Diagnostic Features Research Articles

Prımary External Audıtory Canal Cholesteatoma

External auditory canal (EAC) cholesteatoma is characterized by a bony defect in the auditory canal with a cystic structure lined by keratinizing stratified squamous epithelium and retention of keratin debris. Clinically, patients present with chronic dull pain, otorrhea, or conductive hearing loss. Lamellar keratin debris in a bony defect in the case of an intact tympanic membrane is highly suggestive of external ear canal cholesteatoma. It must be differentiated from keratosis obturans. The locally erosive and indolent nature of cholesteatoma in the bony external ear canal may result in complications due to erosion into adjacent structures such as mastoid cells, semicircular canals, fallopian canal, and temporomandibular joint. The treatment options include conservative therapy and surgery. In this case report, we presented a 75-year-old male with a primary left EAC cholesteatoma underlining the diagnostic and therapeutic features of this rare disease.

Molecular phylogenetic analysis of the East Asian hemicultrine fishes (Teleostei: Cyprinidae: Xenocypridinae), with suggestions to their generic classification and redescription of the recently described species Hemiculter yungaoi Vasil'eva et al. 2022.

The hemicultrine fishes are a group of small-sized cyprinids, widely distributed but endemic to East Asian rivers and lakes. Till now, the taxonomic boundaries and relationships within this group remain poorly explored. In the present study, we study the phylogeny of this group, providing suggestions for classification of the hemicultrine group. Using two mitochondrial and three nuclear genes, and samples representing all genera, our results showed that the group consists of seven major lineages, of which four (Hemiculterella, Hainania, Pseudolaubuca, and Anabarilius) were monophyletic and three (Hemiculter, Toxabramis, and Pseudohemiculter) were not. Based on the phylogenetic tree, we redefined the genera. We revive the genus Siniichthys, which has three species, Siniichthys bleekeri, Siniichthys lucidus, and S. varpachovskii, that were previously treated as members of the genus Hemiculter but showed distant relationships to the genus Hemiculter in our phylogenetic tree. With the new results, a diagnostic key for clades of the hemicultrine group is provided. Furthermore, we provide more detailed information on diagnostic features of the recently described species Hemiculter yungaoi (Vasil'eva et al., 2022). This work will facilitate future systematic studies, pave the way for evolutionary studies, and provide valuable information for the urgent conservation of hemicultrine fishes.

Features of diagnostics and treatments of the patient with type 2 diabetes mellitus and chronic ischtmia with threating lower limb loss

The article presents the result of our own observation of the patient with a poor control of type 2 diabetes mellitus (DM) for a long period, complicated by obliterating atherosclerosis of the arteries of the lower extremities, Menckeberg’s sclerosis and chronic ischemia threatening loss of the lower extremity (CLLI). A feature of the clinical manifestation are complications associated with potentially regional (angiosomal) ischemia of the foot, as well as variant anatomy, represented by hypoplasia of the vascular lower leg in the patient. The clinical consequences of vascular calcification due to long-term decompensation of carbohydrate metabolism and the development of diabetic distal polyneuropathy (DDP) led to falsely high values of the cuff test in the patient. Disadvantages of non-invasive methods for diagnosing limb ischemia and advantages of the complex application of tests for diseases of the arteries of the lower extremities are discussed. Using WIFI classification according to the degree of ulceration, the degree of ischemia, and the degree of infection on the foot (Wound, Ischemia and Foot Infection), the tactics of managing the patient are presented. The important role of ultrasonic duplex scanning (USDS) in the visualization of the arteries of the legs and feet in patients with DM is substantiated. The importance of a multidisciplinary approach in the management of a comorbid patient with type 2 diabetes and CLTI is emphasized.

An Adult Case of Crouzon Syndrome: Diagnostic Features and Treatment Modalities

An Adult Case of Crouzon Syndrome: Diagnostic Features and Treatment Modalities

Clinical and Diagnostic Features of West Nile Virus Neuroinvasive Disease in New York City.

