6th Month Research Articles

Early-life ozone exposure and childhood otitis media: Unveiling critical windows of risk

BackgroundDespite increasing evidence of a strong correlation between air pollution and otitis media (OM), the impact of early-life ozone (O3) exposure on the development of OM in children remains uncertain. ObjectivesTo explore the connection between early-life O3 exposure and OM, and to identify the critical time period(s) during which O3 exposure significantly influences the development of OM in children. MethodsWe conducted a study involving 8689 children living in Changsha, China. Information regarding personal factors, health conditions, and the indoor environment was gathered using questionnaires. Personal exposure to outdoor O3 and other major pollutants at the place of residence during the periods before conception, prenatal periods, and after birth was calculated by applying the inverse distance weighted (IDW) method with data gathered from ten air quality monitoring stations. Multiple logistic regression analyses were employed to investigate the associations between O3 exposure and children's OM. ResultsAfter controlling for covariates and ambient temperature, exposure to O3 during the year preceding pregnancy was correlated with childhood lifetime OM, showing ORs (95 % CI) of 1.28 (1.01–1.64). O3 exposures in the 10th–12th, 7th–9th, and 4th–6th months before pregnancy were all linked to children's lifetime OM. Within the multi-window model, we detected that O3 exposure in the 10th to 12th month prior to pregnancy was significantly related to lifetime OM, showing ORs (95 % CI) of 1.28 (1.05–1.55). A significant link was discovered between childhood OM and O3 exposure after controlling for six other pollutants (SO2, PM2.5, NO2, PM2.5–10, CO, and PM10) during the 10th to 12th month prior to conception. Exposure to O3 during the 36th gestational week significantly raised the likelihood of childhood lifetime OM. There is a significant interaction between O3 and temperature exposure during the first trimester of pregnancy and one year before pregnancy on childhood lifetime OM. ConclusionsPreconceptional O3 exposure and its interaction with low temperature played critical roles in children's OM development, backing the hypothesis of “(pre) fetal origins of childhood OM”.

The Effect Of Weight Loss With Lifestyle Changes On LDL Cholesterol: Retrospective Cohort Study

Aim: This study aimed to investigate the rate of decrease in lipid levels with effective lifestyle changes (LC) and the minimum body weight loss necessary for effective lipid reduction in obese patients. Method: The study is a retrospective cohort study. The study included 71 patients who were followed up in the obesity clinic, who were diagnosed with hyperlipidemia but did not use any hyperlipidemia treatment. The patients' high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, triglyceride, body fat ratio and mass, body mass index (BMI), height and weight information were recorded at the first visit and the 6th month. In our study, patients were divided into two groups (based on the weight loss rates in the 6-month follow-up) those who lost less than 10% of their previous weight and those who lost 10% or more weight and their lipid parameters were compared. Results: LDL-C reduction rates of patients classified according to their weight loss rates were found to be statistically significantly (p=0.011) higher in those with 10% or more weight loss than (group 1=18.48%) in those with less than 10% weight loss (group 2=13.04%). Total cholesterol reduction rates were also significantly (p=0.015) higher in the 1st group than in the 2nd group. According to the findings of our study, at least 10% weight loss is required to decrease total cholesterol and LDL-C significantly. Conclusion: Implementation of primary and secondary prevention strategies to reduce the risk of cardiovascular disease is important in the context of primary care. To reach the targeted LDL-C values, the weight monitoring of obese patients should be considered, and the importance of losing at least 10% of weight as one of the first steps should be emphasized.

The clinical effect of different vertebral body height restoration rates after percutaneous kyphoplasty for osteoporotic vertebral compression fractures

ObjectiveThis study aimed to evaluate the clinical effect of different vertebral body heights restoration rate after percutaneous kyphoplasty (PKP) for the treatment of osteoporotic vertebral compression fractures (OVCF).MethodsThe patients were divided into two groups according to the height restoration rate of the anterior edge of the vertebral body fracture after PKP operation using X-Ray imaging. The group A was below 80%, and the group B was above 80%. Clinical preoperative and postoperative efficacy (1st day, 1st month, 6th month, and 12th month after surgery) were evaluated according to VAS, Oswestry Disability Index(ODI), Quality of Life Questionnaire of the European Foundation for Osteoporosis(QUALEFFO), and Back Pain Life Disorder Questionnaire(RQD). Simultaneously, the preoperative and postoperative local Cobb angles and changes in the injured vertebrae in the two groups were calculated and analyzed.ResultsThe postoperative Cobb angle in group A was significantly higher than that in group B. The correction rate in group B was significantly better than that in group A. The VAS, ODI, QUALEFFO, and RQD scores of group B patients were significantly lower than those of patients in group A at each follow-up time point. The correlation coefficients of vertebral body height restoration rate and VAS, ODI, QUALEFFO, and RQD scores at the last follow-up were − 0.607 (P < 0.01), -0.625 (P < 0.01), -0.696 (P < 0.01), and − 0.662 (P < 0.01), respectively.ConclusionsThe results of the correlation analysis between the vertebral body height restoration rate and the above clinical efficacy scores show that increasing the vertebral body anterior height restoration rate is beneficial for pain relief and improves the clinical efficacy of patients. Simultaneously, improving the height restoration rate of the anterior edge of the vertebral body and restoring the normal spinal structure is beneficial for reducing the incidence of refracture of the adjacent vertebral body.

