Functional Disturbances Research Articles

Characterization of the Elemental Composition of Aerosols Emitted in the Dry Season of the Pantanal Wetland, Brazil

The Brazilian Pantanal region experiences intense biomass burning during the dry season, releasing large quantities of gasses and particles into the atmosphere, which have serious implications on both the climate system and public health. Understanding the dynamics of these emissions is crucial for mitigating the impact on the ecosystem, its functioning, and potential anthropogenic disturbances. This study focused on analyzing emissions in the northern Pantanal during the 2022 drought. Concentrations of fine particulate matter (PM2.5), black carbon (BC), and 25 chemical elements were measured using gravimetry, reflectance analysis, and X-Ray fluorescence, respectively, from samples collected between August and October 2022. The average concentrations of PM2.5 and BC increased approximately 4-fold and 2.5-fold, respectively, compared to averages from a decade ago. Significant increases were also observed in elements such as sulfur (S), potassium (K), iron (Fe), and silicon (Si). The maximum concentrations were comparable to values typical of the southern Amazon, a region known for high deforestation rates and land use changes. Elemental analysis revealed substantial shifts in concentrations, primarily associated with biomass burning (BB) and soil suspension. Additionally, enrichment factor (Ef) analysis showed that lead (Pb) levels, correlated with human activities, were 200 times higher than those found under clean atmospheric conditions.

PATHOPHYSIOLOGICAL AND STRUCTURAL PECULIARITIES OF CARDIAC FIBROSIS DEVELOPMENT IN ATRIAL FIBRILLATION

Introduction. In recent years, the study of the pathogenesis of atrial fibrillation (AF) and its complications resulting from this condition has drawn substantial attention from cardiologists. A comprehensive understanding of this issue is essential for investigating the structural and functional disturbances occurring in the heart during AF. These data are also important for developing novel therapies aimed at preventing the onset and progression of cardiac fibrosis. The aim of this study is to identify the primary pathways that activate cardiac connective tissue cells involved in fibrosogenesis, to examine the structural characteristics of this pathological process, and to investigate the role of fibroblasts in initiating and progressing cardiac fibrosis. Materials and Methods. The primary data for this article were collected through an in-depth analysis of recent scientific literature, with a focus on studies published in the last 5–7 years. Results. A detailed review of primary sources reveals that this cardiological issue has only been partially explored. Findings indicate a close link between the pathophysiological and structural mechanisms of AF and numerous resulting complications, with cardiac fibrosis being a primary consequence. Two major forms of fibrous damage to atrial cardiomyocytes play a key role in the development of cardiac fibrosis associated with AF. This includes both reactive and reparative types of cardiac fibrosis, which develop concurrently in atrial fibrillation. These structural changes lead not only to damage and loss of cardiomyocytes but also to pathological remodeling of fibroblasts, the intercellular matrix, and the atria and ventricles. Disruptions in bioelectrical potential conduction are also observed. Activated fibroblasts play a central role in initiating cardiac fibrosis, with key stages of protein synthesis involved in atrial fibrosis now better understood. Specific intracellular signaling pathways, which present potential therapeutic targets for preventing cardiac fibrosis in AF treatment, have been identified. Conclusion. Atrial fibrillation and cardiac fibrosis are interdependent, with each potentially accelerating the progression of the other. These pathological processes are underpinned by significant structural and functional disruptions within cardiac cells and the intercellular matrix. Fibroblasts, myofibroblasts, and intensive fibrous tissue formation within the matrix are pivotal in the development of cardiac fibrosis. A preventive strategy targeting early intervention in cardiac fibrosis shows the greatest therapeutic promise.