West Nile virus (WNV) neuroinvasive disease (WNND) occurs in approximately 1 percent of WNV-infected patients and typically presents as encephalitis, meningitis, or acute flaccid paralysis (AFP). WNND remains a difficult inpatient diagnosis, creating significant challenges for prognostication and therapy selection. We characterized the clinical and diagnostic features of WNND cases at two major academic medical centers in New York City in routine clinical practice. We retrospectively reviewed the charts of thirty-six patients with WNND, including twenty-six encephalitis, four meningitis, and six AFP cases. The most common presenting symptoms were fever (86.1%) and gastrointestinal symptoms (38.9%) in addition to altered mental status (72.2%), lethargy (63.9%), gait disturbances (46.2%), and headache (44.4%). Fourteen (48.3%) patients displayed acute magnetic resonance imaging (MRI) findings, particularly T2 hyperintensities in the bilateral thalami, brainstem, and deep white matter. New York State Department of Health WNV CSF IgM testing was utilized for diagnosis in 58.3% of patients; however, just 38.1% had the result by discharge, compared to 85.6% of those who underwent serum IgM testing. The median length of stay was 13.5 days, 38.9% were intubated, and three patients (8.9%) died during acute hospitalization. Our findings underscore the morbidity, mortality, and diagnostic challenges of WNND, suggesting the potential utility of serum IgM testing in combination with confirmatory CSF testing to expedite diagnosis in the acute setting.

Recreational Therapists’ Usability Perceptions of the Meta Quest 2 VR System

This study used survey methods to examine recreational therapists’ perceptions of the usability of the Meta Quest 2, a popular commercial virtual reality (VR) system, for recreational therapy (RT) practice. Participants (N = 22) completed the System Usability Scale (SUS) following attendance at a six-hour continuing education workshop that included didactic education and experiential learning with the Meta Quest 2 and eight different VR applications. The SUS scores ranged from 37.50–97.50 (M = 64.31, SD = 17.93) which corresponds with a “high marginal” acceptability rating, a letter grade of C-, and an adjective rating of “good” based on three separate SUS interpretation guidelines. There were no significant differences in SUS scores across several personal (age, gender, race) and professional (years of RT practice experience, primary service setting, client diagnostic characteristics, age of clients served) demographic groups. Findings add to the evidence-base in the emerging area of VR use in RT practice, and suggest opportunities for future research.

Enhanced Brain Tumor Analysis: Integrating ResNet50 with Convolutional Block Attention Modules for Advanced Insights

The process of diagnosing brain tumors is a lengthy task that heavily relies on the experience of radiologists. However, deep learning techniques have become increasingly popular in automating the diagnosis of brain tumors, offering improved precision and effectiveness. One such technique, Convolutional Block Attention Modules (CBAM), uses attention-based models that dynamically enhance and refine diagnostic characteristics. However, the specific impact of using different attention methods, such as channel, spatial, or combined attention, within CBAM for brain tumor classification is yet to be fully explored.To address this gap, our research used ResNet50 coupled with CBAM to classify brain tumors. This novel approach demonstrated superior performance compared to existing methods, including Convolutional Neural Network. ResNet50-CBAM showed remarkable area under the curve (AUC), recall, precision, and accuracy of 99.53%, 99.11%, 98.75%, and 99.35%, respectively, using the same dataset.The fusion of ResNet-CBAM not only captures spatial context but also enhances feature representation, making it a promising integration into brain classification software platforms. This development could benefit doctors by improving brain tumor categorization and facilitating better clinical decision-making.

Size–shape–stable isotope (C and O) relationships of cryogenic cave carbonates formed in permafrost settings

Cryogenic cave carbonates (CCCs) genetically related to permafrost are of special interest in paleoclimate research. Their 230Th/U ages provide unique information about the former presence and depth of permafrost in presently permafrost-free areas. Details of CCC formation processes and their diagnostic features, however, remain incompletely understood. In this paper, we report the results of a study of CCCs from two northern Eurasian caves, currently located in permafrost-free rocks. CCCs in the caves occur in a wide range of grain sizes (micrometers to several centimeters). Stable isotope values of different CCC morphotypes (size range of 0.1 to 4 mm) plot within relatively tight clusters in δ18O-δ13C space, regardless of their grain size, indicating that CCCs of the same morphotype, but of different size, formed simultaneously at certain freezing stages. The clusters conform to an overall negative “freezing trend” in δ18O-δ13C space. The position on the trend indicates the relative age of individual morphotypes; scatter of the data in δ18O-δ13C space suggests multiple episodes of freezing (permafrost formation). The systematic characterization of CCC morphologies and the study of fine-size fractions of CCCs provide important insights into the processes involved in CCC formation in caves located in permafrost.