Evaluating a novel method for vitamin A analysis in an observational study of the UAE's obese population

Vitamin A plays a critical role in various biological functions, including vision, cellular differentiation, and immune regulation. However, accurately assessing its status, particularly in obese individuals, presents challenges due to potential alterations in metabolism and distribution. This study utilized Liquid Chromatography–Tandem Mass Spectrometry (LC–MS/MS) methodology to precisely measure serum vitamin A concentrations in population of UAE. The methodology's reliability and precision, as demonstrated through validation procedures, underscore its potential utility in clinical settings. Employing the Multiple Reaction Monitoring mode of positive ion electrospray ionization, the LC–MS/MS system achieves a limit of detection (LOD) of 0.48 ng/mL in serum, while adhering to FDA-US regulations for accuracy and compliance. A key aspect of this study was the application of LC–MS/MS to assess vitamin A status in an obese population within UAE. By employing a diverse cohort of 452 Emirati participants, including 277 individuals from a randomized controlled trial who were assessed at baseline and at 6th month, and 175 healthy individuals aged 18–82 assessed at baseline, this study explores the relationship between obesity and vitamin A levels, shedding light on potential implications for health and well-being. It was an observational study based on a new vitamin A method and participants were asked to eat vitamin A rich foods. The robust performance of the LC–MS/MS methodology positions it as a valuable tool for clinical research. By accurately quantifying vitamin A levels in human serum, this methodology opens avenues for advancing our understanding of vitamin A physiology and its implications for health, particularly in obese populations. In summary, this LC–MS/MS methodology presents a potent tool for clinical studies, providing reliable, specific, and robust detection of vitamin A in human serum, thus, opening a new frontier for advancing our understanding of vitamin A related physiology and health in the obese population.

Prevalence of post-intensive care syndrome: Observations from a tertiary care hospital in Eastern India

ABSTRACT Background: Post-intensive care syndrome (PICS) refers to physical, cognitive and psychological symptoms that occur after a patient is discharged from the intensive care unit (ICU). Aims: The present study aimed to explore the prevalence of PICS among ICU survivors of a tertiary care setup in Eastern India. Methods: A single-centre prospective cohort study was conducted amongst patients admitted to the ICU. A predefined, structured interview in 1st month, 3rd month, 6th month after ICU admission was done. Baseline characteristics were noted. Physical and cognitive impairment, psychological distress and general health were assessed using the Barthel Index (BI), mini-mental state examination (MMSE) tool, Hospital Anxiety and Depression Scale (HADS) and EuroQoL Visual Analogue Scale. Results: Of the 150 patients included in the study, the mean Acute Physiology and Chronic Health Evaluation II score was 20.87. The leading cause of ICU admission was sepsis (40.7%), followed by acute exacerbation of chronic obstructive pulmonary disease and pneumonia (14%). The median stay in the ICU was 8 days. Mean BI significantly decreased from 79.20 at baseline to 60.17 and 64.33 in the 3rd and 6th months, respectively. The mean HADS-Depression score increased from 3.79 at baseline to 7.08 at 3rd and 5.92 at 6th month. Similarly, the mean HADS-Anxiety score increased from 4.37 at baseline to 7.44 at 3rd and 6.31 at 6th month. The mean MMSE score decreased from 24.61 at baseline to 22.26 at the 3rd and 6th months, respectively. Thus, PICS was recorded in 90% of cases in the 3rd month and 89.3% in the 6th month. Conclusion: The management of PICS involves a multidisciplinary approach, including physical rehabilitation, cognitive rehabilitation and psychological support.

A prediction model of dementia conversion for mild cognitive impairment by combining plasma pTau181 and structural imaging features.

