bluuebunny/crossref_metadata_2025 huggingface dataset:
Tocolytic therapy safeness in various gestational terms
Authors:   Bogomolets National Medical University, Kyiv, Ukraine, Leush S.S. , Govsіeіev D.О. ,   Bogomolets National Medical University, Kyiv, Ukraine, Zahorodnia O.S. ,   Bogomolets National Medical University, Kyiv, Ukraine,
Published: October 2024

Hexoprenaline and nifedipine, known for their side effects, are currently most often used for tocolysis. Duration of use and interactions with other drugs require further study. Aim was to compare the clinical and laboratory manifestations and consequences of tocolysis with hexporenaline and nifedipine in neonates and mothers. Materials and methods. The results of tocolysis with hexoprenaline and nifedipine for more or less than 48 hours before delivery time were compared in extremely premature terms of labor (EPP group - 22-27 weeks, 77 parturients) and in terms of moderate premature parturition (MPP group - 28-34 weeks, 73 parturients). Results. 80.0% and 90.9% of newborns survived within a week in the EPP and MPP groups after tocolysis with hexoprenaline for more than 48 hours. After tocolysis with nifedipine - respectively 66.7% and 92.9%, survival after hexoprenaline is 80.0%, nifedipine is 66.7% in the EPP group. Survival after prolonged tocolysis is higher than the average for the group (63.6%), in the MPP group the difference was 90.9 and 92.9%, without tocolysis 90.0%, and the average for the group was 90.4%. Survival in the EPP group with short-term tocolysis with hexoprenaline (50.0%) and nifedipine (60.0%), close to that without tocolysis (55.2%) and less than the average the EPP group (63.6%). All newborns survived after nifedipine, after hexoprenaline 81.8%, without tocolysis 90.0% in the MPP group. Moderate hyperglycaemia (5.6±0.58 mmol/L and 5.3±0.69 mmol/L) was observed after hexaprenaline and nifedipine, 4.2±0.37 mmol/L without tocolysis. Conclusions. The lower survival rate of extremely preterm infants does not depend on the tocolysis type or its absence and is associated with immaturity in accordance with the term, and not with effectivelessness of therapeutic influences. Survival of moderately preterm infants after tocolysis with nifedipine showed a better outcome. A side effect of tocolysis with both drugs studied was an excess up to 30% of the mean glycemic value. It is desirable to give preference to hexoprenaline at 22-27 weeks, and tocolysis with nifedipine is more appropriate for MPP (28-34 weeks term). The study was carried out in accordance with the Helsinki Declaration principles. The study protocol was adopted by the Local Ethics Committee of the Bohomolets NMU. Informed consent from the women for the study was obtained. Authors declare no conflict of interest.
Evaluation of the efficiency of physical exercises for the elimination of diastasis of the rectus abdominal muscles in postpartum women
Authors:   Ivano-Frankivsk National Medical University, Ukraine, Kinash N.M. , Levytskyi I.V. ,   Ivano-Frankivsk National Medical University, Ukraine, Kravchuk I.V. ,   Ivano-Frankivsk National Medical University, Ukraine, Martyniuk D.S. ,   Clinic of reproductive medicine "Extramed", Ivano-Frankivsk, Ukraine
Published: October 2024

Increased pressure on the muscles of the abdominal wall during pregnancy can often cause thinning and expansion of the white line of the abdomen, which is considered diastasis of the rectus abdominis muscles. Aim - evaluation of the functional consequences and influence of physical exercises on diastasis of rectus abdominis muscles. Materials and methods. We analyzed 54 patients who were diagnosed with diastasis recti during pregnancy and in the postpartum period. 26 women (the main group) after childbirth underwent a six-month rehabilitation program aimed at reducing diastasis (on average from the first to the seventh month after childbirth), 28 women (the control group) did not undergo a rehabilitation program after the birth of a child. Assessment of systemic complaints related to ventral hernia was carried out using a specialized questionnaire VHPQ (Ventral Hernia Pain Questionnaire), which allowed to assess the quality of daily activities. Statistical processing of the material was carried out using the Excel 11 program The results were considered probable when the probability ratio was less than or equal to 0.05. The odds ratio was estimated, the confidence interval was set at 95% and defined as ±1.96 standard error. Results. A statistically significant decrease in the width of the white line was observed in women of both groups 7-8 months after childbirth. Among patients of the main group, this was observed in 73.1% (19 people), and in the control group - in 64.3% (18 people), without a statistically significant difference between the groups. Conservative therapy of diastasis recti of the abdominal muscles made it possible to statistically significantly improve the quality of life of women after childbirth. Conclusions. In 64.3% of women in the postpartum period, diastasis of rectus abdominis muscles resolves itself within 7-8 months and does not require treatment. A course of six-month physical rehabilitation makes it possible to raise this indicator to 73.1% unreliably. Conservative therapy of diastasis recti of the abdominal muscles in women in the postpartum period allows a statistically significant improvement in the quality of life of patients. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research. The authors declare no conflict of interest.
The problem of the prevalence of smoking habit among adolescent girls
Authors:   Ivano-Frankivsk National Medical University, Ukraine, Lisetska I.S. , Divnych T.Y. ,   Ivano-Frankivsk National Medical University, Ukraine
Published: October 2024

