bluuebunny/crossref_metadata_2025 huggingface dataset:
#080 Patência apical no retratamento de cimentos biocerâmicos – revisão sistemática
Authors:   Faculdade de Medicina Dentária da Universidade do Porto, Fernandes Beatriz , Pina-Vaz Irene ,   Faculdade de Medicina Dentária da Universidade do Porto, Ferreira Inês ,   Faculdade de Medicina Dentária da Universidade do Porto
Published: January 2025

Objetivos: Avaliar a influência de soluções irrigadoras/ solventes na recuperação de patência apical durante o retratamento de dentes obturados com cimentos biocerâmicos. Métodos: A presente revisão sistemática foi orientada de acordo com as recomendações PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Realizou- se uma revisão bibliográfica em 29 de Maio de 2024, sem restrições temporais e idioma, com a expressão de pesquisa (retreatment OR retrieval OR retrievability OR endodontic retreatment) AND (bioceramic sealer* OR bioceramic root canal OR calcium silicate sealer* OR calcium silicate cement* OR endodontic sealer* OR root canal sealing material OR root canal sealer* OR tricalcium silicate sealer* OR sealer*), nas bases de dados PubMed, Scopus e Web of Science. Foram incluídos estudos in-vitro em dentes permanentes humanos obturados com diferentes cimentos biocerâmicos que avaliaram a eficácia de soluções irrigadoras/solventes na recuperação de patência apical. Artigos de revisão, casos clínicos e estudos realizados em dentes de bovino ou artificiais foram excluídos. A avaliação do risco de viés foi adaptada pelos critérios definidos pela Colaboração Cochrane. Dois autores analisaram de forma independente todos os estudos, e um terceiro, em caso de divergência, foi consultado. Resultados: Dos 696 artigos resultantes, 3 preencheram os critérios de elegibilidade. Um dos estudos apresentou baixo risco de viés, outro médio e um outro alto. Todos usaram dentes monorradiculares com canal reto. Em dentes obturados com MTA Fillapex, o clorofórmio e o Endosolv E permitiram restabelecer 100% de permeabilidade, ao contrário do EndoSolv R. Com EndoSequence BC sealer, EdgeBioceramic e NeoSEALERFlo, a percentagem de recuperação foi menor quando se utilizou 6% hipoclorito de sódio, 5% ácido acético ou água carbonatada, comparativamente à não utilização de solução. Num dos estudos com EndoSequence BC sealer, independentemente da solução utilizada (10% ácido fórmico, 20% ácido hidrocloridrico ou clorofórmio), a permeabilidade foi restabelecida na maioria das amostras. Conclusões: Os estudos incluídos apresentam metodologias heterógenas. Ainda não existe consenso a respeito da influência de soluções irrigadoras/solventes na recuperação de patência apical durante o retratamento de cimentos biocerâmicos. São necessários mais estudos, avaliando outros parâmetros como anatomias complexas e testar novas propostas de soluções irrigadoras/solventes.
Effectiveness of interventions aimed at preventing and managing childhood obesity: systematic review
Authors: Mane Tahani , Alghamdi Sahar , Alhammad Rayan , Abdulaziz Alosayli , Alhumud Abdullah , Alrasheedi Abdulmajeed , Althunayyan Abdullah , Alyahyawi Tuqa , Alothaim Shrooq , Almujaydil Abdulaziz , Alhomaid Tameem
Published: January 2025

Globally, childhood overweight and obesity are increasing, resulting in several comorbidities. While different interventions to manage childhood obesity exist, their effectiveness is still a subject of debate among scholars. Therefore, this systematic review evaluated the effectiveness of interventions for preventing and managing childhood obesity reported in the literature. The findings showed that community-based, school-based, family-focused, and technology-driven approaches have various positive outcomes. Community-based interventions showed significant decreases in Body Mass Index (BMI), especially in population groups with limited resources, whereas school-based programs effectively reduced both BMI and waist circumference among children with obesity. On the other hand, family-based interventions were shown to be effective in promoting long-term behavioral changes, resulting in sustained BMI reduction. However, the effectiveness of technology-based interventions varied, but their effectiveness was enhanced when paired with human engagement. The review's findings underscored the need for culture-tailored interventions, citing disparities in the effectiveness of different interventions influenced by culture and ethnicity in addition to baseline weight status. Furthermore, to sustain the benefits of interventions, long-term follow-up and support were essential. The findings indicated that multi-component programs involving community, family, digital tools, and cultural context-relevant interventions are essential for long-term success in childhood obesity management.
Knowledge, attitude, and practice of kindergarten and nursery teachers toward cardiopulmonary resuscitation in Al Ahsa, Saudi Arabia
Authors: Alshudukhi Ahmed , Ajmi Ali , Busbait Sarah , Alnami Latifah , Alsaqer Fahad , Alkhalifah Ibrahim , Muhaish Abdullatif , Almulhim Sara
Published: January 2025

