bluuebunny/crossref_metadata_2025 huggingface dataset:
Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis
Authors: Al Sharhan Salma S. , Al Bar Mohammed H. , Assiri Shahad Y. , AlOtiabi Assayl R. , Bin-Nooh Deemah M. , AlSugair Fozia K. , AlRashidi Nada F. , AlSaied Abdulmalik S. , Alghamdi Amal A.
Published: June 2021

Background

Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients.

Methods

This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS.

Results

The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035).

Conclusion

Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life.

Level of evidence

Prospective observational.
Esophageal granular cell tumor and eosinophils: a multicenter experience
Authors: Reddi Deepti , Chandler Christropher , Cardona Diana , Schild Michael , Westerhoff Maria , McMullen Emily , Tomizawa Yutaka , Clinton Lani , Swanson Paul E.
Published: June 2021

Background

Esophageal granular cell tumor (eGCT) is rare, and the recent literature suggests a link between eosinophilic esophagitis (EoE) and eGCT. The aim of our study was to determine if EoE or other disorders associated with eosinophilia are consistently associated with eGCT.

Methods

We retrospectively searched pathology databases of three academic institutions from 1999 to 2018 for eGCTs. The archived slides and medical records were reviewed.

Results

From 294,855 esophagogastroduodenoscopy procedures, 45 patients (17 males and 28 females) with eGCTs were identified. The patients (30–73 years in age, median 50) had eGCT 0.2–2.0 cm in size (average 0.71). Thirteen had a history of gastroesophageal reflux disease, 5 had Barrett esophagus/goblet cell metaplasia and 1 had EoE. Thirty-four eGCTs had intralesional eosinophils (14 with peak > 10 eosinophils/400x hpf); of these, 21 also had eosinophils in lamina propria (9 with peak > 10 eosinophils/hpf). eGCT with atypical features (including nuclear enlargement and prominent nucleoli) were more likely to have increased eosinophils in non-epithelial compartments than those without atypia. Pleomorphism and spindled cells were seen in 3 eGCT cases (mean peak intralesional eosinophils: 43 per hpf); 2 of these had goblet cell metaplasia. We found no association between EoE and eGCT,p = 0.5966, (95% C.I. 0.0276, 6.5389, Fisher’s exact test). Instead, most patients had gastroesophageal reflux disease or Barrett esophagus.

Conclusion

Eosinophilia, common in eGCT and adjacent stroma, likely drives atypical/reactive histologic features, but a pathogenic relationship between eosinophil rich inflammatory conditions and eGCT has not yet been established.
Prevalence of BRCA1 and BRCA2 Mutations Among Patients With Ovarian, Primary Peritoneal, and Fallopian Tube Cancer in India: A Multicenter Cross-Sectional Study
Authors: Gupta Sudeep , Rajappa Senthil , Advani Suresh , Agarwal Amit , Aggarwal Shyam , Goswami Chanchal , Palanki Satya Dattatreya , Arya Devavrat , Patil Shekhar , Kodagali Rohit
Published: June 2021

PURPOSE

There are deficient data on prevalence of germline mutations in breast cancer susceptibility genes 1 and 2 ( BRCA1/ BRCA2) in Indian patients with ovarian cancer who are not selected by clinical features.

METHODS

This prospective, cross-sectional, noninterventional study in nine Indian centers included patients with newly diagnosed or relapsed epithelial ovarian, primary peritoneal, or fallopian tube cancer. The primary objective was to assess the prevalence of BRCA1/ BRCA2 mutations, and the secondary objective was to correlate BRCA1/ BRCA2 status with clinicopathologic characteristics. Mutation testing was performed by a standard next-generation sequencing assay.

RESULTS

Between March 2018 and December 2018, 239 patients with a median age of 53.0 (range, 23.0-86.0 years) years were included, of whom 203 (84.9%) had newly diagnosed disease, 36 (15.1%) had family history of ovarian or breast cancer, and 159 (66.5%) had serous subtype of epithelial ovarian cancer. Germline pathogenic or likely pathogenic mutations in BRCA1 and BRCA2 were detected in 37 (15.5%; 95% CI, 11.1 to 20.7) and 14 (5.9%; 95% CI, 3.2 to 9.6) patients, respectively, whereas variants of uncertain significance in these genes were seen in four (1.7%; 95% CI, 0.5 to 4.2) and six (2.5%; 95% CI, 0.9 to 5.4) patients, respectively. The prevalence of pathogenic or likely pathogenic BRCA mutations in patients with serous versus nonserous tumors, with versus without relevant family history, and ≤ 50 years versus > 50 years, were 40 of 159 (25.2%; 95% CI, 18.6 to 32.6) versus 11 of 80 (13.8%; 95% CI, 7.1 to 23.3; P = .0636), 20 of 36 (55.6%; 95% CI, 38.1 to 72.1) versus 41 of 203 (20.2%; 95% CI, 14.9 to 26.4; P < .0001), and 20 of 90 (22.2%; 95% CI, 14.1 to 32.2) versus 31 of 149 (20.8%; 95% CI, 14.6 to 28.2; P = .7956), respectively.