Today, smoking remains an urgent social and medical problem, a proven cause of many serious diseases (cancer, cardiovascular, respiratory, dental, etc.), and can have serious consequences for the reproductive system and fertility, disability and premature death, which humanity is able to prevent. The issue of the prevalence of smoking habits, especially among adolescent girls, remains relevant. The aim is to study the prevalence of smoking habits among adolescent girls. Materials and methods. An anonymous survey of 280 adolescent girls aged 18 to 24 years was conducted. The questions of the questionnaire were aimed at identifying the presence of a bad habit, the type of smoking, as well as finding out the age of initiation of smoking, the number of cigarettes smoked by the respondent, the reasons that prompted the start of smoking, awareness of the harmful effects on the human body, etc. Results. Among all participants in the anonymous survey, 40.8±2.8% identified themselves as daily regular smokers. Another 14.6±1.8% of respondents indicated that they smoke from time to time. In addition, 21.5±2.3% of respondents admitted that they had tried to smoke at least once. It should be noted that only 23.1±2.1% of respondents have never smoked at all. Among the surveyed adolescent girls with a harmful habit, the majority indicated that they regularly use modern (alternative) types of smoking, namely 76.1±4.3%, which was 3.8 times more than the respondents who regularly smoke traditional cigarettes, respectively - 20.2±1.7% (p<0.05). The analysis of preferences for different modern types of smoking among those who use them showed that 32.5±2.8% smoke electronic cigarettes (VAPE) and 43.6±3.1% prefer tobacco heating systems (IQOS). A detailed analysis of the respondents' answers revealed that women mostly have a smoking history of 1 to 3 years - 46.7±4.1% and 3 to 5 years - 36.8±3.2% of respondents. In addition, it was found that 14.8±1.8% of girls reported smoking experience of up to 1 year. Only 1.7±0.2% of respondents reported smoking for more than 5 years. Conclusions. The results of the study indicate a high prevalence of the harmful habit among adolescent girls. Important reasons for starting to smoke are the presence of smokers in the immediate environment (family, friends), which is a negative example, and a high risk of passive smoking. Advertising, stressful situations, and emotional stress also contribute to the emergence of a bad habit among respondents. At the same time, a significant number of respondents are aware of the harmful effects of smoking and have a desire to get rid of the habit. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research. The authors declare no conflict of interest.
An energy-based criterion for defining slope failure considering the coupling effect of groundwater table and impact loading
Authors: Liu L. , Liu J. , Zhao F. , Xu Z.
Published: October 2024

Slope instability poses significant risks in tunnel construction, particularly under the influence of impact loading and fluctuations in groundwater table. This study addresses the complexity of energy transformation and distribution in slopes affected by these factors. The research aims to analyze the local dynamic factor of safety (FOS) from the perspective of energy-based criterion, considering groundwater table, impact loading, and load position. Key findings indicate that the groundwater table is the most influential factor on slope stability, followed by load position and impact loading. The overall dynamic FOS was observed to peak at 0·35 s and trough appears at 1·0 s during impact loading, stabilizing after 2 s. The evolution of the overall dynamic FOS is explained from the energy dissipation and transformation mechanisms. These insights provide a critical basis for risk assessment and prevention in complex slope scenarios, contributing to sustainable infrastructure development in line with UN SDG 11 (sustainable cities and communities).
Advancing Community Care and Access to Follow-Up after Acute Kidney Injury Hospitalization
Authors: Pannu Neesh , McBrien Kerry A. , Tan Zhi , Ahmad Nasreen , Bignell Coralea , Benterud Eleanor , Palechuk Taylor , Harrison Tyrone G. , Manns Braden J. , Scott-Douglas Nairne , James Matthew T.
Published: October 2024

Key Points

A risk-guided intervention improved adherence to processes of care for AKI survivors.

Further supports are necessary to improve uptake of processes of care for AKI survivors in primary care.

Background

AKI is associated with development and progression of CKD. Gaps in recommended care for CKD are common after AKI.

Methods

In this randomized controlled trial conducted in Alberta, Canada, we allocated adults hospitalized with Kidney Disease Improving Global Outcomes (KDIGO) stage 2 or greater AKI to a risk-guided, transition of care intervention versus usual practices at the time of hospital discharge. For people in the intervention group, we used a validated risk index to predict risk of severe CKD after AKI. People at low risk (<1%) received patient education alone. People at medium risk received additional clinical guidance, provided to their primary care physician. People at high risk (>10%) were referred to nephrology. The primary outcome was the proportion of patients who received treatment with an angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB), statin, and nephrology specialist follow-up within 90 days of discharge.

Results

One hundred fifty-five patients were recruited; the mean (SD) age was 60 (15) years, 91 (60%) were male, and 96 (62%) had eGFR <60 ml/min per 1.73 m2 or urine albumin-creatinine ratio >30 mg/g at discharge. The proportion of participants who received ACE-I/ARB, statin treatment, and nephrologist follow-up was 28% in the intervention group versus 3% in the usual care group (absolute risk difference [RD], 25%; 95% confidence interval [CI], 15% to 36%). The use of ACE-I or ARB in participants with urine albumin-creatinine ratio >300 mg/g or diabetes was greater in the high-risk group with the intervention versus usual care (RD, 37%; 95% CI, 6% to 67%), as was statin use among those with CKD (RD, 30%; 95% CI, 5% to 56%) and nephrologist follow-up for those with sustained eGFR <30 ml/min per 1.73 m2 at discharge (RD, 78%; 95% CI, 56% to 100%). Hyperkalemia was more frequent in the intervention group (RD, 10%; 95% CI, 9% to 19%).