The early stages of Alzheimer's disease (AD) are no longer insurmountable. Therefore, identifying at-risk individuals is of great importance for precise treatment. We developed a model to predict cognitive deterioration in patients with mild cognitive impairment (MCI). Based on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, we constructed models in a derivation cohort of 761 participants with MCI (138 of whom developed dementia at the 36th month) and verified them in a validation cohort of 353 cognitively normal controls (54 developed MCI and 19 developed dementia at the 36th month). In addition, 1303 participants with available AD cerebrospinal fluid core biomarkers were selected to clarify the ability of the model to predict AD core features. We assessed 32 parameters as candidate predictors, including clinical information, blood biomarkers, and structural imaging features, and used multivariable logistic regression analysis to develop our prediction model. Six independent variables of MCI deterioration were identified: apolipoprotein E ε4 allele status, lower Mini-Mental State Examination scores, higher levels of plasma pTau181, smaller volumes of the left hippocampus and right amygdala, and a thinner right inferior temporal cortex. We established an easy-to-use risk heat map and risk score based on these risk factors. The area under the curve (AUC) for both internal and external validations was close to 0.850. Furthermore, the AUC was above 0.800 in identifying participants with high brain amyloid-β loads. Calibration plots demonstrated good agreement between the predicted probability and actual observations in the internal and external validations. We developed and validated an accurate prediction model for dementia conversion in patients with MCI. Simultaneously, the model predicts AD-specific pathological changes. We hope that this model will contribute to more precise clinical treatment and better healthcare resource allocation.

Comparing Ribociclib versus Palbociclib as a Second Line Treatment in Combination with Fulvestrant in Metastatic Breast Cancer: A Randomized Clinical Trial.

Assessment of CBR, PFS, QOL and toxicity profile of palbociclib and ribociclib. This is an interventional concurrent randomised phase III open label clinical trial. It took place at the Oncology Centre Mansoura University, Egypt from July 2022 till December 2023. Patients with pathologically proved ER+ HER2- metastatic breast cancer who either progressed on adjuvant hormonal or progressed on 1st line hormonal for metastatic disease. Patients in arm A received palbociclib 125 mg/day orally for 3 weeks and 1 week rest, plus fulvestrant. Patients in Arm B received ribociclib at a dose of 600 mg, administered orally once daily for 3 weeks and 1 week rest, plus fulvestrant. Pre- and peri-menopausal women received the LHRH agonist goserelin. Patients who lost their endorsement and were considered to be lost to follow up. Quality of life was analysed using the (EORTC) quality-of-life questionnaire (QLQ)-C30 V3.0. Patients were asked to complete the questionnaires at screening; at the 2nd and 6th month. Toxicity was assessed and graded using (CTCAE) v5.0. Patients were evaluated clinically for response and toxicity monthly and radiologically by CT and tumor markers/ 3 months. Treatment continued until objective Progressive Disease (PD), symptomatic deterioration, unacceptable toxicity or death. Both arms had similar baseline characteristics. There was no statistically significant difference regarding the CBR (58.6% for both arms at 6 months and 13.8% in the palbociclib VS 17.2% in the ribociclib arm at 12 months). The median PFS to the whole population was 13 months. COX multivariate analysis revealed that postmenopausal had 2.85 more likely to survive than premenopausal patients. Patients with ECOG performance status 2 and 3 are 0.13 and 0.39 less likely to survive compared to patients with PS 1. Dose reduction increased the likelihood of survival 3.36 compared with no dose reduction. The median PFS was 13.67 months in the palbociclib arm and 12.69 months in the ribociclib arm with no statistically significant difference. During follow up, there was statistically significant improvement in insomnia in both arms and constipation in the palbociclib arm alone. Comparing the two arms, no statistically significant deterioration in the QOL domains except in fatigue and financial difficulties, with more deterioration in the palbociclib arm. Regarding common toxicities there was no statistically significant difference between the 2 arms. Both Ribociclib and palbociclib have similar CBR, PFS and toxicity profile.

Effect of birth type and sex on growth performance, wither height, humerus-radius bone dimensions, humerus-ulna growth plate width and selected hormone profile in growing Gurcu goat kids.