CONCLUSION

There is a high prevalence of pathogenic or likely pathogenic germline BRCA mutations in Indian patients with ovarian cancer.
Risk of Breast Cancer Among Carriers of Pathogenic Variants in Breast Cancer Predisposition Genes Varies by Polygenic Risk Score
Authors: Gao Chi , Polley Eric C. , Hart Steven N. , Huang Hongyan , Hu Chunling , Gnanaolivu Rohan , Lilyquist Jenna , Boddicker Nicholas J. , Na Jie , Ambrosone Christine B. , Auer Paul L. , Bernstein Leslie , Burnside Elizabeth S. , Eliassen A. Heather , Gaudet Mia M. , Haiman Christopher , Hunter David J. , Jacobs Eric J. , John Esther M. , Lindström Sara , Ma Huiyan , Neuhausen Susan L. , Newcomb Polly A. , O'Brien Katie M. , Olson Janet E. , Ong Irene M. , Patel Alpa V. , Palmer Julie R. , Sandler Dale P. , Tamimi Rulla , Taylor Jack A. , Teras Lauren R. , Trentham-Dietz Amy , Vachon Celine M. , Weinberg Clarice R. , Yao Song , Weitzel Jeffrey N. , Goldgar David E. , Domchek Susan M. , Nathanson Katherine L. , Couch Fergus J. , Kraft Peter
Published: June 2021

PURPOSE

This study assessed the joint association of pathogenic variants (PVs) in breast cancer (BC) predisposition genes and polygenic risk scores (PRS) with BC in the general population.

METHODS

A total of 26,798 non-Hispanic white BC cases and 26,127 controls from predominately population-based studies in the Cancer Risk Estimates Related to Susceptibility consortium were evaluated for PVs in BRCA1, BRCA2, ATM, CHEK2, PALB2, BARD1, BRIP1, CDH1, and NF1. PRS based on 105 common variants were created using effect estimates from BC genome-wide association studies; the performance of an overall BC PRS and estrogen receptor–specific PRS were evaluated. The odds of BC based on the PVs and PRS were estimated using penalized logistic regression. The results were combined with age-specific incidence rates to estimate 5-year and lifetime absolute risks of BC across percentiles of PRS by PV status and first-degree family history of BC.

RESULTS

The estimated lifetime risks of BC among general-population noncarriers, based on 10th and 90th percentiles of PRS, were 9.1%-23.9% and 6.7%-18.2% for women with or without first-degree relatives with BC, respectively. Taking PRS into account, more than 95% of BRCA1, BRCA2, and PALB2 carriers had > 20% lifetime risks of BC, whereas, respectively, 52.5% and 69.7% of ATM and CHEK2 carriers without first-degree relatives with BC, and 78.8% and 89.9% of those with a first-degree relative with BC had > 20% risk.

CONCLUSION

PRS facilitates personalization of BC risk among carriers of PVs in predisposition genes. Incorporating PRS into BC risk estimation may help identify > 30% of CHEK2 and nearly half of ATM carriers below the 20% lifetime risk threshold, suggesting the addition of PRS may prevent overscreening and enable more personalized risk management approaches.
Levine Cancer Institute Financial Toxicity Tumor Board: A Potential Solution to an Emerging Problem
Authors: Raghavan Derek , Keith Nicole A. , Warden Hughes R. , Chai Seungjean , Turan Wendy Jo , Moroe Jaynie , Feild Donna , Knight Thomas Gregory
Published: June 2021

PURPOSE:

Fiscal distress or “financial toxicity,” in which patients experience challenges in paying for treatment, are becoming dominant problems for patients with cancer because of burgeoning health care costs and strategies implemented by health insurance payers to reduce their level of expenditure. We report the structure and function of the first Financial Toxicity Tumor Board (FTTB). Modeled on the concept of a conventional multidisciplinary tumor board, FTTB functions as a multidisciplinary conference providing broad problem-solving approaches to financial toxicity.

METHODS:

The FTTB, with participation from physicians, nurses, financial counselors, nurse navigators, social workers, and administrators, meets monthly and is focused on financial toxicity and financial worry experienced by patients with cancer. It is linked to a Patient Assistance Program for oncologic pharmaceutical agents as this domain constitutes a critical area of financial toxicity for many patients.

RESULTS:

In the first years of function, more than $55-$60 million of personal expenditure has been avoided for 1,749 and 1,819 patients, respectively, as well as more than $1.3 million copay assistance provided for financially challenged patients. Problems addressed have included payer impediments, underinsurance, complexities of certification, coding or billing issues, and inadequate internal standard operating procedures.

CONCLUSION:

A focus on proactive management of financial toxicity through the function of multidisciplinary FTTBs substantially ameliorates this burgeoning international problem. This concept is presented early as it may be leveraged readily in other centers.
Longitudinal Dynamics of Circulating Tumor Cells and Circulating Tumor DNA for Treatment Monitoring in Metastatic Breast Cancer
Authors: Gerratana Lorenzo , Davis Andrew A. , Zhang Qiang , Basile Debora , Rossi Giovanna , Strickland Kimberly , Franzoni Alessandra , Allegri Lorenzo , Mu Zhaomei , Zhang Youbin , Flaum Lisa E. , Damante Giuseppe , Gradishar William John , Platanias Leonidas C. , Behdad Amir , Yang Hushan , Puglisi Fabio , Cristofanilli Massimo
Published: June 2021

PURPOSE

Liquid biopsy–based biomarkers, including circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), are increasingly important for the characterization of metastatic breast cancer (MBC). The aim of the study was to explore CTCs and ctDNA dynamics to better understand their potentially complementary role in describing MBC.