Conclusions

A risk-guided intervention for patients hospitalized with AKI increased recommended processes of care for CKD for high-risk patients after hospital discharge.

Clinical Trial registry name and registration number:

Improving Post Discharge Care after Acute Kidney Injury (AFTER AKI), NCT02915575.
Nogomet, migracije, integracija
Authors: Rajković Iveta Marijeta
Published: October 2024

Na temelju kvalitativnog, multilokalnog, istraživanja u knjizi se analizira uloga nogometa u procesima integracije i društvene inkluzije građana različitog, posebice imigrantskog i manjinskog podrijetla. Istraživanje je provođeno kroz četiri studije slučaja kojima se nastojao dobiti što širi i sveobuhvatniji uvid u specifičnosti i kompleksnosti integracijskog procesa. U prvoj studiji slučaja istražuje se najmarginaliziraniju europsku manjinu − Rome. U drugoj se komparativno propituju stavovi navijača prema stranim nogometašima i drugim imigrantima s istim sociodemografskim karakteristikama. U trećoj se problematizira izazove integracije visokokvalificiranih i visokoobrazovanih profesionalaca u sustavu profesionalnog sporta, trenera koji rade u različitim državama. Na kraju se analiziraju međunarodne migracije reprezentativaca, dobivanja građanskog i sportskog državljanstva i (ne)potrebne integracije. Na temelju dobivene etnografske građe (iskustva, stavova i razmišljanja različitih aktera povezanih s nogometom), knjiga završava teorijskom kontekstualizacijom, propitivanjem postojećih teorija integracijskog procesa, modela i dimenzija integracije te donosi smjernice za kreatore javnih integracijskih politika.
Features of Understanding and Describing the Hydrate Formation Process
Authors:   Kuban State Technological University, Russia, Shostak N.A.
Published: October 2024

Clathrate hydrates are not only a huge source of energy, but also potentially interesting from a technological point of view due to their ability to bind water. According to generally accepted modern concepts, hydrates formed by individual hydrate-formers or their mixtures are non-stoichiometric inclusion compounds of a cellular type with the crystal lattice built of water molecules held by hydrogen bonds. The molecules of the hydrate-former are located in the internal cavities of the crystal lattice and are held in them by van der Waals forces. The article presents a formalized description of the hydrate formation process. A model of hydrate formation in gas-water systems is proposed. The model describes the processes occurring during hydrate formation in structures. It contains equations for calculating the main energy and molecular parameters of the hydrate-former, as well as the kinetics of the process.
Hydrogen-Enhanced Martensitic Transformation and Twinning under Rolling of AISI 321 Austenitic Stainless Steel
Authors:   Institute of Strength Physics and Materials Science SB RAS, Russia, Astafurova Elena G. , Melnikov Evgenii V. ,   Institute of Strength Physics and Materials Science SB RAS, Russia, Astafurov Sergey V. ,   Institute of Strength Physics and Materials Science SB RAS, Russia
Published: October 2024

In this paper, we study the effect of hydrogen pre-charging (in a 1N H2SO4 solution with a CS(NH2)2 as a recombination potion, at current densities of 10, 100 and 200 mA/cm2, for 5 hours) on the microstructure and phase composition of a type AISI 321 austenitic stainless steel during room-temperature rolling. Hydrogen pre-charging enhances the contribution of mechanical twinning to the fragmentation of the structure and assists to γ→α' and γ→ε transformations during rolling. Both, twinning and martensitic transformations, are dependent on hydrogen pre-charging regime: an increase in a current density during pre-charging of the specimens causes a decrease in the thickness of twin plates, increases the density of twin boundaries and fraction of α'-martensite in the structure of the rolled specimens. The formation of a high density of Σ3n boundaries (twin and ε-martensite) prevents the formation of a misoriented grain structure in austenite during rolling of steel specimens. Hydrogen pre-charging provides faster kinetics of γ→α' phase transformation in metastable steel AISI 321 during rolling.
Editorial: Data-Driven Campaigning in a Comparative Context—Toward a 4th Era of Political Communication?
Authors: Luke Stephanie , Bon Esmeralda , Dommett Katharine , Gibson Rachel , Lecheler Sophie , Kruikemeier Sanne
Published: October 2024

Contemporary political campaigning takes place both online and offline, and can be data-driven. In this piece, we review existing knowledge around data-driven campaigning (DDC) and introduce the new contributions made by the pieces within this thematic issue. We reveal how the studies included in this thematic issue of Media and Communication contribute to this existing knowledge by providing an up-to-date account of how DDC in general, and political microtargeting in specific, have been employed in election campaigns between 2021 and 2023, in a range of countries: France, Germany, the Netherlands, Sweden, and the US. As a collection, these studies highlight the variance that exists in the degree to which DDC is practiced, the range of DDC tools used, and attitudes toward DDC. In recent election campaigns, DDC takes many forms, and disapproval of DDC varies depending on how it is implemented.
MACROECONOMIC IMPACTS OF THE CIRCULAR TRANSITION: THE GREEN SWANS OF DECARBONIZATION ON THE PATH TO SUSTAINABILITY
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, Reznikova Nataliia , Grod Myhaylo ,   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
Published: October 2024