In this study, the effects of sex and birth type on growth performance, withers height (WH), radiographic measurements and selected hormone profiles in Gurcu goat kids were investigated. Twenty kids (single female=5, single male=5, twin female=5, twin male=5) were included in the study. Body weight (BW), WH, radiographic measurements (humerus length [HL], radius length [RL], proximal humerus epiphyseal plate width [HEP] and distal ulna epiphyseal plate width [UEP]) and biochemical analysis (for serum calcitonin, free triiodothyronine [FT3], free thyroxine [FT4], growth hormone [GH] and insulin-like growth factor-I [IGF-I]) were performed at 1, 3, 5, 7, 9 and 12 months of age. BW was significantly higher in males starting from the seventh month compared to females (p<0.05). HL was higher in males at seventh (p=0.009) and ninth (p=0.033) months, whereas RL was lower in twins at the third month (p=0.021). UEP was wider in males at seventh (p=0.008) and ninth (p=0.036) months. Closure of HEP was observed in 65% of kids by the 12th month. Calcitonin was lower in twins at third (p=0.045) and fifth (p=0.006) months, with changes observed due to group and time effects (p<0.05), whereas other hormones only changed with time (p<0.05). Positive correlations were observed between BW, WH, HL, RL and IGF-I. There was a negative correlation between BW, WH, HL, RL, IGF-I and HEP, UEP, calcitonin, FT3, FT4, GH. Sex and birth type in Gurcu goat kids may have an impact on growth performance, radiographic measurements and certain hormonal profiles.

Cross-Screw Fixation in Isolated Medial Malleolar Fractures.

Isolated medial malleolar fractures are observed less often than are lateral malleolar fractures, bimalleolar fractures, and trimalleolar fractures. The aim of treatment is to provide anatomical reduction, protect this reduction until the fracture heals, and to regain normal ankle function. The aim of our study was to evaluate the clinical and radiological outcomes of patients with isolated medial malleolus fracture treated with cross-screw fixation. The study included 13 patients: 9 males with a mean age of 37.1 years (range, 25-64 years) and 4 females with a mean age of 40.2 years (range, 24-62 years) who were treated with the cross-screw fixation method for an isolated medial malleolar fracture. The fracture union status was evaluated on the 3-month postoperative radiographs, and the functional outcomes with the American Orthopaedic Foot and Ankle Scale (AOFAS) ankle score. The mean AOFAS score was 82 at 3 months postoperatively, evaluated as an excellent outcome in 2 patients, good in 9, and fair in 2. At the 24th month postoperatively, the mean AOFAS score was determined to be 92.2, evaluated as excellent in 11 patients and good in 2. On palpation of the medial malleolus, the mean VAS pain score was 2 (range, 1-3.8) at 3 months postoperatively, and a mean of 0.6 (range, 0.2-3) at 24 months. Cross-screw fixation can be preferred for the fixation of isolated medial malleolar fractures as it causes less soft-tissue damage because it can be performed percutaneously, and the screw head has a low profile, thereby eliminating the need for a Kirschner wire to be applied together with the screw to prevent rotational deformity.

Tumor in the liver: Six inflammatory pseudotumor patient

Inflammatory pseudotumor (IPT) is a rare liver disease confused with liver tumors. It is a disease that should be known in the differential diagnosis for clinicians as the correct diagnosis of IPT will prevent unnecessary surgery. Demographic datas, diagnoses and imaging modalities of six patients with radiologically and/or histopathologically diagnosed hepatic IPT between 2016 and 2023 were retrospectively analyzed. Four out of six patients were female and median age was 57.5 (47-66). C-reactive protein was higher in four patients, and carbohydrate antigen 19.9 level was higher in one patient. We used magnetic resonance imaging (MRI) for diagnosis in five patients. Only in one patient computed tomography was enough for diagnosis. Tumor locations were segment 5 for two patients, segment 7-8 in two patients, segment 7 in one patient, and 8 in one patient. Liver biopsy was performed in five patients because it could not be distinguished from malignancy by imaging methods. Histopathological results of all these biopsies defined as IPT. Initial tumor median size was 31 (17-55) mm. Two patients were operated on. The first one underwent right hepatectomy due to a 2-fold increase in size within 11 months. The second one had a mass indistinguishable from hepatic adenoma by MRI and underwent nonanatomic resection. In one patient, IPT disappeared completely in the 18th month of follow-up period while it regressed in size in two patients. Two of our patients had a history of recurrent endoscopic retrograde cholangiopancreatography, which we noticed incidentally before IPT was diagnosed. IPTs are liver masses with low malignant potential and may shrink spontaneously during follow-up. We suspected that biliary tract interventions may be the cause of IPT.