Thyroid hormones in female and male reproduction with special reference to dogs and cats

Thyroid hormones have an important function in numerous physiological processes in humans and animals, including the regulation of metabolism, growth and development of individual and reproductive function. The thyroid hormones, triiodothyronine (T3) and thyroxine (T4), have a direct effect on the reproductive organs and an indirect effect in interaction with other hormones. Thyroid hormones influence the reproductive system by regulating metabolism and tissue development of the ovaries, uterus and placenta. Changes in the serum concentrations of T3 and T4 lead to disturbances in overall body function. Thyroid dysfunction, including hypothyroidism and hyperthyroidism, can lead to significant reproductive problems. The aim of this review was to describe the functions of thyroid hormones and the effects of hypothyroidism and hyperthyroidism on the animal reproductive system. Hypothyroidism is often caused by autoimmune diseases such as lymphocytic thyroiditis, and is associated with later puberty, reduced fertility and abnormalities in reproductive organ development. Hypothyroidism can lead to a prolonged interval, absent cycles, silent oestrus cycles, prolonged oestrus bleeding, and a lack of libido, with the occurrence of infertility, miscarriages, stillbirths and mummified foetuses. In males, hypothyroidism leads to a decrease in libido, semen quality, ejaculate volume, testicular atrophy, hypospermia and azoospermia. Hyperthyroidism, on the other hand, is usually the result of thyroid cancer, which produces excessive amounts of thyroid hormones. Increased concentrations of thyroid hormones lead to disturbances in the physiological balance of reproductive hormones, irregular oestrus cycles, anovulation and reduced fertility, as well as a decrease in the weight of the ovaries and the number of healthy follicles, with a simultaneous increase in the number of atretting follicles. The effects of hyperthyroidism on male fertility include disorders of spermatogenesis, changes in sex hormone levels and changes in sperm quality, such as hypospermia, oligozoospermia, asthenozoospermia and teratozoospermia. It is important to diagnose and treat thyroid disorders in time in order to prevent negative effects on fertility and reproduction in animals.

Quality of Life in Symptomatic Septal Perforation.

The aim of this study is to investigate the impact of septal perforation (SP) on quality of life (QoL). SP is compared to the general population and patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) using the Sino-Nasal Outcome Test 22 (SNOT-22). Prospective single-center study in a referral Rhinology Unit from January 2014 to March 2023. A total of 392 patients were included in three groups: controls (n = 141), CRSwNP (n = 118), and SP (n = 133). The mean score of the SNOT-22 was significantly higher in the CRSwNP group (42.4, SD = 24.4) and SP (46.5, SD = 22) compared to the control group (6.2, SD = 8.4). Scores by either items or domains were significantly higher in the CRSwNP and SP groups compared to the control group. There were no significant differences in the mean SNOT-22 between the CRSwNP and SP groups (p = 0.26; 95% CI -1.68-9.99). Domain-specific analysis of overall SNOT-22 scores revealed that patients with SP experienced higher levels of disturbances in sleep, function, and psychological domains (p ≤ 0.001). SP produces a negative impact on QoL similar to CRSwNP. Moreover, sleep, psychological, and function domains are significantly worse in SP. Etiology and area of SP influence nasal and emotion domain, though more studies on SP using SNOT-22 and specific questionnaires are needed. 3 Laryngoscope, 134:4480-4487, 2024.

Regulatory roles of histamine receptor in astrocytic glutamate clearance under conditions of increased glucose variability

In diabetic patients, repeated episodes of hypoglycemia can increase glucose variability (GV), which may lead to glutamate neurotoxicity in the brain and consequently affect cognitive functions. Astrocytes play a crucial role in regulating the balance of glutamate within the brain, and their function is influenced by the histamine receptor (HR) signaling pathway. However, the specific role of this mechanism under conditions of high GV is not yet clear. The results showed that increased GV resulted in decreased expression of HRs in mice hippocampus and astrocytes cultured in vitro. Additionally, a decrease in the expression of proteins related to glutamate metabolic clearance was observed, accompanied by a reduction in glutamate reuptake capacity. Notably, the intervention with histidine/histamine was able to reverse the above changes. Further mechanistic studies showed that inhibition of HRs that increased GV led to significant disturbances in astrocytic mitochondrial function. These abnormalities encompassed increased fragmentation morphology and the accumulation of reactive oxygen species, accompanied by decreased mitochondrial respiratory capacity and dysregulation of dynamics. Distinct HR subtypes exhibited variations in the modulation of mitochondrial function, with H3R demonstrating the most pronounced impact. The overexpression of H3R could enhance glutamate metabolic by reversing disturbances in mitochondrial dynamics. Therefore, this study suggests that H3R is able to maintain glutamate metabolic clearance capacity and exert neuroprotective effects in astrocytes that increased GV by regulating mitochondrial dynamic balance. This provides an important basis for potential therapeutic targets for diabetes-related cognitive dysfunction.