Objective:
This study aimed to assess the knowledge, attitude, and practices related to cardiopulmonary resuscitation (CPR) among nursery and kindergarten teachers in Al Ahsa, Saudi Arabia.
Methods:
A cross-sectional, exploratory survey was conducted among 360 nursery and kindergarten teachers in Al Ahsa. Data were collected using a structured questionnaire that assessed demographic factors, knowledge, attitudes, and barriers to CPR training and practice.
Results:
Of the 148 participants, all were females, and 50.7% were aged between 32 and 41 years. The majority (92.6%) held a university degree, yet 77% of the participants demonstrated inadequate knowledge of CPR. Only 23.6% had undergone formal CPR training, with 39.6% cited a lack of knowledge on where to obtain training as the primary barrier. Despite these gaps, 91.2% of participants expressed willingness to attend CPR training in the future. Additionally, 72.3% agreed that every school should be equipped with an automated external defibrillator (AED), although only 27.7% believed anyone could use one.
Conclusion:
This study revealed significant gaps in CPR knowledge and preparedness among nursery and kindergarten teachers in Al Ahsa, Saudi Arabia. There was a strong need for mandatory, accessible CPR training and education on the use of AEDs. Improving CPR skills and confidence among teachers could potentially lead to better emergency preparedness and improved outcomes in school settings.
The use of fibrin glue in sciatic nerve repair: narrative review
Authors: Samman Hasan , Sager Bader , Alturk Hesham , Kaki Waleed , Alamri Suhayb , Seraj Abdurrahman , Alahmadi Mohammed , Amoudi Zaki , Elmahdi Faris
Published: January 2025

The prevalence of peripheral nerve injuries (PNIs) is considerably high in society, yet the outcomes of repairs remain unsatisfactory. According to reports, more than 300,000 individuals in Europe sustain these injuries each year, while over 200,000 surgeries to repair peripheral nerves are performed each year in the USA. The nervous system controls sensations and movements through a complicated mechanism that includes the peripheral nervous system (PNS) and the central nervous system (CNS). The CNS comprises the spinal cord and brain, which is the origin of twelve cranial nerves. The spinal cord, the other major component of the CNS, is comprised of three regions: the posterior, anterior, and lateral regions. The spinal nerves emerge between the vertebrae, with nerves named according to the segment from which they arise, with the PNS consisting of the spinal and cranial nerves. This review aimed to investigate the effectiveness of fibrin glue as a less complicated alternative to sutures for repairs of peripheral nerve damage, namely sciatic nerve damage. Regarding peripheral nerve courses, especially the sciatic nerve, different types of damage could occur due to trauma, musculoskeletal, autoimmune, and iatrogenic aetiologies. Different mechanisms of repair (direct sutures, grafts, nerve guidance conduits, and laser-assisted repair) were mentioned and focused on fibrin glue usage. It was found that fibrin glue is a good replacement for many repair mechanisms and could be involved in others to get a better result because it is easier for application and time-saving.
A Study on Liberal Arts Korean Language Classes Utilizing SNS
Authors:   The Research Society for the Korean Language Education, Park Sue Jin
Published: January 2025

The purpose of this study is to propose a teaching method utilizing social networking services (SNS) to enhance practical communication skills with Koreans in liberal arts Korean language classes, which cater to learners of varying levels and characteristics. Prior to presenting the teaching method, a preliminary survey was conducted, revealing that the majority of Korean language learners use SNS primarily for communication and information exchange, predominantly utilizing Facebook and Instagram in their native languages. The study focuses on the educational characteristics of SNS, such as 'knowledge expression, sharing, and feedback,' and the 'noticing function, hypothesis testing function, and metalinguistic function' of the output hypothesis, incorporating these into the design of Korean language classes utilizing SNS. As a result of the satisfaction survey of 140 students, most learners reported that using SNS helped them use grammar and practice writing and speaking in Korean, thereby boosting their confidence in Korean communication. Furthermore, learners expressed that continued use of SNS in future classes is expected to improve their Korean communication skills, and they hope to communicate and exchange information with Koreans through SNS.
Presentation Status and Improvement Suggestions for ‘mankeum‘, ‘daero‘, and ‘ppun‘ in Korean Language Textbooks
Authors:   The Research Society for the Korean Language Education, Park Ji Hyun
Published: January 2025

This study aims to examine the presentation patterns of the grammatical items 'mankeum', 'daero', and 'ppun' in current Korean language textbooks and propose improvements based on this analysis. These grammatical items, functioning as both particles and bound nouns, have dual characteristics that have been a source of confusion for Korean language learners. The study analyzes four current Korean language textbooks and finds that there is a lack of consistency in how these grammatical items are presented, and a systematic approach to facilitate learners' understanding is insufficient.
Consequently, this paper proposes seven improvement strategies based on the strengths and weaknesses of these textbooks. First, presentation should be meaning-centered and integrated. Second, basic sentence patterns should be presented systematically. Third, example sentences should be consistent with the basic patterns. Fourth, synonyms should be presented if available. Fifth, parentheses and periods should be used appropriately. Sixth, collocations should be presented if they exist. Lastly, presentation should progress from simple to complex in a step-by-step manner.
Furthermore, this study applies these proposed strategies to 'mankeum', 'daero', and 'ppun', presenting their basic forms and meanings, aiming to make a practical contribution to future textbook development and research on grammatical item presentation.
A Study on the Problems and Countermeasures Faced by Korean Language Students in China. : With the focus on Chichihal University in China
Authors:   The Research Society for the Korean Language Education, Fang Xiangyu , Cui Runing
Published: January 2025