Long-term effect observation after 10 years of tonsillotomy （Histological analysis of one case of secondary operation）

Objective:To investigate the long-term effect of partial tonsillectomy in children with tonsil hypertrophy. Methods:A total of 146 children with obstructive sleep apnea（OSA） who received surgical treatment for tonsil hyperplasia from January 2010 to January 2013 were selected and divided into the observation group（n=69） and the control group（n=77）. The observation group was received tonsillotomy（TT）, and the control group was received total tonsillectomy（TE）. Parental satisfaction and OSA quality of life questionnaire for children（OSA-18） were surveyed. Residual tonsil size was measured, and polysomnography（PSG） was monitored after 10 years. HE and immunohistochemical analysis were performed on tonsil tissues of one patient who performed a second operation after TT in 2017 year. Results:The results of questionnaire survey showed that the symptoms of respiratory obstruction were significantly improved in both groups, and the satisfaction of TT group was higher than that in the TE group. No increase in the number of respiratory tract infections was observed in all patients. In the TT group, nine cases（13.04%） had tonsil hyperplasia toⅡ°, and the remaining patients had tonsil hyperplasia to Ⅰ°. In addition, one case hadtonsil suppurative infection at the 14th month after surgery, and no recurrence or reoperation was found after treatment. There were seven cases in the TT group and eight cases in the TE group with occasional snoring and mouth breathing after surgery, but the PSG examination of the patients did not meet the diagnosis of OSA. The main causes were obesity and allergic rhinitis. Compared with the first operation, the cicatricial obstruction and infection of tonsil tissue in the second operation were not significantly changed, and the immunohistochemical results also demonstrated that the expression of CD20 was not changed, and the expression of CD3 was decreased. Conclusion:Both TT and TE can effectively improve the symptoms of OSA obstruction in children. TT has less trauma, less postoperative pain, faster recovery and lower rate of hyperplasia, which can be used as one of the main methods for the treatment of tonsil hypertrophy in children.

Impact of Package Type on Selected Health Quality Parameters of Organic, Conventional and Wild Raspberries (Rubus idaeus L.) Frozen Stored

Functional foods and the nutritional value of products are now very relevant for consumers. Additionally, interest in biodegradable components made from natural products has recently increased. The aim of this study was to determine the effect of different package types (with addition of films made of biopolymers enriched with natural extracts of ginger, cinnamon, and turmeric) on antioxidative properties of conventional, organic, and wild-grown raspberry fruit during frozen storage for 1-, 4-, 8-, and 12-month periods. The content of total polyphenol and anthocyanins, as well as antioxidant activity, were studied. Additionally, structural (FT-IR and UV-Vis), mechanical (tensile strength and elongation), and surface wetting angle tests of used films were studied. In all crop types, polyphenol content increased at 8 and 12 months of frozen storage in packages with an addition of biopolymer films. There was a statistically significant increase in the amount of total polyphenols in the last month of storage in the package with films with added cinnamon extract. In contrast, packages with ginger-enriched films contributed to an increase in polyphenols only in organically grown and wild raspberry fruit at the 4th, 8th, and 12th month and 8th and 12th month, respectively. The addition of films with turmeric extract increased the polyphenol content in the 8th month of frozen storage of organically grown raspberry fruit and in the 12th month of wild-grown raspberry. During frozen storage of wild raspberry fruit, an increase in anthocyanin content was observed in all cases in the 12th month. This result was almost twice as high as in the control sample. The greatest rise in the content of anthocyanins occurred when packages with films with turmeric extract were applied. Tendencies presented by this paper are not clear-cut in cases of antioxidant activity of analysed raspberries. A common feature was that, in general, after 12 months of storage, raspberries from all crops had higher and statistically significant antioxidant values compared to the first month of storage. Studies on the biocomposite films have shown that the structure of chitosan and alginate polymers was partly decomposed after 12 months, and the natural extracts and raspberry crops used had different effects on the mechanical properties of the biocomposites films. Based on the results of research that has been carried out, it can be concluded that it has not been clearly proven whether the addition of polysaccharide films to packages contributes to the increase in bioactive compounds during frozen storage.

Prediction of treatment outcome for branch retinal vein occlusion using convolutional neural network-based retinal fluorescein angiography

Deep learning techniques were used in ophthalmology to develop artificial intelligence (AI) models for predicting the short-term effectiveness of anti-VEGF therapy in patients with macular edema secondary to branch retinal vein occlusion (BRVO-ME). 180 BRVO-ME patients underwent pre-treatment FFA scans. After 3 months of ranibizumab injections, CMT measurements were taken at baseline and 1-month intervals. Patients were categorized into good and poor prognosis groups based on macular edema at the 4th month follow-up. FFA-Net, a VGG-based classification network, was trained using FFA images from both groups. Class activation heat maps highlighted important locations. Benchmark models (DesNet-201, MobileNet-V3, ResNet-152, MansNet-75) were compared for training results. Performance metrics included accuracy, sensitivity, specificity, F1 score, and ROC curves. FFA-Net predicted BRVO-ME treatment effect with an accuracy of 88.63% and an F1 score of 0.89, with a sensitivity and specificity of 79.40% and 71.34%, respectively.The AUC of the ROC curve for the FFA-Net model was 0.71. The use of FFA based on deep learning technology has feasibility in predicting the treatment effect of BRVO-ME. The FFA-Net model constructed with the VGG model as the main body has good results in predicting the treatment effect of BRVO-ME. The typing of BRVO in FFA may be an important factor affecting the prognosis.