METHODS

The study retrospectively analyzed 107 patients with MBC characterized with paired CTCs and ctDNA assessments and a second prospective cohort, which enrolled 48 patients with MBC. CTCs were immunomagnetically isolated and ctDNA was quantified and then characterized through next-generation sequencing in the retrospective cohort and droplet digital polymerase chain reaction in the prospective cohort. Matched pairs variations at baseline, at evaluation one (EV1), and at progression were tested through the Wilcoxon test. The prognostic role of ctDNA parameters was also investigated.

RESULTS

Mutant allele frequency (MAF) had a significant decrease between baseline and EV1 and a significant increase between EV1 and progression. Number of detected alterations steadily increased across timepoints, CTCs enumeration (nCTCs) significantly increased only between EV1 and progression. MAF dynamics across the main altered genes was then investigated. Plasma DNA yield did not vary across timepoints both in the retrospective cohort and in the prospective cohort, while the short fragments fraction showed a potential role as a prognostic biomarker.

CONCLUSION

nCTCs and ctDNA provide complementary information about prognosis and treatment benefit. Although nCTCs appeared to assess tumor biology rather than tumor burden, MAF may be a promising biomarker for the dynamic assessment of treatment response and resistance.
Ulnar-Sided Wrist Pain in the Athlete: Sport-Specific Demands, Clinical Presentation, and Management Options
Authors: Rios-Russo Jose L. , Lozada-Bado Lianette S. , de Mel Sandra , Frontera Walter , Micheo William
Published: June 2021

Ulnar-sided wrist injuries are common in sports that require repeated pronosupination, wrist radial/ulnar deviation, axial loading, and gripping equipment. Common anatomic structures affected include the triangular fibrocartilage complex, extensor carpi ulnaris tendon, distal radioulnar and ulnocarpal joints, and hamate bone. Presenting symptoms include pain with activity, swelling, possible snapping or clicking, and reproduction of symptoms with provocative maneuvers. Imaging may confirm or rule out pathologies, but abnormal findings also may present in asymptomatic athletes. Initial treatment is usually nonoperative with splinting, load management, activity modification, strengthening the components of the kinetic chain of the particular sport, and pain management. Surgery is usually indicated in ulnar-wrist pain pathology such as hook of hamate fractures and required in associated instability. Future research should address specific treatment and rehabilitation protocols, emphasizing the complete kinetic chain along with the injured wrist.
Achilles Tendinopathy: Evaluation, Rehabilitation, and Prevention
Authors: von Rickenbach Kristian J. , Borgstrom Haylee , Tenforde Adam , Borg-Stein Joanne , McInnis Kelly C.
Published: June 2021

Achilles tendinopathy is a common overuse condition that is characterized by degenerative, cumulative tissue microtrauma. It is largely a clinical diagnosis in which the patient typically presents with localized pain that is worse with tendon-loading activities. Imaging modalities may be helpful with the diagnosis of difficult cases or in the planning of interventional procedures. Midportion (noninsertional) and insertional tendinopathy have distinct features and differences for therapeutic paradigms. Overall, Achilles tendinopathy has a good clinical prognosis with most patients improving with activity modification and rehabilitation, with a focus on progressive tendon-loading. Recalcitrant cases may require adjuvant treatment with procedures (e.g., injections, shockwave therapy) and rarely surgical intervention.
The Warrior Wellness Study: A Randomized Controlled Exercise Trial for Older Veterans with PTSD
Authors: Hall Katherine S. , Morey Miriam C. , Beckham Jean C. , Bosworth Hayden B. , Pebole Michelle M. , Pieper Carl F. , Sloane Richard
Published: June 2021

Posttraumatic stress disorder (PTSD) affects up to 30% of military veterans. Older veterans, many of whom have lived with PTSD symptoms for several decades, report a number of negative health outcomes. Despite the demonstrated benefits of regular exercise on physical and psychological health, no studies have explored the effect of exercise in older veterans with PTSD. This article describes the development, design, and implementation of the Warrior Wellness exercise pilot study for older veterans with PTSD. Veterans ≥60 yr old with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of PTSD will be recruited and randomized to (a) Warrior Wellness, a 12-wk supervised, facility-based exercise intervention, or (b) usual care for 12 wk. Warrior Wellness is a theory- and evidence-based behavioral intervention that involves three sessions per week of multicomponent exercise training that targets strength, endurance, balance, and flexibility. Warrior Wellness focuses on satisfaction with outcomes, self-efficacy, self-monitoring, and autonomy. Factors associated with program adherence, defined as the number of sessions attended during the 12 wk, will be explored. Primary outcomes include PTSD symptoms and cardiovascular endurance, assessed at baseline and 12 wk. Compared with those in usual care, it is hypothesized that those in the Warrior Wellness condition will improve on these efficacy outcomes. The Warrior Wellness study will provide evidence on whether a short-term exercise intervention is feasible, acceptable, and effective among older veterans with PTSD, and explore factors associated with program adherence.