Разработка и валидация ПИТС-индекса для оценки тяжести синдрома последствий интенсивной терапии: описательное проспективное несравнительное когортное исследование

INTRODUCTION: The post intensive care syndrome (PICS) is a clinical manifestation of “learned non-use” phenomena, resulting from the application of metabolic rest strategies such as bed rest, sedation, and ventilation. This leads to prolonged, multifocal dysfunction in vital functions. The lack of standardized diagnostic methods for this syndrome limits its study. For the diagnosis of PICS, we combined 15 signs of vital function disturbances that have the greatest impact on quality of life, with a scoring value of 0.5–1. The sum of these symptoms has been designated as the PICS-index. OBJECTIVE: To develop a scale for calculating the PICS-index with stratification of its values into three ranges of severity: mild, moderate and severe. MATERIALS AND METHODS: A descriptive, prospective, and unmatched cohort study was conducted on 169 patients who had a high dependency on medical care and were admitted to a rehabilitation center between 2022 and 2023. RESULTS: Using the PICS-index, showed that 100 % of patients who spent more than 72 hours in the ICU during the early recovery period (up to 6 months) developed PICS, with a predominance of moderate cases (35–52 %). The proportion of severe PICS forms reached its maximum (37 %) between 3 and 6 months. In the late recovery phase (more than 6 months), mild PICS forms were predominant (45 %). The severity of PICS was influenced by the duration of ICU stay and the timing of mechanical ventilation, but not the age of patients. CONCLUSIONS: The PICS-index is a clinically effective tool for the multidisciplinary diagnosis and assessment of the severity and progression of PICS. Using the PICS-index, we have devised a method for evaluating the predominance of specific signs. The most common signs are disturbance of the gravitational gradient, polyneuromyopathy, dysphagia. This confirms the essence of PICS as a clinical manifestation of the "learned non-use" phenomenon.

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C-reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

Surgical removal of an impacted third molar is one of the most common oral surgical procedures performed in dental offices. The postoperative phase is often associated with severe inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to manage postoperative discomfort. NSAIDs have been associated with gastrointestinal bleeding, renal function disturbances, and platelet count reductions. Thus, the present study demonstrates the utility of aescin in managing postoperative discomfort after the surgical removal of impacted mandibular third molars.This study aimed to correlate and compare the impact of aescin and diclofenac on salivary PGE2 levels and serum C-reactive protein levels after surgical extraction of the mandibular third molar. The study will also evaluate and compare the effectiveness of individual drug therapy in managing postoperative pain, swelling and mouth opening. The planned study is a single-center, double-blind, randomized, parallel, prospective clinical trial. Each patient will be prescribed either diclofenac sodium 150 mg/day or aescin (escin) 120 mg/day to be taken orally in divided doses for five days after surgically removing the impacted mandibular third molar.Pain will be assessed using a visual analog scale. Facial swelling and mouth opening will be recorded using a metric scale with standardized reference points. ELISA (enzyme-linked immunosorbent assay (ELISA) will be employed to measure salivary Prostaglandin E2 and serum C-reactive protein levels. All parameters will be recorded preoperatively (T0) on the second postoperative day (T1) and fifth postoperative day (T2). The proposed study is expected to show a clinically acceptable response to the administration of aescin for the management of postoperative discomfort compared to diclofenac sodium after third molar surgery.The proposed study is expected to positively manipulate the levels of salivary Prostaglandin E2 and serum C-reactive protein, which are reliable inflammatory markers.The outcome of this study may provide an efficacious and safe alternative to conventional nonsteroidal anti-inflammatory drugs for managing postoperative discomfort following third molar surgery.