The purpose of the article is to determine the prerequisites for a theoretical rethinking of the problem of price instability and inflation processes as such in the context of a managed green and circular transition as a consequence of the institutional legitimation of climate neutrality on the path to achieving sustainable development. The circular economy, as an important component of the ambitious concept of sustainable development, involves a change in the approach to natural resources, which entails the abandonment of traditional business models and the search for new investment solutions that cannot be fully achieved by attracting private capital. This places great responsibility on governments, which, on the one hand, set ambitious goals (green transition, energy transition, circular transition, sustainable development), and, on the other hand, are not able to respond in a timely manner to the consequences of climate change and to respond to the impacts created by these two factors (institutional pressure and market failures) negative spillover effects. Control of hydrocarbon emissions should be offset by the use of a wide range of green incentives (green quantitative easing policy, green guarantee policy, green subsidy policy) and by providing access to long-term loans as part of responsible government planning. Fiscal, monetary, exchange rate and industrial policies must ensure the sustainability of the green transition. Only in this case can the stability and efficiency of the financial system be guaranteed, as well as the technical re-equipment of the production sector, focused on new technologies, while maintaining its productivity indicators. It has been established that green inflation can occur: as a reaction to irresponsible management (where economic agents actively created such a reality in which environmental degradation and climate problems lead to food, raw material, energy and other crises, which reduces supply, and therefore provokes an increase in prices ); as a reaction to an attempt to implement large-scale projects aimed at decarbonization within a limited time frame (where economic agents and consumers become "victims" of monetary and fiscal policies of governments); as a reaction to the tightening of business standards, for which the end consumer will have to pay (the price of minerals needed for green technologies - from wind turbines and solar panels to electric cars - will require a "green premium" (or "greenium") as due to relatively higher demand on them with limited supply, as well as due to the fact that the extraction of minerals is usually associated with higher environmental costs, which will be "punished" by taxes).
DIGITAL PLATFORM AS A GLOBAL BUSINESS MODEL OF INDUSTRY 4.0
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, Stupnytskyy Oleksiy , Panikar German ,   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, Morozov Volodymyr ,   NationalAviationUniversity, Kyiv, Ukraine
Published: October 2024

This article explores the evolution and impact of digital platforms (DPs) within the context of global business models and the digital economy. DPs serve as pivotal mechanisms in the transformation of business processes, facilitating network effects and enhancing competitive advantages through the sharing economy and gig economy. The study examines how private and public organizations within digital ecosystems benefit from expanded customer bases, diverse service offerings, and improved digital communications with consumers. Key strategies for DP development are identified, including the creation of diverse services (proposition), personalized client interactions (personalization), innovative pricing models (price), maintaining customer trust and data protection (protection), and strengthening partnerships with app developers and payment service providers (partners). The implementation of this 5P model leverages digital tools and client-oriented strategies within DP ecosystems. As new digital technologies progress towards widespread adoption, the article anticipates active discussions on DP management models, legal compliance, commercial trust, online reputation, and public-private partnerships. This research underscores the critical role of DPs in shaping the future economic landscape and driving business model innovation.
The female reproductive tract microbiome and obesity
Authors: Lebedeva O. P. , Belyaeva N. O. , Ivannikova D. S. , Altukhova O. B. , Gryaznova M. V. , Korneeva O. S. , Syromyatnikov M. Yu.
Published: October 2024

High-throughput 16S rRNA sequencing has allowed us to identify novel microorganisms and their relationships in the female reproductive tract. However, in obese patients, the female reproductive tract microbiome, unlike the intestinal microbiome, has been understudied. Here, the literature review analyzes and describes microbiome features in the external genitalia, vagina, cervical canal, uterus, and ovaries in overweight and obese nonpregnant and pregnant females. The microbiome of the lower female reproductive tract in obese patients is characterized by increased bacterial diversity, pH, decreased Lactobacillus abundance, and increased abundance of obligate anaerobes and yeasts of the genus Candida. The endometrial microbiome in overweight and obese patients has been studied only in postmenopause and is characterized by higher Proteobacteria abundance. No data on the characteristics of the ovarian microbiome in obese patients are available. The mechanisms accounting for microbiome changes in obese patients are likely to due to the ability of adipose tissue-derived leptin and estrone to inhibit production of pituitary gonadotropic hormones resulting in blocked ovulation and lowered estradiol production in patients of reproductive age. Consequently, a decline in glycogen synthesis in the vaginal epithelium, decreased Lactobacillus abundance followed by elevated vaginal mucus pH value and number of obligate anaerobes, including those associated with bacterial vaginosis are observed. Weight loss can have a beneficial effect on the state of the vaginal microbiome, restoring normal Lactobacillus abundance.
Peculiarities of Synchronisation of Resting EEG Rhythms in Girls with High and Low Anxiety Levels
Authors: Rabadanova A.I. , Cherkesova D.U.
Published: October 2024