The effect of nutritional risk management program on the growth and development of infants and toddlers with congenital heart disease after discharge.

To evaluate the effect of nutritional risk management program on the growth and development of infants and toddlers with congenital heart disease (CHD) after discharge. Infants and toddlers with CHD discharged from a children's specialized hospital in southeast China were selected as the research subjects. The subjects were divided into the intervention group and the control group. The intervention group underwent a nutritional risk management program combined with traditional follow-up after discharge, whereas the control group received traditional follow-up after discharge. The primary outcome measure were the height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height Z-score (WHZ) at different time point and the percentage of growth and development curves were also recorded and analyzed. There were no statistically significant differences in general characteristics between the two groups. However, in the intervention group, the percentages of HAZ < -2, WAZ < -2, and WHZ < -2 were lower than those in the control group at 3rd and 6th months after discharge (P < 0.05). The percentage of growth and development curves (3%-97%) was higher than that in the control group (P < 0.05). The readmission rate within 6 months after discharge in the intervention group was lower than that in the control group (P < 0.05). Implementing nutritional risk management program for infants and toddlers with CHD after discharge can help improve postoperative malnutrition, promote growth and development and achieve catch-up growth as soon as possible.

VARIABILITY REGULARITIES OF THE CEPHALOMETRICAL PARAMETERS OF THE HUMAN FETAL SKULL

The purpose of the study – to find out the regularities of the age dynamics of cephalometricparameters and critical periods of the development of the skull of human fetuses.Material and methods. 60 preparations of skulls and 63 computer tomograms of theheads of human fetuses aged from 4 to 10 months of intrauterine development werestudied. A complex of morphological research methods was applied, which includedanthropometry, morphometry, three- dimensional reconstruction and statistical analysis.Linear and angular parameters of the skull were measured, and their ratios, characterizingthe constitutional and cephalometric parameters of the individual (cranial and facialindices), were determined. Results. The analysis of absolute cephalometric parameters (longitudinal, transversediameters, skull circumference, height dimensions) demonstrated the predominanceof logarithmic dynamics of their changes in human fetuses, that is explained by theiraccelerated growth during the 4th month of intrauterine development and a slowdownduring the 7th month with subsequent acceleration in the 8th month of prenatal development.A straight trend line is characteristic of the V-S height (distance from the Sella turcica tothe highest point of the skull), which is explained by the accelerated growth of the anteriorand posterior cranial fossae, while the sphenoid bone and the region of anterior fontanelledevelop in a consistent direction and pace. The linear pattern of growth is typical for theforamen magnum, hard palate, length of the orbit, body and ramus of the mandible, aswell as for relative cephalometric parameters that show a wide range of morphometricvariability. Analysis of the scatter diagram using the method of weighted least squaresdistances showed a decrease in the angle of the front part of the cranial base until the5th month of intrauterine development, followed by an increase in the 7th-8th months ofprenatal development. Multivariate regression analysis of the relationship between fetalage, cranial index and the value of the angle of the front part of the cranial base showedpronounced anatomical variability, which depended on the craniotype. Before the end ofintrauterine development, the N-S-Ba angle increases, but at the beginning of the fetal periodof ontogenesis, it decreases. It has the smallest values in dolichocephals compared to othercraniotypes. The largest values of this angle are found in mesocephals at the beginning of thefetal period, and in brachiocephals and mesocephals at the end of intrauterine development.Conclusions. 1. Critical periods of skull development in the fetal period of humanontogenesis are the 4-5th and 7-8th months, during which uneven changes in absoluteand relative craniometric parameters are observed. 2. The value of the angle of the frontpart of the cranial base can be a diagnostic and prognostic indicator in combinationwith the cranial index, which characterize the craniotype of the individual, during themonitoring of the normal development of the skull and brain of the fetus.