Predictors and Clinical Characteristics of Relapses in LGI1-Antibody Encephalitis.

Relapses occur in 15%-25% of patients with leucine-rich glioma-inactivated 1 antibody (LGI1-Ab) autoimmune encephalitis and may cause additional disability. In this study, we clinically characterized the relapses and identified factors predicting their occurrence. This is a retrospective chart review of patients with LGI1-Ab encephalitis diagnosed at our center between 2005 and 2022. Relapse was defined as worsening of previous or appearance of new symptoms after at least 3 months of clinical stabilization. Among 210 patients, 30 (14%) experienced a total of 33 relapses. The median time to first relapse was 23.9 months (range: 4.9-110.1, interquartile range [IQR]: 17.8). The CSF was inflammatory in 11/25 (44%) relapses, while LGI1-Abs were found in the serum in 16/24 (67%) and in the CSF in 12/26 (46%); brain MRI was abnormal in 16/26 (62%) relapses. Compared with the initial episode, relapses manifested less frequently with 3 or more symptoms (4/30 patients, 13% vs 28/30, 93%; p < 0.001) and had lower maximal modified Rankin scale (mRS) score (median 3, range: 2-5, IQR: 1 vs 3, range: 2-5, IQR: 0; p = 0.001). The median mRS at last follow-up after relapse (2, range: 0-4, IQR: 2) was significantly higher than after the initial episode (1, range: 0-4, IQR: 1; p = 0.005). Relapsing patients did not differ in their initial clinical and diagnostic features from 85 patients without relapse. Nevertheless, residual cognitive dysfunction after the initial episode (hazard ratio:13.8, 95% confidence interval [1.5; 129.5]; p = 0.022) and no administration of corticosteroids at the initial episode (hazard ratio: 4.8, 95% confidence interval [1.1; 21.1]; p = 0.036) were significantly associated with an increased risk of relapse. Relapses may occur years after the initial encephalitis episode and are usually milder but cause additional disability. Corticosteroid treatment reduces the risk of future relapses, while patients with residual cognitive dysfunction after the initial episode have an increased relapse risk.

LGBTQ+ outpatients present to eating disorder treatment earlier and with more severe depressive symptoms than cisgender heterosexual peers

ABSTRACT Community evidence indicates high eating disorder (ED) and comorbid symptom severity among LGBTQ+ compared to cisgender heterosexual (CH) individuals. Little is known about such disparities in ED treatment samples, especially in outpatient treatment. We aimed to descriptively characterize and investigate baseline group differences in symptom severity between LGBTQ+ and CH ED outpatients at treatment intake. Data from 60 (22.3%) LGBTQ+ and 209 (77.7%) CH ED outpatients were used to examine: (1) demographic and diagnostic differences; (2) differences in ED, depressive, and emotion dysregulation symptoms. Objectives were tested using Fisher-Freeman-Halton exact and independent samples t-tests, and analyses of covariance adjusted for age and diagnosis, respectively. Most LGBTQ+ outpatients were bisexual (55.2%), and 6.5% identified as transgender and non-binary. LGBTQ+ outpatients presented to treatment at younger ages (Mean Difference [MD] = -3.39, p = .016) and reported more severe depressive symptoms (MD = 5.73, p = .004) than CH patients, but endorsed similar ED symptom and emotion dysregulation severity. Groups did not differ in other demographic or diagnostic characteristics. LGBTQ+ individuals may develop more severe depression and similarly severe EDs at earlier ages but seek outpatient care sooner than CH peers. Managing depressive symptoms may be particularly important for LGBTQ+ ED patients.

Worldwide revision of synanthropic silverfish (Insecta: Zygentoma: Lepismatidae) combining morphological and molecular data.