The article presents the results of a comparative analysis of the coherence of the main EEG rhythms (δ, θ, α, β1 and β2) in different areas of the cerebral cortex relative to frontal pole leads(Fp1 and Fp2) leads in girls with high and low levels of anxiety during passive wake state. In highly anxious individuals, there is an increase in the synchronization of EEG rhythms in all areas of the cerebral cortex, with a greater severity in the left hemisphere. At the same time, there is an increase in intra- and interhemispheric coherence between the local and distal zones of the cortex of the left hemisphere. In the right hemisphere, the highest values ​​of coherence at a high level of anxiety were found between distant areas of the cerebral cortex. A characteristic feature of the EEG of highly anxious individuals is the redistribution of rhythm synchronization from the frontal regions to the caudal cortical zones. Possible reasons for the change in the process of EEG rhythm synchronization during anxiety are discussed.
The role of transforming growth factor β in COVID-19 lung injury: clinical and diagnostic parallels
Authors: Budnevsky Andrey V. , Avdeev Sergey N. , Ovsyannikov Evgeniy S. , Alekseeva Nadezhda G. , Choporov Oleg N. , Shishkina Viktoria V. , Ivanova Elena E. , Perveeva Inna M.
Published: October 2024

BACKGROUND: Severe acute respiratory syndrome causes complex immune responses of hyperactivation of immunocompetent cells, including increased degranulation activity of mast cells and release of their secretome products. Mast cell granules may contain a lot of profibrotic enzymes and cytokines (chymase, tryptase, interleukin-4, 10, and 13) as well as growth factors. The entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the body and the subsequent strong immune and inflammatory response and dysregulation of coagulation and fibrinolytic pathways cause massive activation of latent (inactive) transforming growth factor β (TGF-β) in the lungs and the latent pool of TGF-β in the blood of patients with coronavirus disease 2019 (COVID-19).
AIM: To evaluate the role of TGF-β in lung involvement in patients with COVID-19 by examining autopsy lung material, determining the quantitative level of TGF-β with further correlation analysis of clinical and laboratory parameters.
MATERIALS AND METHODs: The study included autopsy lung samples from patients who died from severe COVID-19. Autopsies were performed 2 days after the patients died. Autopsy material was collected for histology. Correlation analysis was performed between the number of TGF-β-positive cells and clinical and laboratory parameters.
RESULTS: Extensive representation of TGF-β positive cells was found in autopsy tissues. A negative correlation was found between the number of TGF-β-positive cells and the blood concentration of band neutrophils (r=−0.617; p=0.033); between the number of TGF-β-positive cells and the concentration of C-reactive protein according to blood chemistry (r=–0.491; p=0.013). A positive correlation was found between the number of TGF-β-positive cells and blood platelet concentration (r=0.384; p=0.012); the number of TGF-β-positive cells and erythrocyte sedimentation rate (r=0.409; p=0.025). A positive correlation was also found between the number of TGF-β-positive cells and the presence of a cough in the patient at the beginning of the hospital stay (r=0.367; p=0.046).
CONCLUSION: A correlation was found between the number of TGF-β-positive cells, neutrophil concentration, platelet concentration, erythrocyte sedimentation rate, C-reactive protein concentration, and the presence of cough in patients who died from severe COVID-19. These correlations suggest the negative role of TGF-β and the therapeutic possibilities of regulating its activation. Further studies in a larger number of patients are required.
Risk factors for decreased bone mineral density in patients with Hodgkin’s lymphoma
Authors: Badykova Ksenija M. , Kitaeva Yuliya S. , Praskurnichiy Evgeny A. , Nagieva Amaliya R. , Kuznetsova Elena V.
Published: October 2024

BACKGROUND: Osteoporosis is a disease characterized by a decrease in bone mineral density that leads to low-energy fractures. Hodgkin’s lymphoma, which occurs mainly in young people (16–35 years), may be one of the causes of impaired bone remodeling. Given the high prevalence of osteoporosis in young patients with Hodgkin’s lymphoma, it is important to identify early predictors of the development of osteoporosis.
AIM: To evaluate risk factors for decreased bone mineral density in patients with Hodgkin’s lymphoma receiving pathogenetic therapy.
MATERIALS AND METHOD: The study included 63 patients with Hodgkin’s lymphoma and 30 healthy volunteers who served as controls. All participants completed a questionnaire to identify common and specific risk factors for osteoporosis. Common risk factors included sex, age, body mass index, history of fractures in the patient and immediate family, use of hormone replacement therapy, proton pump inhibitors, corticosteroids, comorbidities, amenorrhea in women, level of physical activity, and calcium intake. Specific risk factors for osteoporosis included polychemotherapy as a pathogenetic therapy for Hodgkin’s lymphoma.
RESULTS: The study identified four main risk factors for the development of osteopenia/osteoporosis in young patients with Hodgkin lymphoma following pathogenetic therapy such as use of proton pump inhibitors, corticosteroids, chemotherapy-induced amenorrhea in women, and low physical activity.
CONCLUSION: Methods for predicting and preventing osteoporosis have not yet been developed for young patients, as this disease is considered to be associated with old age. However, some groups of young patients are at high risk for disruption of bone microarchitecture with low-energy fractures, significantly reducing quality of life. All these factors make early detection of osteoporosis predictors important.
Reconstructive and plastic treatment of extensive laryngotracheostomy following mine blast injury
Authors: Kirasirova Elena A. , Mamedov Ramis F. , Lafutkina Nadezhda V. , Piminidi Olga K. , Tyutina Svetlana I. , Trusov Vladislav A. , Krokhmal Aleksandra D.
Published: October 2024