ClinicalTrials.gov Identifier: NCT02295995
Εκκλησιαστική ποίηση και υμνωδία
Authors: Ματθαίου Νικόλαος
Published: June 2021

Η παρούσα διατριβή εστιάζει στην εξιχνίαση των θεμελιωδών αισθητικών αρχών που διέπουν τη γλώσσα και την ρυθμοποιΐα της υμνογραφίας, ανιχνεύει γλωσσικά την μορφή του ποιητικού λόγου, τις γλωσσικές επιλογές των υμνογράφων και την καταγραφή των πατερικών θέσεων για την σχέση λόγου μέλους ως κριτήριο του λειτουργικού και αισθητικού κάλλους των ύμνων. Ιδιαίτερη αναφορά γίνεται στη σύνθεση της μελωδίας, στην μελική επένδυση της ποίησης, στο κέντημα του μέλους στον καμβά του λόγου. Eρευνάται το κάλλος και η αισθητική της στιχοποιΐας, δηλαδή μέτρα, είδη, ρυθμός, ωραιότητα. Επιχειρείται σπουδή στην ποιητική δεξιοτεχνία των ακροστιχίδων, οι οποίες και χαρακτηρίζουν τα χαρίσματα των υμνογράφων. Προσεγγίζεται και καταγράφεται η αισθητική και εφευρετικότητα των ιαμβικών δωδεκασυλλάβων συναξαριακών διστίχων και των ηρωϊκών εξάμετρων τρίτων στίχων. Η έρευνα εντοπίζει τα είδη του εκκλησιαστικού μέλους, τις μουσικές σημειογραφίες που διαμορφώθηκαν διαχρονικά, τις αρετές και τα προσόντα των ποιητών και μελωδών, τις θεμελιώδεις καλαισθητικές αρχές και τους συμβολισμούς του βυζαντινού μέλους, όσο και την αξία και το κάλλος της οκταηχίας. Από τις υμνογραφικές πηγές των εν χρήσει λειτουργικών βιβλίων διερευνώνται οι υμνολογικοί και μουσικολογικοί όροι και καταγράφονται η ερμηνεία, οι αισθητικές αρχές χρήσης τους και η παράλληλη σύνθεσή τους με σχήματα λόγου και καλλιλογίας. Παρατίθενται αναλυτικά, με πληθωρικά παραδείγματα, τα σχήματα λέξεων: α) κατά κυριολεξία και β) κατά ακυριολεξία-τρόποι, καθώς και τα σχήματα νοημάτων. Εδώ όχι μόνο ομαδοποιούνται γνωστά και από τις επισημάνσεις άλλων ερευνητών καλολογικά άνθη, αλλά παρουσιάζονται και πολλά νέα και αταύτιστα, όπως τα εγκωμιαστικά άνθη, οι ηθικές προτροπές και τα αυτομεμπτικά σχήματα, τα σχήματα δήλωσης πένθους και κατανύξεως, χαράς και πανηγύρεως, εκφραστικού ρεαλισμού και παραβολικού λόγου∙ σχήματα που αναδεικνύουν το αμέτρητο βάθος όχι μόνο της θεολογίας αλλά και του αισθητικού κάλλους των μνημείων αυτών της παγκοσμίου λογοτεχνίας, των κειμένων της εκκλησιαστικής ποιήσεως της oρθοδόξου λατρείας. Τέλος γίνεται αναφορά σε ένα λεπτό και ακανθώδες ζήτημα, που σχετίζεται με την εκκλησιαστική υμνωδία: η χρήση μουσικών οργάνων κατά την τέλεση της λατρείας. Το θέμα εξετάζεται κατά τη στοχοθεσία της διατριβής σύντομα και διαχρονικά.
Modern ideas about morphological changes in the cerebellar cortex under influence of factors of different origin
Authors: Ohinska Nataliia , Nebesna Zoia , Kramar Solomiia
Published: June 2021

The work is a fragment of scientific research “Peculiarities of structural reorganization of the nervous, digestive, endocrine systems, hematopoietic and immune organs under conditions of thermal injury and the use of corrective factors” (0120U104152).The study of the state of internal organs and systems of the body under the influence of external factors that are stressful is relevant. The negative impact of environmental factors on the central nervous system, including cerebellum, leads to their structural and functional restructuring. The cerebellum is a multifunctional component of the brain and the object of numerous lesions.The purpose of this work is analysis of scientific literature which is dedicated study of the influence of exogenous and endogenous factors on the morphological structure of the cerebellum.The article analyzes the scientific literature of the effects of hypodynamia, hypothermia, hypokinesia, alcohol intoxication, toxic effects of Lead, drugs, pharmacological agents, low-frequency pulsed electromagnetic field on the micro- and submicroscopic organization of the cerebellum. In lots of experimental studies, which were analyzed it is established that in the dynamics of the influence of different factors there is a reorganization of the cerebellar cortex layers and disruption of the microcirculatory bed structures. Purkinje cells change shape to spherical, their processes are thinned, sharply hyperchromic neurocytes prevail over normochromic ones. The functional activity of neurons is reduced, because the chromatophilic substance is almost absent. The thickness of the molecular and granular layers decreases. The ganglionic layer loses its single-row arrangement of neurons. There are erythrocytes in the coin columns in the lumens of hemocapillaries. The dilatation and prevascular edema are observed. Thus, under the conditions of negative influence of various factors in neurocytes of a cerebellar cortex and links of a microcirculatory channel there are destructive and degenerative changes on micro- and submicroscopic levels. In the long run there are adaptive-compensatory processes and necrotic, which had a phase dependence. So, destructive and degenerative changes on micro- and submicroscopic levels. In the long run there are adaptive-compensatory processes and necrotic, which had a phase dependence.
Content and efficiency of the technique, aimed at formation of "working" and "dynamic position" of lower acrobates, taking into account the requirements of the chosen specialty
Authors: Denysenko Vladyslava , Maksymova Yuliya , Filippov Mikhail
Published: June 2021