With the deepening of economic globalization and the active promotion of the Belt and Road Initiative, the importance of small languages is becoming more and more prominent in international exchanges. Although many universities are paying more and more attention to fostering talented people with 'non-conventional language +' complex skills, it can be seen that there are many problems in the actual curriculum. Therefore, this paper aims to promote the sustainable development of the Korean language major by revealing the various difficulties faced by Korean language students, such as limited learning resources, lack of effective learning strategies and methods, lack of practical skills, and serious employment conditions, through research and research centered on Chihar University.
Therefore, we tried to find a solution in response to problems such as lack of learning resources, lack of effective Korean language strategies and methods, lack of practical skills, difficulty in finding employment, and lack of Korean language skills. Not only should we provide abundant learning resources for Korean language students, but we should also actively induce foreign language learning thinking. And by creating speaking contests and exchange programs in schools and departments, students should have opportunities to practice them and challenge jobs related to Korean with an ideology that fits the present era.
A Study on The Logicality in The Written Texts of Chinese Korean Majors at The Beginner Level
Authors:   The Research Society for the Korean Language Education, Choi In Sook
Published: January 2025

All human languages possess universality, and the human way of thinking is characterized by logical reasoning. On this premise, this study qualitatively analyzed the written texts of Chinese Korean majors at the Beginner level. As a result, a clear logical structure was identified within their text structure, which involves introducing a text, stating a central thought, providing a rationale for this central thought, and confirming or emphasizing this thought. In addition, the study also identified the frequent use of the logical cohesive device, which is the main subject of this paper's analysis. This verifies that humans fundamentally think logically and express themselves in language form. The results of this study suggest that in argumentative text writing education for Chinese Korean learners for academic purposes, more emphasis should be placed on designing effective educational plans for logical cohesive devices rather than on improving thinking ability or text structure. It is suggested that the instructor should understand the universality of language and, as well as the contrasting linguistic knowledge and mediating variables between the learner's native language and Korean, to effectively design instructional plans.
Mobile Technologies: Undergraduate STEM Students’ Perspectives about Webtools for Writing
Authors: Dunn Michael William , Olson Wendy , Otoikhian Adenike , Anderson Jon , Yuan Weili , Gregory Kyrin
Published: January 2025

Many students struggle with writing skills. The most recent National Assessment of Educational Progress-Writing (2017) concluded that only 25% of eighth- and twelfth-grade students could proficiently write a text. The results for students from diverse backgrounds were even lower. This has impacts on students as they move into post-secondary education and are expected to write more specific genres of texts such as lab reports. This study focused on low-er-division university STEM students completing an online survey about their writing skills and how webtools could be a source to help them improve the content and quality of their writing during a 15-week semester. The results of the survey (n = 40) and follow-up interviews of students (n = 10) indicated that they have persistent challenges with writing such as organizing ideas and editing. With access to the writing webtools at mid-semester, students' lab report grades demonstrated improved content and quality scores in weeks 8-15. The authors also discuss limitations and ideas for future research.
Structural evaluation of selected reinforced concrete buildings within the scope of urban renewal in Izmir province
Authors: Ergin İbrahim , Seçer Mutlu
Published: January 2025

In this study, 160 reinforced concrete buildings located in Izmir, with different numbers of floors and construction years, within the scope of urban renewal between 2013 and 2018, were examined, and their risk status was determined according to the Principles for Identification of Risky Buildings 2013 (RYTEIE 2013). Reinforced concrete buildings were evaluated in detail considering characteristic properties such as concrete compressive strengths, column longitudinal reinforcement ratios, floor weights, ratio of column sectional areas to floor areas, natural vibration periods, ratio of column axial stresses to existing concrete compressive strength, and failure ratios. The structures examined within the scope of the paper were also grouped into two main categories: before and after 1998. In addition, all these buildings were evaluated in terms of Life Safety (LS) performance level with the linear elastic calculation method given in Specification for Structures to be Built in Disaster Areas 2007 (DBYBHY 2007), which was also in force between 2013 and 2018. It is observed that 72% of reinforced concrete buildings were determined as risky buildings according to RYTEIE 2013 and couldn’t provide the LS performance level according to DBYBHY 2007.
Flexible Working Arrangement and Well-Being amongst Private University Employees: A Pilot Study
Authors: Nugraha Fida Nirmala , Aisha Atya Nur , Suwarsono Litasari Widyastuti
Published: January 2025