BACKGROUND: The nature of combat operations in modern military conflicts is leading to an increase in the number of casualties due to mine blast trauma. Combat wounds to the neck are often associated with damage to the larynx and trachea, resulting in scarring airway stenosis. Surgery is the primary treatment for chronic scarring stenosis of the larynx and trachea. However, despite the large number of surgical techniques, not all of them are effective. Anatomic features of the larynx and trachea, difficulties in maintaining the formed airway lumen in most cases lead to postoperative restenosis of the larynx and trachea, which significantly reduces the effectiveness of surgical treatment and complicate the rehabilitation of the patient.
CLINICAL CASE DESCRIPTION: This article presents the experience of treating an extensive laryngotracheal defect resulting from a mine blast injury. A patient with an extensive defect of the anterior wall of the larynx and trachea was admitted to the Department of Reconstructive Surgery of Cavitary Organs of the Neck of L.I. Sverzhevsky Research Clinical Institute of Otolaryngology. After clinical evaluation, laryngotracheoplasty was performed with alloimplant material, followed by stenting of the lumen of the larynx and trachea with a specially developed silicone stent.
CONCLUSION: The use of the most advanced medical technologies allowed to achieve a positive clinical outcome, to reduce the number of stages of surgical treatment, to prevent restenosis of the lumen of the larynx and trachea, to restore breathing through the natural ways of breathing, the physiological process of swallowing and the voice of the patient.
Microglia and macrophages in the human pineal gland
Authors: Sufieva Dina A. , Fedorova Elena A. , Yakovlev Vladislav S. , Grigorev Igor P. , Korzhevskii Dmitrii E.
Published: October 2024

BACKGROUND: Over the past two decades, inflammatory responses in the central nervous system (CNS) have been shown to play a role in the etiology of most neurological and psychiatric diseases, as well as in the aging process. Microglia and macrophages are the most important immune cells in the CNS. In contrast to the role of microglia and macrophages in various parts of the CNS, the human pineal gland has not been studied.
AIM: To evaluate the morphological characteristics, types and localization of microglial cells in the human pineal gland by immunohistochemistry.
MATERIALS AND METHODS: The study was performed using samples of a pineal gland of the human brain obtained in individuals between the ages of 16 and 61 years (n=7). Immunohistochemistry was performed on pineal gland sections using antibodies against Iba1 and TMEM119, selective markers for microgliocytes. Statistical methods were used to evaluate the frequency of immunostained cells.
RESULTS: The majority of phagocytic cells identified by immunohistochemistry were found to be microglia and not macrophages. Microglia are represented by both inactive and activated forms. Microglia in the human pineal gland are typically localized in connective tissue trabeculae, both near and far from blood vessels. Microgliocytes are also found in the pineal parenchyma in the hormone-synthesizing cells of the pinealocytes. The number of Iba1 and especially TMEM119 immunoreactive cells decreased significantly with age.
CONCLUSION: This study is the first to evaluate microglia and macrophages in the human pineal gland. The prevalence of microglial cells over macrophages was found. The morphological characteristics and localization of the identified microglial cell types suggest their involvement primarily in immune defense and probably also in the regulation of pinealocyte functions. In addition, there are data suggesting the involvement of microglial cells in the development of inflammation in the human pineal gland during aging.
Development of CODO: A Comprehensive Tool for COVID-19 Data Representation, Analysis, and Visualization
Authors: Dutta Biswanath , Bain Debanjali
Published: October 2024

Artificial Intelligence (AI) has become indispensable for managing and processing the vast amounts of data generated during the COVID-19 pandemic. Ontology, which formalizes knowledge within a domain using standardized vocabularies and relationships, plays a crucial role in AI by enabling automated reasoning, data integration, semantic interoperability, and extracting meaningful insights from extensive datasets. The diversity of COVID-19 datasets poses challenges in comprehending this information for both humans and machines. Existing COVID-19 ontologies are designed to address specific aspects of the pandemic but lack comprehensive coverage across all essential dimensions. To address this gap, CODO, an integrated ontological model has been developed encompassing critical facets of COVID-19 information such as aetiology, epidemiology, transmission, pathogenesis, diagnosis, prevention, genomics, therapeutic safety, and more. This paper reviews CODO since its inception in 2020, detailing its developments and highlighting CODO as a tool for the aggregation, representation, analysis, and visualization of diverse COVID-19 data. The major contribution of this paper is to provide a summary of CODO’s development and outline the overall development and evaluation approach. By adhering to best practices and leveraging W3C standards, CODO ensures data integration and semantic interoperability, supporting effective navigation of COVID-19 complexities across various domains.
“You Already Know That the Town of Shiraz No Longer Exists”: Reappraising the May 1853 Devastating Earthquake in Shiraz, Iran
Authors: Shafiee Amir Hossein , Saadat Sina
Published: October 2024