Synanthropic silverfish are the best-known and most widely distributed insects of the order Zygentoma. However, there is a great gap in the knowledge and confusion about the geographic distribution and the diagnostic characteristics that allow their identification. In this work, we provide an exhaustive and deep analysis of the most common 9 synanthropic silverfish of the world, combining previously published and newly derived morphological and molecular data. Updated descriptions of Ctenolepisma calvum (Ritter, 1910) and Ctenolepisma (Sceletolepisma) villosum (Fabricius, 1775) are included, and morphological remarks, illustrations, and photographs of the remaining synanthropic species are provided to clarify their diagnosis and differentiation among them and from other free-living species. In addition, Ctenolepisma targionii (Grassi and Rovelli, 1889) is synonymized with C. villosum. A molecular phylogeny is presented based on the COI sequences of all the synanthropic species deposited in BOLD and GenBank, with 15 new sequences provided by this study. This has allowed us to detect and correct a series of identification errors based on the lack of morphological knowledge of several species. Moreover, 2 different lineages of Ctenolepisma longicaudatumEscherich, 1905 have also been detected. To help future studies, we also provide a taxonomic interpretation guide for the most important diagnostic characters of the order Zygentoma, as well as an identification key for all the Synanthropic studied species. Finally, an approximation of the global distribution of synanthropic silverfish is discussed. Several new records indicate that the expansion of these species, generally associated with the transport of goods and people, is still far from over.

Assessing MRI Sensitivity and Specificity for Detecting Occult Nipple-Areolar Complex Malignancy in Nipple-Sparing Mastectomy Candidates: A Systematic Review and Meta-Analysis

Background: Approximately 8% of breast cancers originate within the central ducts near the nipple-areolar complex(NAC), which revealed higher rates of occult involvement than previously thought. Precise preoperative imaging to assess NAC and subjacent tumor involvement has become critical to identify candidates for nipple-sparing mastectomy(NSM) while ensuring oncological safety. The aim of our study is to determine whether MRI could be used for the detection of subtle neoplastic infiltration. Method: Electronic databases including PubMed, Scopus, Web of Science, and EMBASE were systematically searched to identify all relevant studies on diagnostic performance of Magnetic Resonance Imaging(MRI) in malignant extension to the nipple published before 2024. The keywords include MRI, NAC, breast cancer, NSM. True Positive(TP), True Negative(TN), False Positive(FP), False Negative(FN) were extracted for analysis. Finally, 5 articles were selected for our meta-analysis. STATA version 15 was used to analysis data. Result: Our meta-analysis showed a pooled sensitivity of 89%(95% CI: 81%-94%)with low heterogeneity(I2 = 17.51%), and a pooled specificity of 89% (95% CI: 71%-96%), with significant heterogeneity(I2 = 95.87%). The pooled positive diagnostic likelihood ratio(pDLR) was 7.81(95% CI: 2.82-21.61, I2 = 92.66%), and the negative diagnostic likelihood ratio(nDLR) was 0.12(95% CI: 0.07-0.22, I2 = 11.94%). Conclusion: Diagnostic MRI characteristics such as NAC enhancement, non-mass enhancement(NME) type, mass size (greater than 20 mm), and tumor-to-nipple distance(TND) were assocaited with the presence of NAC involement. Because of high diagnostic accuracy, MRI imaging can be used as a helpful tool for NAC diagnosis.

Of sea, rivers and symbiosis: Diversity, systematics, biogeography and evolution of the deeply diverging florideophycean order Hildenbrandiales (Rhodophyta)