MORPHOMETRIC CHARACTERISTICS OF NECK PARAMETERS IN THE PERINATAL PERIOD OF ONTOGENESIS

This study aims – to establish the normative morphometric parameters of the neckcircumference, anterior- posterior diameter, height, and width during the perinatal periodof ontogenesis, after which the parameters will be used to construct anatomical models. Material and Methods. The study was conducted on 63 human fetuses aged 4 to10 months and 7 newborns (including 5 isolated organ systems). To create anatomicalmodels, the well-known dimensions of the neck in all age groups were determined usinga centimeter tape and a caliper. The neck circumference was measured at the level of thehyoid bone. The anteroposterior neck diameter was defined as the distance between thebody of the hyoid bone and the VII spinous process of the cervical vertebra. Neck heightwas measured from the upper to the lower neck borders. Neck width was determined inthe frontal plane at the level of the hyoid bone between the lateral edges of the neck.Statistical analysis of the data was performed using the licensed program RStudio.Results. A morphometric analysis of the average values of the well-known neck parameters,namely its circumference, anterior- posterior diameter, height, and width, was conductedin the perinatal period of ontogenesis. The analysis revealed that these parameters exhibitnon-synchronous growth throughout the studied period of the development, with periodsof intensive and relative growth. A correlation analysis was conducted between allmorphometric parameters of the neck of fetuses and newborns. The results demonstratedthat the correlation coefficients between the values of all paired correlation coefficientswere positive and close to 1 (≥0.90), indicating a strong positive correlation between allstudied parameters. A statistical analysis of the data from the Conover- Iman test indicatesthat the median values of the morphometric parameters of the neck cannot be consideredreliable for the pairs «9 months – 10 months» and «10 months – Newborns». This isjustified by the fact that individual anatomical variability is inherent in each individual,and these periods of the development are critical for the neck area. The constructedstandard anatomical models of the morphometric parameters of the neck will serve asa norm for the subsequent determination of certain morphological deviations, which willthen be used to establish variants of the structure and developmental defects of the neck.Conclusions. 1. During the perinatal period of the development, the well-known parametersof the neck, namely its circumference, anterior- posterior diameter, height and width,increase asynchronously. 2. The average values of the morphometric parameters of the neckcircumference and anterior- posterior diameter during the perinatal period of ontogenesisindicate that one period of accelerated development is evident, occurring between the 7thand 9th month of intrauterine development for the neck circumference and between the 6thand 9th month of development for the anterior- posterior diameter of the neck. Two periods ofaccelerated development are observed for the parameters of neck height and width. For neckheight, these periods are from the 5th to the 7th month of development and from the 8th to the9th month of development. For neck width, the periods are from the 4th to the 5th month ofthe development and from the 7th to the 9th month of intrauterine development. In all otherperiods of development, the morphometric parameters of the neck exhibit a slight increase. 3.Based on the arithmetic mean data of the circumference, anterior- posterior diameter, height,and width of the neck, models for predicting the normative morphometric parameters of fetusesand newborns were constructed. The systematized data on the peculiarities of spatial andtemporal transformations of the morphometric parameters of the neck circumference, anteriorposterior diameter, neck height and width, followed by their construction of mathematicalmodels, will contribute to the individualization of the norm, improvement of early diagnosticmethods and development of new methods of surgical correction of congenital neck defects.

Pharmacological Study of Guben Yifei-Tang on a Rat Model of Pneumoconiosis

Background Diffuse pulmonary fibrosis is a progressively worsening lung disease that poses a serious threat to human health. Current treatment options are limited and generally ineffective. Objectives This study aimed to investigate the therapeutic effects of GubenYifei-Tang (GB) in a rat model of pneumoconiosis. Materials and Methods We established a chronic pneumoconiosis model in rats through intratracheal injection of silica dust. Subsequently, the rats were randomly assigned to various groups, including the model group (NC group), Hanfangji Masu tablet group (TET group), high-dose GB group (GB-H group), low-dose GB group (GB-L group), and a blank control group comprising 12 normal rats (NC group). We assessed blood biochemical, vascular endothelial function, immunoinflammatory factors, and oxidative stress indices in four rats from each group at the 1st, 3rd, and 6th months of administration. Results Throughout the 6-month administration period, rats in the GB-L and GB-H groups displayed no significant abnormalities in their general condition or body weight. Both high and low doses of GB significantly reduced the respiratory rate and increased the respiratory amplitude of the pneumoconiosis model rats ( p &lt; 0.05). Additionally, they significantly decreased the mean pulmonary arterial pressure of these rats ( p &lt; 0.05). Moreover, we observed noteworthy improvements in blood gas indices and hypoxemia symptoms, including increased pH, decreased arterial partial pressure of carbon dioxide, increased arterial oxygen partial pressure, and arterial oxygen saturation. Compared to the NC group, the model group rats exhibited significantly elevated concentrations of serum transforming growth factor-beta (TGF-β), tumor necrosis factor-alpha (TNF-α), and interleukin-1 ( p &lt; 0.01). High-dose GB significantly reduced serum levels of TGF-β, TNF-α, and interleukin-10 in rats, while low-dose GB partially improved serum inflammatory factor levels. Additionally, the lung mass index, malondialdehyde (MDA) levels, and hydroxyproline levels were significantly increased in the model group rats compared to the NC group ( p &lt; 0.01), accompanied by decreased superoxide dismutase (SOD) levels. Both high and low doses of GB demonstrated substantial improvements in lung mass index, MDA, SOD, and hydroxyproline levels in rats ( p &lt; 0.05). Conclusion In the rat model of pneumoconiosis, GB exerts a positive therapeutic impact on lung tissue lesions and respiratory function, with its effectiveness being both time- and dose-dependent.