The Iranian plateau is located in the middle section of the Alpine-Himalayan seismic belt and has experienced high-magnitude earthquakes during its turbulent history. Shiraz, a historic and prosperous city in southwestern Iran, was heavily damaged by an earthquake on 4 May 1853. An earthquake with an estimated magnitude of 6.2 shook the city of Shiraz and killed at least 9000 people. This earthquake was definitely the deadliest one in the country’s nineteenth century. In the present article, this earthquake is reappraised by reviewing and comparing the available and original published resources. The territory of the historic region of the city and the landmark buildings damaged in the earthquake are identified using satellite imagery from Google Earth. Complete details of the construction method and the material used at the time of the earthquake are also presented using the information available in the literature and from a personal visit by the authors.
Comparative evaluation of analgesic efficacy of buprenorphine transdermal patch and fentanyl transdermal patch in the management of postoperative pain after lower limb surgery
Authors: Qutubuddin Saifee Sakina , Agarwal Sangeeta Bansal , Parashar Deepshikha , Singh Vijaya Laxmi , Gupta Garima
Published: October 2024

Background: Postoperative pain represents a significant medical issue that needs immediate attention. Despite advancements in pain management, managing postoperative pain remains challenging. Transdermal drug delivery systems (TDDS) offers a straightforward, reliable, non-invasive, and patient-friendly approach for alleviating post-surgical pain. Hence, this study was planned to evaluate the analgesic efficacy of buprenorphine and fentanyl transdermal patch in the management of post-operative pain after lower limb surgery.
Methods: In this prospective, randomised study, 82 adult patients of either sex undergoing elective lower limb surgery were randomly allocated into two groups- Group A (Transdermal Buprenorphine 20 mg patch) and Group B (Transdermal Fentanyl 50 mcg patch). Postoperative pain was assessed by 10-point Visual Analogue Scale (VAS) every 6 hours following surgery on the first day and then daily for next 4 days. All patients were also monitored for total rescue analgesic requirement, drug-related adverse effect and haemodynamic status. Statistical analysis was carried out using student t-test and Chi-square test. A p-value <0.05 was considered significant.
Results: The mean pain intensity scores were found to be significantly different (p<0.0001) between the two groups, with VAS scores consistently lower in Buprenorphine group as compared to Fentanyl group. Also, Buprenorphine group had the lowest demand for rescue analgesic, with 58.5% of patients requiring two administrations and 36.6% needing only one. Patients belonging to Fentanyl group exhibited higher occurrence of nausea (46.3%), vomiting (46.3%) and pruritus (31.7%).
Conclusions: Our study concludes that transdermal patch of buprenorphine demonstrates superior efficacy and safety profile as compared to fentanyl patch for post-operative pain management in lower limb surgeries.
Knowledge, attitude and practices regarding travel medicine among health care workers in a tertiary care centre
Authors: Sadiq Shamiya , Bhagat Veenakshi , Rani Neelam
Published: October 2024

Background: International travel whether for business, work or other reasons is increasing very rapidly. Along with this the risk for travel related illness has also increased exponentially as a very few travellers seek pre and post travel advice and our health care workers can play an important role in this field. To access the current knowledge, attitude, practice of travel medicine among health care workers.
Methods: The participants were briefed about the purpose of the study prior to its commencement. The questionnaire was framed in 2 sections. Section I covered the demographic profile while section II pertained to knowledge, attitude and practice. The questions were developed focusing on the domains that were already used in similar published literature. A Google form link was sent to the participants and they were given a time span of 2 days to completely fill the Google Form.
Results: Nearly all the participants had a fair knowledge regarding travel medicine (52.1%), associated diseases with it (68.6%) and the most common medicines to be prescribed during travel (65.3%). But (71.9%) were still unaware about the recommended guidelines related to travel medicine. A great number of participants (90%) were of the impression to create awareness among HCWs about presentation of illness in travellers. Most of the HCWs (72.7%) were aware of the issues that needed to be addressed in pre-travel consultation which could help to reduce the risk of illness and injury during travel. Most of HCWs (81%) were of the belief to encompass training related to travel medicine to be incorporated in medical curriculum.
Conclusion: HCWs has fair knowledge and positive attitude and practices with more trainings in the form of workshops and CMEs on Travel Medicine.
Subclinical hypothyroidism and plasma levels of commonly prescribed anti-seizure medications
Authors: Natarajan Anusha , Priyadharsini R. , Xaviar Suja , Sugumaran Ramkumar
Published: October 2024