The COVID-19 epidemic led to several adjustments in the workplace. Working from home or having flexible arrangements (FWA) has become standard practice in many workplaces. A Bandung-based private institution implemented a similar setup. FWA practices, tenure, and gender, as well as the combination of the three, had a substantial impact on the relationship dimension of subjective well-being. The association between the influence of FWA on the relational dimension of subjective well-being is strengthened by the effects of tenure and gender. This indicates that in this case where respondent used FWA, had a longer tenure, and is the same gender as his or her co-workers, they positively interact with other individuals (in a work setting, according to the context of this research). With the addition of other criteria (tenure and gender), the favorable perspective on the relationship of subjective well-being was amplified. FWA practices generated a positive perception of subjective well-being.
Legal Responsibility for Environmental Damage Caused by Russian and Ukrainan Wars: International Humanitarian and Criminal Law Perspectives
Authors: Romdoni Rafi Nasrulloh Muhammad
Published: January 2025

Not only inflicted human casualities, the war between Russia and Ukraine, also injured the environment. Russia's discriminating attacks on essential objects such as gas, energy, oil, and mining infrastructure become the most significant root cause. UNEP affirmed that the attacks resulted in widespread water, soil and air pollution, as well as a significant deterioration in Ukraine's ecosystem stability. Accordingly, the study intends to examine the framework of international humanitarian and criminal law, specifically in terms of enviromental protection, as well as to analyze accountability before the International Criminal Court. The study employed doctrinal method involving a statutory and conceptual approach. In this case, relevant legal instruments such as the 1949 Geneva Conventions and their Additional Protocols,  as well as the Rome Statute, were being examined. Furthermore, the study is also certified by the evolution of legal doctrines in books, jounals, and other credible sources. According to the findings,  humanitarian law, which is underpinned by customary international law,  protects the environment slightly better than international criminal law. In short, the state bears multiple duties for environmental damage caused by the outbreak of war. Individual accountability before the ICC, on the other hand, is being overlooked. It is due to the Rome Statute's flaws, which include vagueness in the formulation of the articles,  stringent standards for proof of environmental damage, and bias in proving mens rea. As a result, improvements in the enforcement of international crimes (war crimes and related types) that cause environmental damage are urgently required.
Relationship between transmembrane emp24 domain containing 2 expression and tumor stem cell characteristics in oral cancer
Authors: Wu Yanhui , Zhang Shunchu , Zou Guimei
Published: January 2025

Objective:

Transmembrane Emp24 Domain Containing 2 (TMED2) is a mediator of membrane protein trafficking involved in intracellular protein transport. Recent research suggests that TMED2 plays an important role in the development and metastasis of tumors; however, its exact mechanisms in oral cancer (OC) remain unclear. This study aims to elucidate the role and possible mechanisms of TMED2 in OC.

Material and Methods:

We investigated the impact of TMED2 knockdown on the invasion, migration, and proliferation capabilities of OC cells. Furthermore, we analyzed the in vitro and in vivo interactions between TMED2 and polypeptide-N-acetylgalactosaminyltransferase 7 (GALNT7) as well as explored the regulatory function of TMED2 on GALNT7. The alterations in stem cell markers were assessed using clone formation assays, western blot, and quantitative real-time polymerase chain reaction.

Results:

The upregulation of TMED2 promoted the proliferation and invasion abilities of OC cells. Further analysis revealed that TMED2 enhanced the stem-like properties and tumorigenicity of OC cells by directly regulating the expression of GALNT7. In vivo and in vitro results suggested that silencing TMED2 expression reduced the incidence of OC.

Conclusion:

Our data imply that TMED2 stimulates GALNT7 transcription, which in turn amplifies the stem-like characteristics and carcinogenic potential of OC cells. Moreover, the block of TMED2 prevents cancers from growing and spreading in vivo. This finding provides a new therapeutic target for the treatment of OC and highlights the critical role of TMED2 in the condition.
Consensus statement on the surgical management of vitiligo
Authors: Bhingradia Yogesh M. , Gupta Somesh , Ghia Deepti , Shah Samkit , Patel Nandita Krishnagopal , Salim T. , Kumari Pradeep , Vasudevan Biju , Shah Swapnil , Jain Nitin , Borkhatariya Piyush B. , Mitra Debdeep , Prasad Davinder
Published: January 2025

Vitiligo is a chronic skin disorder characterized by the loss of melanocytes, leading to depigmented patches on the skin. The global lifetime prevalence of vitiligo diagnosed by a physician or dermatologist was estimated at 0•36% in the general population, 0•67% in the adult population adults, and 0•24% in the child population. Vitiligo prevalence was higher in adults than in children across all regions. Central Europe and south Asia reported the highest prevalence 0•52% and 0•52%, respectively, in the general population. Vitiligo significantly impacts patients’ quality of life, causing psychological distress and social stigmatization. While medical treatments such as corticosteroids and phototherapy exist, they often fail to achieve satisfactory repigmentation, particularly in extensive or recalcitrant cases. In recent years, surgical interventions have gained prominence as effective alternatives for managing vitiligo. Techniques such as autologous melanocyte transplantation, suction blister grafting, split-thickness skin grafting, and punch grafting offer promising repigmentation results. However, the lack of standardized protocols and guidelines for vitiligo surgery presents challenges in patient selection, procedural approaches, and post-operative care. This study aims to review current surgical techniques, assess patient-specific factors influencing surgical success, and evaluate long-term outcomes, including repigmentation rates and patient satisfaction. Key factors include disease stability, lesion characteristics, and the involvement of exposed areas. Moreover, the study emphasizes the importance of post-operative adjuvant therapy, such as topical tacrolimus and excimer therapy, to enhance surgical outcomes. By establishing evidence-based protocols for vitiligo surgery, this study seeks to improve treatment efficacy and patient care, addressing gaps in current practices and advancing the field toward more consistent and successful outcomes in vitiligo management.
Clinical-morphological features of hemodynamic strokes
Authors: Tanashyan Marine M. , Ablyakimov Renat E. , Gulevskaya Tat'yana S. , Anufriev Pavel L. , Evdokimenko Anna N.
Published: January 2025