The content of the methodology aimed at the formation of “working” and “dynamic posture” of bottom acrobats who train at the stage of preliminary basic training is discussed in the article presented. The methodology mentioned was developed with taking into account the requirements of the athletes’ chosen specialty, as well as on the basis of the kinematic structure of motor action which form the basis of functional duties of the bottom acrobat. It solved the following tasks: formation of a “working posture”, formation of “rational dynamic posture” of a bottom acrobat in the performance of functional duties; optimization of balancing technique and throwing actions of the bottom acrobats. The sequential implementation of the following stages created the algorithm of the methodology developed. It included formation of a “working posture” under simple conditions; formation of a “working posture” under the conditions of an increased load on the muscles that fix the “working posture”; formation of the “working posture” under the various spatio-temporal conditions; formation of a “rational dynamic posture” under simple conditions; formation of “rational dynamic posture” under conditions with a reduced  support area; formation of “working posture” and “rational dynamic posture” under the conditions close to the performance of acrobatic exercises. AS a result of the experiment the Authors has shown that the use of the technique developed contributes to the optimization of the balancing technique and technique of throwing actions of the bottom acrobats. So among main group acrobats the indicators of “working posture” and “dynamic posture” significantly differ (p<0.05) from those in control group and approach the model characteristics.
Determining the structure and content of the formation of the readiness of future teachers of music for vocal and pedagogical activities in higher education institutions in Chinawang Jin
Authors: Wang Jingyi
Published: June 2021

The article defines the essence of the concept «readiness of future teachers of music art for vocal and pedagogical activities» and proposes its structure. The author substantiates the components of readiness of future music teachers for vocal and pedagogical: motivational and value (focus on music and aesthetic education), content-target (systematization of knowledge, skills and abilities that meet the purpose), operational (set of knowledge and skills of students), which contribute to the formation of cognitive-value, emotional and artistic attitude to the art of music), productive-reflective (self-esteem and reflection).
Predictors of adverse outcomes in preterm infants in the early neonatal period
Authors: Klishch O. V. , Pavlyshyn H. A. , Коzak K. V. , Sarapuk I. M.
Published: June 2021

Introduction. Extremely and very preterm infants are a special cohort of newborns with inherent functional immaturity and specific pathological conditions which are accompanied by hypoxia, reoxygenation, tissue hypoperfusion, increased risk of oxidative stress. Premature infants are prone to oxidative deterioration which plays a key role in the pathogenesis of severe diseases such as respiratory distress syndrome, necrotizing enterocolitis, periventricular leukomalacia, patent ductus arteriosus, bronchopulmonary dysplasia, and retinopathy of prematurity.Objective. The aim of the research was to estimate the predictors of adverse outcomes in preterm infants with gestational age less than 32 weeks in the early neonatal period by assessment of oxidative stress markers.Material and methods. A total amount of 46 preterm infants with gestational age less than 32 weeks in the early neonatal period were included in the research. According to the results of early outcomes newborns were divided into two groups: I group – 12 infants with adverse outcomes and II group - 34 preterm infants with favorable outcomes. Twenty healthy newborns were included in the control group (III group). Clinical examination of infants and laboratory determination of oxidative stress markers were done for all participants.Results. Asphyxia, early onset sepsis, intraventricular hemorrhage in preterm infants less than 32 weeks of gestation had increased the risk of mortality in the early neonatal period. The level of 8-isoprostane, ROS, TBP, LHP was significantly higher in neonates with adverse outcomes (group I). It was found that the level of 8-isoprostane more than 595.4 mg/ml, ROS level above 0.483 IU, TBP higher than 5.14 μmol/l and LHP levels above 5.91 U/m were associated with unfavorable outcomes in the early neonatal period. Decreased activity of the antioxidant system (catalase, SOD) increases the risk of early neonatal mortality.Conclusions. The activation of oxidative stress in preterm infants may be a predictor of adverse outcomes in the early neonatal period.
Antibacterial effect of nisin in vitro
Authors: Mishina Marina M. , Burov Andrey N. , Vekshin Vitaliy A. , Grabovetskaya Evgeniya R.
Published: June 2021

Results of experimental studies of antimicrobial action of gel compositions containing active substance nisin are presented in the article. It is shown that increasing concentration of nisin at constant concentrations of the other components in the mixture inhibits growth of Staphylococcus aureus and Pseudomonas aeruginosa. The optimal concentration of nisin at which the process of pathogens growth inhibition is the most effective was determined in the experiment.
The issue of polycultural competence formation in Ukraine and Chine
Authors: Glazkova Iryna
Published: June 2021

The article deals with the search of the effective ways of the students’ polycultural competence formation process at Chinese and Ukrainian universities. The analysis of Ukrainian and Chinese scientists’ view scientific papers, give us possibility to state that polycultural competence is an integrative personal formation that includes the knowledge, skills, traits and values of a person. Polycultural competence facilitates one’s ability to interact effectively with representatives of other cultures on the basis of mutual respect, understanding and tolerance as well as the willingness to continue and to develop the diversity of cultural self-expressions in the context of a globalized society. The author proves that the basis of the polycultural competence formation is a foreign language. The effectiveness of such method as: reading, direct method, method of analogy and purposeful and practical methods in the process of polycultural competence formation while teaching foreign languages in higher education institutions inUkraineand Chine are described.
Microvessels in tumor tissue in patients with central nervous system tumors
Authors: Nowacka Agnieszka , Śniegocki Maciej , Woźniak-Dąbrowska Kamila , Smuczyński Wojciech
Published: June 2021