Background: Epilepsy remains the most common neurological problem worldwide. Most commonly prescribed antiseizure medications (ASMs) like phenytoin, sodium valproate, and carbamazepine show high inter-individual variability in bioavailability due to genetic and epigenetic factors resulting in either therapeutic failure or toxicity. In our study, we aim to determine the association between subclinical hypothyroidism and the plasma levels of these commonly prescribed ASMs, leading to either therapeutic failure or adverse drug reactions.
Methods: We collected demographic data, details about the antiepileptic medication, and plasma levels of ASMs (phenytoin, carbamazepine, and sodium valproate) from patients on antiseizure medications who came for routine therapeutic drug monitoring (TDM). High-performance liquid chromatography (HPLC) estimated plasma levels of the antiseizure medications as per the TDM laboratory standard operating procedure (SOP) and thyroid function test (TSH) by a standard enzyme-linked immune-sorbent assay (ELISA) kit.
Results: Of the 158 patients who had TDM, 75.31% were taking sodium valproate, 15.18% were on phenytoin, and 9.49% were on carbamazepine monotherapy. In our study, we found that 12 patients (7.59%) had TSH levels between 4 to 10 mIU/l, indicating subclinical hypothyroidism (SCH). The plasma drug levels of all 12 patients who had SCH were found to be below the therapeutic range.
Conclusions: This study has established a significant association between ASMs, particularly sodium valproate, and thyroid dysfunction, specifically SCH, in patients with epilepsy. Our findings suggest that prolonged ASM therapy can lead to thyroid disturbances, warranting careful monitoring of thyroid function in these patients.
Is the combination of propranolol and flunarizine better than propranolol, flunarizine and amitriptyline alone in prophylaxis of migraine? An observational study at a tertiary care centre of North India
Authors: Dixit Madhumita , Singh Abhishek K. , Nim Dwividendra K. , Chaurasia Rakesh C.
Published: October 2024

Background: Migraine is a primary headache disorder marked by recurrent attacks of pain and associated symptoms. Propranolol is traditionally considered highly effective for migraine prophylaxis, but other drugs have recently shown promise.
Methods: This study was a prospective, observational, randomized, parallel-arm, unicentric trial conducted in the neurology department of a tertiary care hospital in North India. Patients with migraine without aura were randomly assigned to one of four treatment groups. After obtaining consent, patients were randomized using a random number table. Group 1 received propranolol (80 mg), group 2 received flunarizine (10 mg), group 3 received a combination of propranolol (40 mg) and flunarizine (10 mg), and group 4 received amitriptyline (10 mg) daily. The primary outcome was a change in the frequency of migraine days, while secondary outcomes included changes in moderate-to-severe headache days and disability levels.
Results: The combination of propranolol (40 mg) and flunarizine (10 mg) was significantly more effective in reducing the frequency of migraine attacks at the end of 3 months compared to the group receiving amitriptyline (10 mg). However, no significant differences between the groups were observed at baseline, 1 month, and 2 months. For other outcomes, including adverse drug reactions (ADRs), there were no significant differences between the groups.
Conclusions: The combination of propranolol (40 mg) and flunarizine (10 mg) demonstrated superior efficacy over amitriptyline (10 mg) after prolonged treatment, while its effectiveness was comparable to other groups at earlier time points. ADRs were similar across all groups.
A panoramic view of the strategies for epithelial ovarian cancer: a review of current challenges
Authors: Mustafa Mohd , Habib Safia , Moinuddin  , Singh Yogendra
Published: October 2024

Epithelial ovarian cancer (EOC) remains a formidable challenge in the field of gynecological oncology, accounting for a significant proportion of cancer-related deaths among women worldwide. Despite advances in surgical techniques and chemotherapeutic regimens, the prognosis for patients with advanced-stage disease continues to be dismal, underscoring the urgent need for novel and more effective treatment strategies. This editorial review examines intriguing therapeutic modalities that have the potential to improve treatment outcomes as well as overcome the current difficulties in managing EOC. It presents a brief but comprehensive examination of current research literature about epithelial ovarian cancer, challenges, disease recurrence, molecular complexity, and emerging therapeutic modalities. The importance of gene- and stem-cell therapy in pursuing effective ovarian cancer treatments still holds the platform. While traditional chemotherapy remains crucial for advanced cases, surgical interventions remain pivotal for early-stage patients. Treatment options include innovative DNA polymerase (alpha/delta/epsilon) inhibitors, personalized treatments, and immunotherapies toward advanced cases for quality survival. The challenges posed by epithelial ovarian cancer and late diagnosis necessitate a continuous quest for improved therapeutic options. Emerging approaches such as gene and stem cell therapies show promise in reshaping treatment paradigms. Further exploring localized treatment modalities presents avenues for enhancing improved patient payoff.
A rare case report of diclofenac induced Steven Johnson syndrome
Authors: Deuri Juchitra , Aziz Sahid , Deka Dipjyoti
Published: October 2024

Stevens Johnson syndrome (SJS) and Toxic epidermal necrolysis (TEN) are acute life-threatening mucocutaneous diseases characterized by extensive necrosis involving the mucous membrane and epidermis. In this case, a 54-year-old female after intake of prescribed diclofenac tablet presented with multiple reddish maculopapular eruptions over face, abdomen, both limbs, over lips and oral cavity associated with pain and intense pruritus. This case is a rare presentation of drug induced SJS caused by commonly prescribed NSAID, diclofenac. Patient’s condition improved after withdrawal of offending drug and prompt treatment. This case suggests that emphasis on early detection, assessment and timely management of adverse drug reactions is of upmost importance. Thus, establishment of proper vigilance centre and regular monitoring is necessary and taking caution in prescribing drugs as well in elderly groups.