Introduction. An important objective of neurology is to clarify the pathogenesis of ischemic strokes and the diagnostic distinction of their pathogenetic subtypes that determines the possibility of targeted treatment and adequate prevention of strokes.Objective: Definition of clinical and morphological features of the hemodynamic subtype of ischemic stroke.Materials and methods. A clinical-pathological comparison in 32 cases of hemodynamic strokes.Results. It was established that hemodynamic strokes were caused by the presence of factors reducing systemic and cerebral hemodynamics in combination with tandem atherostenosis of carotid arteries (40% of strokes) and vertebrobasilar arteries (43%), and, occasionally, stenosis of both brain arterial systems or isolated cerebral arterial stenosis (10% and 7%, respectively). The severity of tandem stenosis on the side of the cerebral infarction ranged from 50% to 90%, and some strokes developed with minimal stenosis of each of the vessels. Eighty eight percent of strokes developed in patients having combination of stenosis on the side of the infarction with significant contralateral stenosis. In 43% of strokes, single or multiple small-sized cortical or medium-sized cortical-subcortical infarctions in areas of adjacent blood supply of cerebral hemispheres, as well as lacunar or medium-sized infarctions in the white matter of the hemispheres were seen. Thirty nine percent of strokes were associated with infarctions in the areas of adjacent blood supply of the cerebellar and the brainstem arteries. Eighty percent of cases were associated with atypical for this stroke subtype large-sized and medium-sized cortical-subcortical infarctions outside the areas of adjacent blood supply, resulting from inability to compensate cerebral blood supply deficiency through arterial anastomoses because of severe insi- and contralateral stenoses.Conclusions. Our clinical-pathological comparisons confirmed the previously established differential diagnostic criteria of hemodynamic strokes and, in addition, showed some specific features of their realization.
Pharmacological correction of cerebrovascular disorders in various experimental pathological conditions
Authors: Mirzoyan Ruben S. , Gan,shina Tamara S. , Kim Galina A. , Kurdyumov Il'ya N. , Maslennikov Denis V. , Kurza Elena V.
Published: January 2025

Abstract
Introduction. In the treatment of patients with cerebrovascular disorders, pharmacological correction of cerebral circulation largely depends on the character and the state of the pathological process. This determines the need to study the pharmacological regulation of the cerebral blood supply in various pathological conditions.
Objective. To study the effects of oxymethylethylpiridine succinate, nicotinoyl gamma-aminobutiric acid, nimodipine, amlodipine besylate and S-amlodipin nicotinate on the cerebral circulation of intact and ischemic rats, and to assess the effects of oxymethylethylpiridine succinate and nimodipine in experimental myocardial infarction and combined vascular pathology of the brain and heart.
Materials and methods. The cerebral circulation was evaluated using the laser Doppler flowmetry technique. Global transient ischemia was caused by occlusion of both common carotid arteries with simultaneous decrease in arterial pressure by bleeding and subsequent reinfusion. Experimental myocardial infarction was modeled by occlusion of the left coronary artery.
Results. Oxymethylethylpiridine succinate significantly increases blood supply to the brain in rats under conditions of global transient ischemia of the brain and combined vascular pathology of the brain and heart, in contrast with intact animals and animals with experimental myocardial infarction. Nicotinoyl gamma-aminobutiric acid equally increased blood circulation of the intact and the ischemic brain. Nimodipine equally increased cerebral blood flow in intact rats and in rats underwent brain ischemia, whereas this effect was significantly weakened in experimental myocardial infarction and disappeared in combined vascular pathology. S-amlodipin nicotinate and, to a lesser extent, amlodipine bisilate increased blood supply to the ischemic brain. The vasodilating effects of oxymethylethylpiridine succinate, nicotinoyl gamma-aminobutiric acid and S-amlodipin nicotinate, but not of nimodipine, were eliminated by GABAA receptor blockers.
Conclusions. The dependence of the vasodilating effect of the studied drugs on the initial state of the organism was revealed. This phenomenon should be taken into account in prescribing target pathogenetic therapy of ischemic stroke.
Multimodal studies of the human brain using functional magnetic resonance imaging and magnetic resonance spectroscopy
Authors: Ublinskiy Maksim V. , Manzhurtsev A. V. , Men'shchikov P. E. , Akhadov T. A. , Semenova N. A.
Published: January 2025