The Hildenbrandiales, a typically saxicolous red algal order, is an early diverging florideophycean group with global significance in marine and freshwater ecosystems across diverse temperature zones. To comprehensively elucidate the diversity, phylogeny, biogeography, and evolution of this order, we conducted a thorough re-examination employing molecular data derived from nearly 700 specimens. Employing a species delimitation method, we identified Evolutionary Species Units (ESUs) within the Hildenbrandiales aiming to enhance our understanding of species diversity and generate the first time-calibrated tree and ancestral area reconstruction for this order. Mitochondrial cox1 and chloroplast rbcL markers were used to infer species boundaries, and subsequent phylogenetic reconstructions involved concatenated sequences of cox1, rbcL, and 18S rDNA. Time calibration of the resulting phylogenetic tree used a fossil record from a Triassic purportedly freshwater Hildenbrandia species and three secondary time points from the literature. Our species delimitation analysis revealed an astounding 97 distinct ESUs, quintupling the known diversity within this order. Our time-calibration analysis placed the origin of Hildenbrandiales (crown age) in the Ediacaran period, with freshwater species emerging as a monophyletic group during the later Permian to early Triassic. Phylogenetic reconstructions identified seven major clades, experiencing early diversification during the Silurian to Carboniferous period. Two major evolutionary events—colonization of freshwater habitats and obligate systemic symbiosis with a marine fungus—marked this order, leading to significant morphological alterations without a commensurate increase in species diversification. Despite the remarkable newly discovered diversity, the extant taxon diversity appears relatively constrained when viewed against an evolutionary timeline spanning over 800 million years. This limitation may stem from restricted geographic sampling or the prevalence of asexual reproduction. However, species richness estimation and rarefaction analyses suggest a substantially larger diversity yet to be uncovered—potentially four times greater. These findings drastically reshape our understanding of the deeply diverging florideophycean order Hildenbrandiales species diversity, and contribute valuable insights into this order evolutionary history and ecological adaptations. Supported by phylogenetic, ecological and morphological evidence, we established the genus Riverina gen. nov. to accommodate freshwater species of Hildenbrandiales, which form a monophyletic clade in our analyses. This marks the first step toward refining the taxonomy of the Hildenbrandiales order, a task demanding thorough revisions, notably the creation of several genera to address the polyphyletic status of Hildenbrandia. However, the limited diagnostic features pose a challenge, necessitating a fresh approach to defining genera. A potential solution lies in embracing a molecular systematic perspective, which can offer precise delineations of taxonomic boundaries.

CLINICAL FEATURES OF MANAGEMENT OF PATIENTS WITH HYPERURICEMIA IN COMBINATION WITH ARTERIAL HYPERTENSION AND CHRONIC HEART FAILURE

Objective: To evaluate clinical and diagnostic features of patients with AH and CHF combined with hyperuricemia. Design and method: The study included 49 patients divided into two groups: Group 1 - 32 patients with AH and CHF on the background of elevated uric acid (UA) 24(75%) men, 8 (25%) women, median age 66.0 (59.0;75.0) years and Group 2 - 20 patients with AH and CHF without hyperuricemia: 13 (65%) men, 7 (35%) women, median age 69.0 (63.0;73.5) years). Clinical data, laboratory and instrumental investigations were analyzed. Results: Comparative analysis showed that patients in the group with normal MC levels compared to patients in the hyperuricemia group had higher SCF (62 and 57 ml/min/1.73 m2 (p=0.04) respectively). A negative correlation of medium strength between blood MC level and LVEF was also observed, with lower values in group 1 patients (52.4 and 59.5, respectively). Differences were also observed when NTproBNP level was determined (385.5-2500.4) (R=-0.64 p&lt;0.01). Separately it should be noted that out of 32 patients included in the study, 6 patients showed resistance to standard doses of diuretics, which required intensification of therapy in the form of increasing their dose. In a comparative analysis, MC levels were significantly higher in patients who subsequently underwent intensified therapy compared with patients with a satisfactory response to standard diuretic doses [543.8 (459.4-719.9) and 485(422.4-605.4), respectively; p=0.011]. Conclusions: The performance of this study further confirmed the high prevalence of hyperuricemia in AH and CHF. Moreover, the severity of hyperuricemia increased in parallel with the increase in the severity of CHF (according to NYHA FC and NUP concentration). Therefore, the patient management strategy should include screening and correction of purine metabolism. One of the main tasks in the algorithm of management of patients with hyperuricemia is rationalization of therapy with the main focus on cardiovascular risk factors and metabolic safety of drugs.

MedTransCluster: Transfer Learning for Deep Medical Image Clustering

This work introduces the “MedTransCluster” framework, a novel approach to medical image clustering in chest radiography through the application of transfer learning, leveraging the capabilities of pre-trained deep learning models. Our evaluation encompassed a variety of neural networks, considering their adaptability to the nuances of medical imaging data. The study incorporated four renowned clustering algorithms and an expanded set of evaluation metrics, offering a comprehensive comparison and a refined analysis of these models’ ability to cluster complex diagnostic features. Notably, EfficientNetB0 coupled with DBSCAN clustering algorithm achieved a silhouette score of 0.924131, and ResNet152 with KMeans displayed a Calinski Harabasz score of 9655.213964, indicating their superior proficiency in capturing the intricacies of medical features. These results emphasize the critical importance of model refinement within the healthcare imaging sphere and underscore the potential of methodologies like MedTransCluster in enhancing diagnostic accuracy and patient outcomes.