Comparison of the efficacy of drug-coated balloon angioplasty and conventional balloon angioplasty in the endovascular treatment of thrombosed arteriovenous dialysis fistulas.

To evaluate the efficacy and safety of paclitaxel-coated balloon angioplasty in the treatment of thrombosed arteriovenous fistulas. This prospective, randomized, controlled study investigated the use of drug-eluting balloons in the treatment of the thrombosis of arteriovenous fistulas (AVFs) at our center between January 2018 and January 2023. A total of 246 patients were included in the study. The mean age of the patients was 61.3 ± 11.5 years. Of the patients, 150 (61%) were male and 96 (39%) were female. Angioplasty was performed using a plain balloon (PB) in 126 patients (51.2%) and a drug-coated balloon (DCB) in 120 (48.8%). The control images of the patients were obtained at the sixth and 12th months. Patency was evaluated during the follow-up. There was no significant difference between the two groups in terms of age, gender, hypertension, hyperlipidemia, diabetes, fistula location, or stenosis length. No significant difference was observed between the groups regarding the number of complications observed during and after the procedure. At the end of the sixth month, the patency rate was found to be 86.7% in the DCB group and 78.6% in the PB group. The 12th-month patency rate was 77.5% in the DCB group and 57.9% in the PB group. A significant difference was detected between the two groups in relation to the 6th- and 12th-month patency rates (p = 0.034 and p = 0.046, respectively). Drug-coated balloon angioplasty is an effective approach to the treatment of thrombosed AVFs, especially in terms of prolonging primary patency and reducing the need for secondary procedures.

Short and Long-Term Effects of COVID-19 on Male Sexual Function

Background: Reviewing the literature, a vast number of studies are available about the pulmonary effects of coronavirus disease 2019 (COVID-19). However, the effects of COVID-19 infection on sexual function, especially the long-term effects, have been rarely reported. Here, we report the short and long-term effects of COVID-19 infection on male sexual function. Methods: Using the International Index of Erectile Function (IIEF) questionnaire, the sexual function of 96 COVID-19 patients was evaluated at months 0, 1, 3, and 6 following hospitalization. Results: The findings showed that the sexual function indicators decline during the first month of infection, then start to improve and reach the baseline by the 6th month of infection. Additionally, the analysis of the demographic data revealed that higher age and lower education levels are associated with lower levels of sexual function indicators. Conclusions: Infection with COVID-19 may result in sexual dysfunction, which gradually improves over six months.

Comparison of Microsurgical and Conventional Techniques for Augmentation of Keratinized Mucosa Around Dental İmplants

Objective: This study aims to compare the clinical outcomes of periodontal microsurgery with conventional periodontal surgery in keratinized mucosa augmentation around the implant. Materials and Methods: Ten patients with at least 2 implants with a keratinized mucosal width of &lt; 2 mm were included. Free gingival graft (FGG) was applied in the test group with the microsurgery technique whereas in the control group with the conventional periodontal surgery technique. Keratinized mucosa width (KMW) and palatal mucosal thickness (MT) were measured at baseline and 3rd month. Graft shrinkage(GS) was evaluated at the 3rd month. Donor site wound healing was evaluated at the 10th day and 3rd month. Feedback forms were collected on the 10th day. Results: KMW values increased significantly in both groups at 3rd month compared to baseline. The percentage of GS was lower in the test group at 3rd month, but this difference was not significant. MT values in the test group were closer to the baseline values at 3rd month compared to the control group. Wound healing scores were similar in both groups at the 10th day and 3rd month. Postoperative pain levels decreased more rapidly in the test group. Conclusion: The microsurgical technique provides a faster increase in palatal mucosal thickness and lower graft shrinkage during the healing period and an earlier reduction in postoperative pain levels.