Abstract
Studying the brain structure and function in health and disease is one of the most important and intensively developing fields of neuroscience in the new century. Nowdays, in vivo studies of brain structure, metabolism, blood flow and function are mostly performed using safe imaging technologies not requiring ionizing radiation and based on magnetic resonance imaging (MRI). In this review, the detailed description of the principles of commonly used techniques that provide high-quality information about the brain, such as functional MRI (fMRI) and magnetic resonance spectroscopy (MRS), is presented. The potential and advantages of these methods including their use in combination with other imaging techniques (MR-tractography etc.) are outlined. The authors believe that combining all MRI options in one study may produce a complex approach for exploring physical-chemical mechanisms underlying brain function which may be of value for basic and applied research.
MRI in the assessment of cerebral small vessel disease
Authors: Gnedovskaya Elena V. , Dobrynina Larisa A. , Krotenkova Marina V. , Sergeeva Anastasiya N.
Published: January 2025

Abstract
Cerebral small vessel disease (cSVD) is a leading cause of vascular cognitive impairment and dementia, cerebral hemorrhages, and lacunar strokes. It is considered to be the most common clinically silent vascular brain disorder. Major forms of cSVD are age- and hypertension-associated arteriolosclerosis and cerebral amyloid angiopathy. For most types of cSVD causes and mechanisms of disease development and progression remain unknown. Detailed research of cSVD is hindered by lack of technical approaches to an in vivo assessment of microvasculature. MRI equivalents of pathological changes in cSVD might serve as surrogate markers of vascular damage and might be associated with clinical signs and symptoms. We review studies that demonstrated clinical significance of the primary MR signs of cSVD, i.e. white matter hyperintensity (formerly known as leukoareosis), lacunes, enlarged perivascular spaces and cerebral microbleeds, as well as their role in the disease progression. Recently introduced STRIVE standards established MRI changes as diagnostic criteria for cSVD. These standards may significantly improve our understanding of the role of various factors in the development of cSVD and its heterogeneity. However, individual prognostication and assessment of short-term and long-term treatment efficacy is still lacking. The use of diffusion-weighted MRI techniques for the assessment of microstructural changes of visually normal bran tissue might be helpful. Strong association between microstructural changes and clinical manifestation of cSVD supports the need for multimodal MRI studies for the assessment of pathophysiological mechanisms of the disease progression even on preclinical stages.
The role of personality disorders in the management of patients with pharmacoresistant epilepsy after neurosurgical resections
Authors: Narodova Ekaterina A. , Schneider Natalia A. , Narodov Andrey A. , Dmitrenko Diana V. , Strotskaya Irina G. , Moskaleva Polina V.
Published: January 2025

The review focuses on the problem of personality disorders that arise in patients with pharmaco-resistant epilepsy after neurosurgical resections. We analyzed 47 research articles, selected by keywords from Russian and international databases for 20102017. It was found that, despite the achievements in epilepsy surgery and the high percentage of remission in the postoperative period, the problem of personality disorders remains important. The most frequent postoperative personality disorders are anxiety and depression, which greatly exacerbate the course of the postoperative period and make it difficult for the patient to adapt in society because of his internal stigmatization. In addition, depression can provoke the aggravation of epileptic seizures in the postoperative period. Psychiatric anamnesis and a severe form of depression in the preoperative period are the powerful predictors of the depression onset in the postoperative period. Despite this, there are no psychiatric contraindications to the surgical treatment of pharmaco-resistant epilepsy. The authors discuss the need for perioperative psychiatric testing of patients suffering from epilepsy.
Analysis of the factors limiting reperfusion therapy in patients with ischemic strokes
Authors: Maslova Natalia N. , Miloserdov Maxim A.
Published: January 2025

Introduction. Systemic thrombolytic therapy with recombinant tissue plasminogen activator is the only reperfusion method available to most primary vascular units which allows significantly improving the functional prognosis of patients with ischemic stroke.
Objective. To analyze the main determinants limiting reperfusion therapy administration in a subsidized region with demographic aging of the population, and to develop and scientifically justify the ways of their elimination.
Materials and methods. We analyzed the data of the ambulance station in Smolensk electronic archive accounting for 17,143 phone requests for medical aid for patients with strokes, the data from the annual report of the neurological department for patients with acute cerebrovascular accident of the Clinical emergency care hospital, and 200 clinical records of patients diagnosed with acute stroke that were delivered to the in-patient facility by emergency medical service (EMS) teams in the period of the "therapeutic window" and who did not receive reperfusion therapy. The operative work of the dispatcher service, the efficiency of the mobile teams work, the structure of time losses during the call service, and the distribution of patients by the time period before the admission to a hospital depending on the way of admission and the remoteness of the "zone of responsibility" from the primary vascular surgery department were assessed.
Results. It was found that statistically significant differences in time period before admission to a hospital of patients with ischemic strokes depend on the admission way and, in the case of arrival by the EMC, do not depend on the distance of the delivery area. The low efficiency of the mobile teams is due to the imperfection of call processing by dispatchers and the lack of a systematic approach and a single algorithm aimed for diagnosing and providing emergency assistance to the medical personnel of EMS teams. The main non-regulating factors for abandoning systemic administration of the recombinant tissue plasminogen activator in patients with ischemic strokes delivered to the hospital in the period of the "therapeutic window" are mild neurological symptoms, the age over 80 years and poly-morbidity of patients.
Conclusion. It is necessary to adopt a series of measures aimed at advancing the efficiency of the EMS teams and rising awareness within the general public in order to reduce mortality of patients with ischemic strokes through increasing frequency of reperfusion therapy administration.
Comparison of effects and electrophysiological mechanisms of action of valproic acid and levetyracetam in an experimental model of focal epilepsy
Authors: Litvinova Svetlana A. , Avakyan Georgii G. , Voronina Tatyana А. , Gaidukov Igor O. , Nerobkova Lyubov N. , Kutepova Inga S. , Avakyan Gagik N.
Published: January 2025