Angiogenesis plays an essential role in the development of a tumor. The most preferred histological evaluation method of this process is the determination of microvessel density (MVD) in the biopsy. Numerous studies report the possibility of using various MRI techniques for imaging the network of neoplastic vessels and determining the angiogenesis in them, as well as the subsequent analysis of the obtained images. In this study, a classic MRI imaging with intravenous contrast agent administration was used, and in order to ensure objectification and repeatability, and to eliminate human error that may occur in classic MRI image analysis, an automatic evaluation algorithm was used to determine the degree of angiogenesis, which was then presented in the form of a statistical pixels analysis. The study involved 48 adult patients of both sexes, treated surgically at the Department of Neurosurgery, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, due to a solid brain tumor. The highest mean density of MVD microvessels in tumor tissue was observed in high-grade gliomas. The high level of MVD expression in tumors of the central nervous system showed a positive correlation with the high degree of tumor malignancy. Based on the conducted research, it was concluded that the determination of the level of MVD expression in the tumor tissue is an additional prognostic factor in neoplasms of the central nervous system. The comparison of the results obtained with the tests performed routinely translates into a more accurate selection of treatment and assessment of the prognosis for survival.
Functional problems after surgical treatment of spine fractures
Authors: Nowacka Agnieszka , Woźniak-Dąbrowska Kamila , Smuczyński Wojciech
Published: June 2021

Introduction: Despite the large amount of research on the spine injuries themselves and on methods of their treatment, there are only a few reports of functional problems faced by patients after surgical treatment of these injuries. Aim: The aim of the study was to demonstrate the occurrence of functional problems and determine their type in patients after surgical treatment of spinal injuries, to determine the impact of the severity of the injury on the occurrence of dysfunctions, to determine the impact of patients' health and fitness on the occurrence of functional problems and coping with them, to demonstrate the relationship between the mental state and the occurrence of dysfunction, determination of the impact of pain on the occurrence of functional problems, assessment of the degree of coping with dysfunctions. Materials and methods: The study included a group of 20 people (13 men and 7 women) treated surgically at the Department of Neurosurgery, Nicolas Copernicus University Collegium Medicum in Bydgoszcz, due to a spine injury. The average age of the respondents was 44.6 years. The research consisted of patient answering the questions included in the patient's questionnaire, subjective descriptive test of pain intensity, modified Barthel scale and determination of pain intensity on the VAS scale. The investigator also completed an additional questionnaire in order to obtain additional information about the patient's health. Results: Research results indicate pain as the main cause of postoperative dysfunction. They concern self-service activities, travel, sleep and social life. As it has been shown on the basis of research, the quality of coping with functional problems depends on factors such as physical fitness, the activity of daily life before the injury, the presence of comorbidities, mental attitude and the severity of the injury.
Analysis of the structure of medical reports concerning hearing loss due to exposure to noise as an occupational disease in Poland in the years 2017-2018
Authors: Drożak Ireneusz , Pachucka-Włas Elżbieta , Nowosad-Sugier Anna , Drożak Paulina , Drożak Martyna
Published: June 2021

Introduction and purpose. Hearing impairment caused by noise is defined as a symmetrical, slowly progressing, permanent, receiving loss of hearing, of cochlear or sensoneurinal type, which concerns especially high frequencies. Hearing loss develops within the space of many years of exposure to high levels of noise which causes it to be an occupational disease of those who work in such conditions for a long period of time. The aim of this work was to analyse the structure of medical reports concerning hearing loss as an occupational disease in Poland in the years 2017-2018.Material and method. An analysis concerned cases of diagnosis of hearing loss diagnosed as an occupational disease based on Centralny Rejestr Chorób Zawodowych Instytutu Medycyny Pracy.Results. The occurrence of cases of hearing loss due to occupational factors decreased in 2017 and 2018 compared to 2016. Almost all cases of hearing loss as an occupational disease concerned male workers. This problem is almost non-existent among female workers. Hearing loss was the most prevalent among workers at pre-retirement age and those who worked more than 20 years in exposure to noise. Compared to other occupational diseases, hearing loss is not common in Poland.Conclusions. A decrease in cases of hearing loss as an occupational disease suggests that a system of periodic examination which is 1 examination each year during first 3 years of employment with medical appointment and a reminder of hearing protection works very well. Actions taken by all services (doctors, nurses, Occupational Health and Safety inspectors and employers) responsible for the protection of a worker cause a proper downward trend of diagnoses of hearing loss as an occupational disease among employees in Poland.
Self-assessment of inters on the efficiency of online preparation for the licensed integrated exam "Krok 3. General medical training" in a pandemic COVID-19 (analysis results of anonymous survey)
Authors: Koloskova Olena , Khilchevska Victoria , Bilyk Galyna
Published: June 2021

