektov Aleksandr
Published: April 2022

The fundamental laws of the positive algebra of logic are considered, including the rules relating to the elements of equivalence and non-equivalence. Logic gates used in practice are presented. The whole set of standard schemes is implemented, in particular, the frontal version, minimized, in the "OR–NOT" basis, in the "AND–NOT" basis based on the initial logical dependence: ¬(¬(A¬B) × ¬(¬CD) + ¬(¬AB) × ¬(C¬D)) + ¬(¬(AB) × ¬(CD) + ¬(¬A¬B) × ¬(¬C¬D)) . A combination device based on K176LE5 chips has been designed. It is noted that the implementation of this function requires at least 3 chips in the Pier basis, which is not optimal in terms of reliability and weight and size indicators. The transition from the minimized variant to the basis of "Non-Equivalence" + "Conjunction", as well as the basis of "Equivalence" + "Pierce function" is carried out. The results of the search for existing chips that implement the functions "Exclusive OR", "AND", "Exclusive OR–NOT" and "OR-NOT" are presented. 4 groups of chips were found, such as: chips based on logic with emitter coupling (ECL), based on transistor-transistor logic (TTL), based on a series of CMOS chips: with a supply voltage of 5-15 V, and also with a supply voltage of 3-5 V. The corresponding descriptions of each of the MC10H1xx chips (group 1 series); K155xx, xx74xx (group 2 series); K561xx, CD40xxxx (group 3 series); SN74LVCxxx (group 4 series) are presented. Implementation options for these groups of chips in both bases are presented. The cost analysis of the applied microcircuits is made. The calculation of the final cost of products is presented. The conclusion is made about the expediency of using one or another group of microcircuits, depending on the initial requirements set.
Numerical modeling of the technical state of frame building structures
Authors: Krivobokov Nikolay , Sazonova Svetlana , Akamsina N.
Published: April 2022

Structures of a multi-storey frame building are considered as the object of the survey. Based on the results of the inspection of the technical condition of the object, verification calculations of the bearing capacity of structures for the effect of the design forces on the actual design schemes and on the action of real operational loads and influences were carried out. An assessment of the technical condition of individual structural elements of the object has been carried out. The actual technical condition of the building and its elements has been determined. Additional defects and damages were revealed that appeared in the investigated object at the stage of a forced interruption in construction. Quantitative assessments of the actual indicators of the quality of load-bearing building structures in the required volume for carrying out a variant design of the reconstruction of a building and making an informed decision about the possibility of its further trouble-free operation have been obtained. With the help of a verification calculation on a computer, diagrams of bending moments and shear forces, as well as diagrams and mosaics of longitudinal forces, were obtained for the considered axes of the cinema hall in the building. Based on the performed verification calculations based on the use of a finite element model, the obtained survey results and the performed assessment, it was concluded that the object under study is in a working technical condition.
Simulation of a possible situation in case of fire at facilities with a massive presence of people
Authors: Sazonova Svetlana , Epifanov Evgeniy , Asminin Viktor , Mozgovoy Nikolay , Osipov Aleksandr , Druzhinina Elena , Korablin Sergey
Published: April 2022

The article analyzes fires in the Russian Federation, which are a complex physical phenomenon in conjunction with the physical features of the objects under consideration, on which the fire occurred. From the point of view of solving an engineering problem, a possible variant of the development of fires in a shopping and entertainment center is considered. It has been established that, despite a significant difference in the quantitative ratio, fires at objects with a massive stay of people, in comparison with fires at other objects, simultaneously affect a larger number of people, as a result of which they can have much more tragic consequences. As a result of the analysis carried out on the study of objects with a massive stay of people, in our case, at the proposed object of extinguishing a fire and carrying out emergency rescue operations, it can be noted that at the time of the fire there were quite a lot of people at the protection object. In this paper, when calculating the provision of resources for fire departments when extinguishing a fire using the example of the object under study, a mathematical model is proposed related to the structural model, where the object is represented as a system with its device and functioning mechanism. A scheme has been developed for the alignment of forces and means at the time of localization of the fire in accordance with the chosen scenario for the development of the fire. Modeling of a possible situation in case of fire was carried out on the example of the Passage shopping and entertainment center in Voronezh.