Introduction. Despite rapid development of the antiepileptic pharmaceuticals market, about 2/3 of patients suffering from epilepsy do not receive adequate treatment, which is partly due to the variety of mechanisms for the development of epileptic seizures
Objective. А comparative study of the electrophysiological mechanisms of action and effects of valproic acid (Depakin Chrono) and levetiracetam (Levetinol) under experimental focal epilepsy and status epilepticus (SE) in rats.
Materials and methods. Focal chronic epilepsy was caused by the application of cobalt to the sensorimotor cortex. On the 7th8th day, SE was modeled by the injection of homocysteine, which provoked the development of secondary generalized tonic-clonic seizures.
Results. Levetiracetam had a suppressing effect on the paroxysmal activity of the rat brain only under conditions of a stable SE on the 5th6th day after the application of cobalt. Its most prominant effect was seen in the hippocampus and was characterized by a significant decrease in epileptic activity (EpiA) in this structure and in the maintenance of a regular rhythm. Valproic acid significantly suppressed EpiA in the ipsilateral cortex, hippocampus and hypothalamus at a stable stage of EpiS development, with the most pronounced effect on the primary cortical focus and hypothalamus. In the model of SE caused by the injection of homocysteine, levetiracetam was ineffective, whereas valproic acid decreased the severity of paroxysmal activity in all the studied structures, especially in the cortex (ipsi- and contralateral, 33 times) and hypothalamus (28 times), which was accompanied by suppression of generalized motor manifestations and reduced number of animal deaths.
Conclusion. In the model of focal cobalt-induced epilepsy, the hippocampus is the leading structure and the target of the levetiracetam action, while the effect of valroic acid is executed through the inhibitory effect on the cortical foci of EpiA and the hypothalamus, which may be main feature in its ability to suppress the SE.
Theoretical basis for classical methods of motor rehabilitation in neurology
Authors: Ustinova Ksenia I. , Chernikova Lyudmila A. , Khizhnikova Anastasia E. , Poydasheva Alexandra G. , Suponeva Natalia A. , Piradov Mikhail A.
Published: January 2025

Authors review the milestones of the historical formation of various theories of motor control, from the reflex to the system model. These theories form the basis forь the methods and approaches of motor rehabilitation of patients with neurological diseases and injuries. The task-oriented approach, based on systemic theories of motor control, is now generally accepted. One of its main fundamentals is the dependence of movement on parameters and conditions of the motor under performance.
Rehabilitation methods and approaches presented in this paper are not mutually exclusive, but supportive. This is the reason why the study of effectiveness of a particular rehabilitation method does not always yield valuable results. Various rehabilitation methods and approaches should be combined in the treatment of neurological patients. Moreover, relative contribution of individual methods into the rehabilitation of each patient may vary depending on the safety of his or her motor functions and many other factors that are to be taken into account when planning rehabilitative activities.
Surgical methods of treatment of back pain syndrome recurrence in the degenerative pathology of the lumbar spine
Authors: Shnyakin Pavel G. , Botov Anton V. , Amelchenko Andrey A.
Published: January 2025