An anonymous survey of interns of the specialty "Pediatrics" on the quality of training interns for the licensed integrated exam "KROK 3. General medical training" at the Department of Pediatrics and Children's Infectious Diseases of Bukovinian State Medical University was conducted using the google form.The main purpose of the survey was to assess the effectiveness of training interns for the licensed test exam "KROK 3. General medical training" in the context of distance learning. It is shown that interns positively assess the quality of training in a distance form for passing this exam. Most interns point to the effectiveness of consultations of teachers and experts of creating tests in preparation for the exam. According to 60.0% of interns, the most effective component of preparation for the LIE "KROK 3. General medical training" was training on the program of the module "Emergencies", 25.0% noted thematic consultations conducted by teachers of the department immediately before the exam, and according to 15.0% of respondents, the best component was preparation for rector's tests. The most useful and informative for interns were consultations on emergencies in pediatrics (50.0% of responses), neurology and psychiatry (20.0%), cardiology (15.0%) and radiation medicine (15.0%).
Gluten and gluten-dependent diseases
Authors: Strońska Aleksandra , Pluta Waldemar Wojciech , Lalko Alicja , Lubkowska Anna
Published: June 2021

Gluten to mieszanina wielu pojedynczych, powiązanych białek, które tworzą materiał magazynowy w pszenicy. Są to głównie gliadyny monomeryczne i gluteniny polimeryczne tworzące ze sobą kompleksy, stabilizowane mostkami dwusiarczkowymi, dlatego też tworząca je cysteina odgrywa bardzo ważną rolę w budowie i funkcjonalności glutenu. W artykule porównano cechy wybranych zbóż, takie jak zawartość poszczególnych składników pokarmowych, wymagania glebowo-klimatyczne oraz właściwości stosowane w produkcji żywności. Obecność glutenu w żywności jest problemem z punktu widzenia jej wpływu na organizm człowieka. Oczekuje się, że skupienie badań na modyfikacji genomu pszenicy doprowadzi do otrzymania odmiany pszenicy o nietoksycznych właściwościach dla osób cierpiących na celiakię i różne formy nietolerancji białka glutenu. Specyficzne sekwencje znalezione w białkach pszenicy wiążą się z przeciwciałami IgE, powodując różnorodne objawy chorobowe. W artykule omówiono kryteria diagnostyczne celiakii i alergii na pszenicę oraz wpływ odstawienia glutenu na kliniczne objawy celiakii.
Effects of COVID-19 on doctors burnout
Authors: Medak Edyta , Niedzielski Antoni
Published: June 2021

The impact of COVID-19 on the mental health of doctors who come into contact with suspects or sick people is being studied worldwide. Appropriate questionnaires sent by e-mail to the surveyed groups are used for this. The most common respondents are anaesthesiologists working at the ICU and HED. Women experience stress and anxiety more often than men. Physicians' mental health is affected by their age, workplace and access to personal protective equipment. A review of the literature shows the negative impact of the growing number of SARS-CoV-2 cases on the level of stress, anxiety and satisfaction with the work of doctors.
Relationship of EEG and tremorogram indicators
Authors: Lobasyuk B. A. , Bodelan M. , Zamkovaya A. V.
Published: June 2021

The existing facts and hypotheses regarding the localization of the "pacemaker" of tremor are rather controversial. Fundamentally, the development of tremor (TrG) is explained by the formation of an oscillator (a source of rhythmic activity) at any level of the central nervous system. The objective is to study the mutually oriented influences between the frequency and amplitude of the TRH rhythms and the electroencephalogram (EEG), reflecting the work of the generators (oscillators) of both oscillatory processes. It was revealed that more regression coefficients from the EEG indicators of both the right and left hemispheres were determined for the left hand TRG indicators. This may indicate that the generators that form the physiological tremor of the left and right hand are not identical, as well as that the physiological tremor of the left hand is to a greater extent controlled by the generators that form the EEG than the generators that form the tremor of the right hand. The largest number of regression coefficients of multiple regression analysis was determined by the rate of beta-1 rhythm of the left hand TrH from EEG indicators. It was shown that the generators forming the physiological tremor of the left and right hands are not identical. The physiological tremor of the left hand is to a greater extent under the control of the generators that form the EEG than the generators that form the tremor of the right hand. The generator of the alpha rhythm of the TrG of the left hand is an independent formation and is not similar to the generator of the alpha rhythm of the TrG of the right hand.
Bilateral Gunshot Wounds to the Chest at Different Levels of Medical Care
Authors: Nehoduiko V. , Tsema Ie. , Humenyuk K. , Kravchenko K. , Yurkiv O. , Dubenko D. , Khuda M. , Myrhorodskiy D. , Bunin Yu.
Published: June 2021

The article provides a definition of a bilateral gunshot wound to the chest, the features of diagnosis and treatment according to the level of medical care. The isolation of this pathology into a separate nosological unit is justified due to the peculiarities of the lesions of the respiratory system and mediastinum, severe injury, high mortality, long duration of treatment and the existing complications of the same type.
Diagnostics and physiotherapy in rheumatoid arthritis
Authors: Strońska Aleksandra , Pluta Waldemar Wojciech , Lalko Alicja , Lubkowska Anna
Published: June 2021