Accuracy of Antenatal Ultrasound in Predicting Large for Gestational Age Babies: Population Based Cohort Study

Pregnancies with large for gestational age fetuses are at increased risk of adverse maternal and neonatal outcomes. There is uncertainty about how to manage birth in such pregnancies. Current guidelines recommend a discussion with women of the pros and cons of options including expectant management, induction of labour and caesarean birth. For women to be able to make an informed decision about birth, antenatal detection of large for gestational age is essential. To investigate the ability of antenatal ultrasound scans to predict large for gestational age at birth. In this retrospective cohort study, we analysed data from a routinely collected database from the West Midlands, United Kingdom. We included pregnancies that had an antenatal ultrasound estimated fetal weight between 35+0 and 38+0 weeks gestation for any indication, as well as a subgroup where the reason for scan was that the fetus was suspected to be big. Large for gestational age was defined as >90th customized GROW centile, for estimated fetal weight as well as for neonatal weight. We also tested performance of an uncustomized standard, with Hadlock fetal weight >90th centile and neonatal weight >4kg. We calculated diagnostic characteristics for the whole population as well as groups with different maternal body mass indices. The study cohort consisted of 26,527 pregnancies which on average had a scan at 256 days gestation and delivered 20 days later at a median of 276 days (interquartile range 15). In total 2241 (8.4%) of neonates were large for gestational age by customized centiles, of which 1459 (65.1%) had a scan estimated fetal weight >90th centile, with a false positive rate of 8.6% and a positive predictive value of 41.0%. In the subgroup of 912 (3.4%) pregnancies scanned for a suspected large fetus, 293 (32.1%) babies were large for gestational age at birth, giving a positive predictive value of 50.3%, with sensitivity of 77.1% and false positive rate 36.0%. When comparing subgroups from low (<18.5kg/m2) to high body mass index (>30kg/m2), sensitivity increased from 55.6 to 67.8%, false positive rate from 5.2 to 11.5% and positive predictive value from 32.1 to 42.3%. A total of 2585 (9.7%) babies were macrosomic (birthweight >4kg), and of these 1058 (40.9%) were large for gestational age (>90th centile) antenatally by Hadlock's growth standard, with a false positive rate of 4.9% and a positive predictive value 41.0%. Analysis within subgroups showed better performance by customized compared to uncustomized standards for low body mass index (<18.5; diagnostic odds ratio 23.0 vs 6.4) and high body mass index (>30; diagnostic odds ration 16.2 vs 8.8). Late third trimester ultrasound estimation of fetal weight for any indication has good ability to identify and predict large for gestational age at birth, and improves with the use of a customised standard. Detection rate is better when ultrasound is performed for a suspected large fetus, however at the risk of higher false positive diagnosis. Our results provide information for women and clinicians to aid antenatal decision making about birth of a fetus suspected of being large for gestational age.

Transformer-Based Approach to Pathology Diagnosis Using Audio Spectrogram

Early detection of infant pathologies by non-invasive means is a critical aspect of pediatric healthcare. Audio analysis of infant crying has emerged as a promising method to identify various health conditions without direct medical intervention. In this study, we present a cutting-edge machine learning model that employs audio spectrograms and transformer-based algorithms to classify infant crying into distinct pathological categories. Our innovative model bypasses the extensive preprocessing typically associated with audio data by exploiting the self-attention mechanisms of the transformer, thereby preserving the integrity of the audio’s diagnostic features. When benchmarked against established machine learning and deep learning models, our approach demonstrated a remarkable 98.69% accuracy, 98.73% precision, 98.71% recall, and an F1 score of 98.71%, surpassing the performance of both traditional machine learning and convolutional neural network models. This research not only provides a novel diagnostic tool that is scalable and efficient but also opens avenues for improving pediatric care through early and accurate detection of pathologies.