The number of surgical interventions on the lumbar spine is constantly growing due to the emergence of new surgical techniques aimed at treatment of degenerative spine pathology and a large number of patients, suffering from the back pain. Quite often, surgical intervention turns to be not effective enough and the pain syndrome persists, leading to the necessity for the repeated revision surgeries with the use of stabilizing systems. The review represents research data on the causes of recurrent-remitting course of degenerative process, problems of epidural adhesion as one of the back pain syndrome predictors, the survey of various stabilization systems and operative approaches for their implantation. The disadvantages and advantages of ventral approach with the use of interbody fusion are summarized in comparison with dorsal approach used for the installation of the transpedicular system and interbody fusion with a bone graft.
The positive features of interbody fusion from anterior retroperitoneal approach include the ability to quickly and completely remove the entire disc, decompress the dural sac without entering the vertebral canal, optimally select an implant corresponding to the size of the vertebral end plates, creation of the optimal lordosis angle, and provision of the shortest approach to the operated disk and to the place of neural structures compression.
The advantages of the dorsal approach with transpedicular system implantation and interbody fusion with a bone graft are better visualization of neural structures in comparison with discectomy from the ventral approach, the possibility of wide decompression and expansion of the extent of operation, the possibility of ablation of the facet joints by diathermocoagulation after the surgical wound was made, the reliability of posterior fixation, and familial approaches for a neurosurgeon with a lesser duration of training.
Tissue-type plasminogen activator and MRI features of cerebral small vessel disease
Authors: Zabitova Maryam R. , Shabalina Alla A. , Dobrynina Larisa A. , Kostyreva Marina V. , Akhmetzyanov Bulat M. , Gadzhieva Zukhra Sh. , Kremneva Elena I. , Gnedovskaya Elena V. , Krotenkova Marina V.
Published: January 2025

Introduction. Сerebral small vessel disease (SVD) is a one of the leading causes of cognitive decline, and of ischemic and hemorrhagic stroke. It is diagnosed with the MRI criteria elaborated by international society (STRIVE, 2013). The development of SVD is closely related with endothelial dysfunction. Of special importance are studies of factors produced by endothelium and participating in the pathogenesis of SVD.
Objective: to clarify the relationships of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) with MRI signs of SVD.
Materials and methods. Seventy-one patients (23 males and 48 females, mean age 60.56.9) with SVD diagnosed according to the STRIVE criteria were examined. Arterial hypertension of grade 1 was revealed in 12 patients, grade 2 in 7, and grade 3 in 37 patients. White matter hyperintensities (WMH), according to Fazekas (F) scale, were graded stage F1 in 17 patients, F2 in 23, and F3 in 30 patients. Control group comprised 21 age- and sex-matched individuals with normal brain MRI. Brain MRI (3 Tl) was performed in all patients, with the assessment of the following SVD features: WMH, lacunes, microbleeds, and enlarged perivascular spaces. Blood levels of t-PA and PAI-1 were measured by enzyme immunoassay. An ANOVA variance analysis was used (p0.05).
Results. High t-PA level was associated with more severe WMHs assessed with Fazekas stages (p=0.000) and with larger volume of WMH (p=0.019), as well as with the size of subcortical and semioval perivascular spaces (p=0.001). This dependence was not related with the presence arterial hypertension or its characteristics (p0.05). PAI-1 levels were not associated (p0.05) with t-PA levels or MRI features of SVD.
Conclusion. The determined effect of t-PA level on the severity of WMH and perivascular spaces, the SVD features associated with increased blood-brain permeability, confirms the role of endothelial dysfunction in the development of SVD and the involvement of t-PA in the mechanisms of brain injury.
Monoclonal antibodies in neurology: current state and future development
Authors: Zakharova Maria N.
Published: January 2025

Monoclonal antibodies are one of the most fastly developing areas of specific therapy for cancer, infectious, autoimmune and demyelinating diseases. The main targets of monoclonal antibodies in autoimmune and demyelinating diseases are T and B-lymphocytes, cytokines, complement, and adhesion molecules. In the field of neurodegenerative diseases, the largest number of studies has been carried out in patients with Alzheimer's disease, in which monoclonal antibodies are targeted to brain aggregates of beta-amyloid. This review presents new therapeutic approaches to the use of antibody fragments, with a focus of their new class, nanobodies. A special attention is paid to new anti-CD20 and anti-CD19 monoclonal antibody drugs in multiple sclerosis (ocrelizumab, ofatumumab) and neuromyelitis optica (inebilizumab). Ocrelizumab is the first medication that proved to be effective in primary progressive multiple sclerosis. There have been significant advances in the treatment of neuromyelitis optica: the first multicenter study of Inebilizumab (MEDI-551) is currently underway.
Cervical arthroplasty: 5-year follow-up
Authors: Guscha Artyom O. , Dreval Maxim D. , Petrosyan David V. , Arestov Sergey O. , Kascheyev Alexey A. , Vershinin Andrey V. , Poltorako Yekaterina N.
Published: January 2025

Research objective: analysis of the early and long-term outcomes of cervical intervertebral disc prosthetics, assessment of the amount of movement and of the regression of radicular symptoms within 5 years.
Materials and methods. Thirty patients (19 women and 11 men, average age 35.8 years) were operated on for a single-level degenerative lesion of the intervertebral disk. The amount of movement was assessed based on functional X-ray data. Regression of radicular pain symptoms was assessed using visual analogue scale (VAS).
Results. Good and excellent results were obtained. In the long-term period (60 months), local cervical pain syndrome ranged from 0 to 3 VAS points, with initial estimation at 68 points. Radicular pain was estimated at 02 VAS points, initially 58 points.
Conclusion. Arthroplasty is a highly effective method for the treatment of degenerative lesions of cervical intervertebral discs. The technique can definitely compete with rigid stabilization systems and proves its efficacy in treatment of the disease of the adjacent segment.