Reumatoidalne zapalenie stawów (RZS) jest jedną z najczęstszych chorób autoimmunologicznych tkanki łącznej. Pierwsze objawy choroby pojawiają się zwykle między 30 a 50 rokiem życia i obejmują przewlekły proces zapalny, który powoduje postępujące niszczenie układu kostno-stawowego i zmiany narządowe. Etiologia RZS nie jest dotychczas dostatecznie poznana, a zarówno czynniki genetyczne, jak i środowiskowe odgrywają rolę w patogenezie RZS. Rozpoznanie opiera się na kryteriach American Collegium of Reumathology (ACR) oraz European League Against Rheumatism (EULAR) z 2010 roku. Wśród metod fizykoterapii stosowanych w leczeniu RZS szczególną rolę odgrywa krioterapia (kriostymulacja). Zgodnie z wytycznymi Panelu Ottawa kinezyterapia czynnościowa powinna odgrywać szczególną rolę u chorych na RZS, który ma na celu przywrócenie wzorców ruchowych najbardziej zbliżonych do fizjologii. Stosując kinezyterapię u chorych na RZS, należy monitorować przebieg procesów kompensacyjnych. Brak nadzoru lekarza i fizjoterapeuty nad powyższym procesem prowadzi do przeciążenia, a następnie deformacji układu mięśniowo-szkieletowego.
The most common injuries, rehabilitation and recovery among soccer practitioners
Authors: Mojsiewicz Karol , Kempińska-Podhorodecka Agnieszka
Published: June 2021

Introduction. Soccer is the most popular sport in the world. As a contact sport it has a high risk and incidence of injuries, which most often affect the lower limb. For the player to recover it is neessary to attend to well planned rehabilitation. Purpose. Analyzing the most common injuries among people practicing soccer and determining the role of rehabilitation in the treatment of these injuries.Material and methods. The research group was 101 individuals, 88 male and 13 female who played soccer as amateurs or professionals, aged 10 to 45 and had been training for a minimum of 2 years.Results. There were 487 injuries in total among all respondents, of which 370 were related to the lower limb and 117 to the upper body. Contussions and ankle sprains were the most common injuries. Every single preson included in the studies suffered from injury, but only 75.2% of them went to see a doctor after the incident and  only  56,4% attended rehabilitation.  Statistical significance has been present in the time to return to sports depending on the continuation of physical exertion after the injury, in the time to return to sport due to treatment or the lack of it, in the time to return to sports in relation to whether or not rehabilitation took place for patients with serious injury.Conclusion. The most common sports injuries in soccer are lower limb injuries, including damage to muscles and tendons. Recovery time is related to the type of injury, treatment options and rehabilitation methods. People practicing soccer should monitor their training loads with a physiotherapist. This can reduce the amount of problems later in career or daily life.
Look under the sheets – a case report of diabetic foot
Authors: Makuch Marcin , Makuch Marcelina
Published: June 2021

Diabetic foot is a long-term complication of diabetes mellitus that results directly from peripheral arterial disease or sensory neuropathy affecting the feet in diabetes mellitus. Diabetic foot is rare, but potentially lethal complication associated with the diabetes. The management of diabetic foot infections requires assessing the microbial etiology, attentive wound management, good nutrition, antimicrobial therapy and glycemic control. In several clinical circumstances, surgical resection is preferable.     A 65-year-old patient with 2-month necrosis of the second toe of the left foot and recurrent fever is presented. Diabetic foot developed. Citrobacter koseri was isolated from bone cultures. Intravenous treatment with amoxicillin + clavulanic acid and metronidazole was administered for 2 weeks and the wound was poorly recovered. After a surgical consultation, the patient was qualified for the amputation of the second toe of the left foot.
Getting to grips with neurosciences intensive care
Authors: Saddler Oliver
Published: June 2021

In this month's instalment of Paramedic Roles, Oliver Saddler shares his journey towards becoming a trainee advanced critical care practitioner in neurosciences intensive care, and walks us through a day in his work life
Fruit and vegetables consumption among school-going adolescents: Findings from the baseline survey of an intervention program in a semi-urban area of Dhaka, Bangladesh
Authors: Salwa Marium , Subaita Fatima , Choudhury Sohel Reza , Khalequzzaman Md , Al Mamun Mohammad Abdullah , Bhuiyan Mahfuzur Rahman , Haque M. Atiqul
Published: June 2021

Introduction

Interventions aimed at promoting healthy eating habits in adolescence can help prevent chronic diseases and promote healthy ageing. The aim of this paper is to describe the fruit and vegetables consumption habits of adolescents in Dhaka, Bangladesh as well as to identify the socio-environmental, personal, and behavioral factors that influence these habits.

Materials and methods

The baseline data from an intervention study involving 823 grade ten students from two randomly selected secondary schools in a semi-urban area of Dhaka were analyzed. The intake of fruit and vegetables was measured in terms of serving size per day. Hierarchical multiple regression was used to assess the ability of socio-environmental factors such as social support, perceived barriers, and living with patient with chronic diseases; personal factors such as knowledge, self-rated practice, behavioral intention, and body mass index; and behavioral factors such as physical activity, sedentary hours, and sleep duration to predict the level of daily fruit and vegetables intake, after controlling the effect of demographic characteristics of adolescents.

Results

The average daily consumption of fruit and vegetables was 1.22 and 1.99 servings, respectively. Only one-fifth of the respondents (21%) reported eating five servings of fruit and vegetables a day. Inaccessibility at home was reported as the most perceived barrier for both fruit and vegetables intake. Adolescents’ higher fruit and vegetables intake was found to be associated with higher maternal educational attainment, more social support, adequate self-rated practice, positive behavioral intention, higher body mass index, better physical activity, and adequate daily sleeping.

Conclusion

The findings revealed insufficient fruit and vegetables intake among adolescents in a semi-urban area of Bangladesh and associated socio-environmental, personal, and behavioral factors that were utilized in developing an intervention program for this transient age group.

Trial registration

Trial was registered at ClinicalTrials.gov (NCT03975335) https://clinicaltrials.gov/ct2/show/NCT03975335 on June 01, 2019.