A hybrid ICEEMDAN and OMEDA-based vibrodiagnosis method for the bearing of rolling stock

Purpose. To develop a hybrid method based on ICEEMDAN and OMEDA for high-fidelity detection of the diagnostic features of the technical condition of roller bearing. Methodology. Due to digital signal processing the search was made of the informative components on the broadband spectra, envelope spectra, squared envelope spectra. The usage of the methods of mathematical statistics for the selection of informative IMFs as a result of iterative calculate procedures. The introduction of blind deconvolution method with a proper objective function for the enhancement of impulse fault features. Findings. The use of traditional spectral methods provided an incomplete list of diagnostic features of bearing roller damage. The empirical mode decomposition (EMD) method and its minor versions provide the series of intrinsic mode functions (IMFs). On the broadband vibration spectra of the selected low-frequency IMFs, diagnostic features were not detected in a sufficient number. Further research focused on the development of a hybrid method that takes into account the demodulation procedure of the high-frequency components of those IMFs that were selected according to the complex evaluation index. The Fast Kurtogram technique determined an informative frequency band of 7.2–7.5 kHz for demodulation and construction of the squared envelope spectra, where harmonics of the roller spin frequency and some side bands with a width equal to the separator rotation frequency appeared. The use of OMEDA caused the reduction of residual noise on the squared envelope spectra and bilateral sidebands to appear around all harmonics of the roller spin frequency. Originality. For the first time, the whole list of the diagnostic features of roller faults of the axle-box bearing was identified using the developed hybrid method, which involves steps of noise reduction for enhancing a physical meaning of a proper frequency components, associated with faults. The usage of the optimal minimum entropy deconvolution adjusted method helped to eliminate noise and provide all diagnostic features of the technical condition on the squared envelope spectrum. Practical value. The results of the study help to control the quality of repair of the axle-box rolling bearings on the test rig at the workshop of the freight railway car depot.

Diagnostic features of paediatric catatonia: multisite retrospective cohort study.

Catatonia is a neuropsychiatric disorder characterised by psychomotor changes that can affect individuals across the lifespan. Although features of catatonia have been described in adults, the most common clinical symptoms among paediatric patients with catatonia are not well characterised. The goal of this study was to characterise the symptoms of catatonia demonstrated by paediatric patients, and to explore demographic and diagnostic factors associated with greater catatonia severity. We conducted a multicentre retrospective cohort study, from 1 January 2018 to 6 January 2023, of patients aged 18 and younger with a clinical diagnosis of catatonia and symptom assessment using the Bush Francis Catatonia Rating Scale (BFCRS). A total of 143 patients met inclusion criteria. The median age was 15 (interquartile range: 13-16) years and 66 (46.2%) patients were female. Neurodevelopmental disabilities were present in 55 (38.5%) patients. Patients demonstrated a mean of 6.0 ± 2.1 signs of catatonia on the Bush Francis Catatonia Screening Item, with a mean BFCRS score of 15.0 ± 5.9. Among the 23 items of the BFCRS, six were present in >50% of patients (staring, mutism, immobility/stupor, withdrawal, posturing/catalepsy, rigidity), and four were present in <20% of cases (waxy flexibility, mitgehen, gegenhalten, grasp reflex). In an adjusted model, patients with neurodevelopmental disorders demonstrated greater BFCRS severity than those with other diagnoses. Catatonia was diagnosed in a range of mental health conditions. Further research is needed to define optimal diagnostic criteria for catatonia in paediatric patients, and clarify the clinical course of the disorder.

A Fossil Paederinae from a Lacustrine Deposit at Orapa Diamond Mine in Botswana1

Abstract A staphylinid beetle morphotype, Mesostaphylinus orapa sp. n., is described based on a single well–preserved compression fossil from an Upper Cretaceous lacustrine deposit at Orapa Diamond Mine in Botswana. Mesostaphylinus Zhang is placed in the extant subfamily Paederinae based on general habitus and an unambiguous synapomorphy, the concealed antennal insertions. Mesostaphylinus is a genus of convenience for fossils belonging in Paederinae, but lacking diagnostic features (e.g., maxillary palpomeres) to assign and delineate them into appropriate tribes and subtribes. The fossil described here is morphologically similar to M. laiyangensis Zhang, M. fraternus Zhang, Wang and Xu, M. elongatus Solodovnikov and Yue, M. yixianus Solodovnikov and Yue, and M. antiquus Solodovnikov and Yue. Compared to other fossil staphylinid beetles that have been described thus far, the fossil also portrays morphological conservatism, morphological stasis, or arrested evolution dating back to the Cretaceous, thereby suggesting a punctuated equilibrium pattern of evolution.