Deletion of nephrocystin 4 exacerbates cardiac function and survival rate in a mouse model of cardio-renal syndrome

Abstract Background Cardiorenal syndrome (CRS), characterized by cardiac and renal dysfunction, is an increasing health problem associated with high mortality rate. Nephrocystin 4 (NPHP4) gene is the major cause of end-stage renal disease in children. We have reported NPHP4 single nucleotide polymorphism is the genetic risk for CRS and subsequent cardiovascular events in general population. However, the functional role of Nphp4 in the development of CRS has never been examined yet. Methods and Results We generated systemic Nphp4 knockout (KO) mice deleting exon 3 to 8 using CRISPR-Cas9 system. RNA sequence analysis of heart and kidney tissues demonstrated that gene-sets related to mitochondrial function were significantly downregulated in Nphp4 KO mice compared to their wild-type (WT) littermates. Nphp4 KO mice showed less cardiac hypertrophy, however, exacerbated cardiac function and survival compared to WT mice in a CRS model induced by thoracic transverse aortic constriction. Nphp4 located in endosome and cell membrane in H9C2 cardiomyocytes. Immunoprecipitation confirmed protein interaction between Nphp4 and HECT-type E3 ligase Itch. Furthermore, we found that Itch targeted Lats2 and insulin-like growth factor-1 receptor in cardiomyocytes. Knockdown of Nphp4 activated Hippo signaling and worsened mitochondrial function in H9C2 cardiomyocytes through the inhibition of Itch-dependent Lats2 degradation. Knockdown of Nphp4 inhibited insulin-like growth factor-1 signaling through the disturbance of Itch-mediated endosome function. Conclusions Deletion of Nphp4 impaired compensatory cardiac hypertrophy and exacerbated cardiac function and survival in a mouse CRS model through mitochondrial dysfunction. Nphp4 mediated Hippo signaling and insulin-like growth factor-1 signaling through the interaction with Itch. NPHP4 could be the novel therapeutic target in CRS.figure1figure2

Cardiac contractility index, a novel biomarker of incident heart failure amongst people with normal left ventricular ejection fraction in the UK Biobank

Abstract Background Cardiac contractility index (CCI) is a simple non-invasive measure of myocardial contractility defined by systolic blood pressure divided by indexed left ventricular end-systolic volume. Although left ventricular ejection fraction (LVEF) is essential for phenotyping patients with suspected heart failure (HF), it is load dependent and insensitive to subtle subclinical ventricular dysfunction. Left ventricular (LV) strain, although more sensitive at detecting subtle disturbances in myocardial function, also does not reflect loading conditions and dependency on image quality and inter-vendor variability limit widespread use. The ability of CCI to identify patients with subclinical left ventricular dysfunction at risk of developing HF is unknown. Purpose We aimed to: 1) explore the relationship between CCI with conventional imaging biomarkers of LV systolic dysfunction and 2) assess whether CCI could identify those at increased risk of incident HF in people without pre-existing left ventricular dysfunction in the UK Biobank imaging study. Methods We explored the relationship between CCI and laboratory and imaging biomarkers of systolic function, including LVEF and LV strain. Scatter plots were constructed for CCI with LVEF and LV strain. Pearson’s coefficients (r) and coefficient of determination (r2) were calculated to assess for correlations. People with sex-specific thresholds of abnormally low LVEF derived from within the same cohort (<48% for men, and <51% for women) were then excluded. CCI was then dichotomised as being high or low based its median value (4.4 mmHg/ml/m2). Age-sex adjusted Cox proportional hazards ratios (HR) with 95% CIs were estimated for the primary outcome of incident HF (derived from linked national digital registries) in addition to modelling with restricted cubic splines. Results We included 38,215 people (median age 55 years, 48% men). There was moderate correlation between CCI with LVEF (r=0.53 [0.53-0.54], R2=0.29; p<0.001), LV global circumferential strain (r=-0.50 [-0.50- -0.49], R2=0.25; p<0.001) and radial strain (r=-0.49 [0.48-0.50], R2=0.24; p<0.001), although was only weekly correlated with LV global longitudinal strain (r=-0.19 [-0.20- -0.18], R2=0.03; p<0.001) (Figure 1A). Using sex-specific thresholds 33,739 (88.3%) had a normal LVEF. During 195,584 person-years of follow-up (median 5.5 years), a total of 221 (0.7%) participants developed HF. Age-sex adjusted low CCI at baseline was associated with an increased risk of incident HF (adjusted HR 1.33 [1.01-1.75]; p=0.043). The association between CCI and incident HF was curvilinear (Figure 1B). Conclusions CCI identifies people with subclinical left ventricular systolic dysfunction at risk of developing incident heart failure.

Transanal total mesorectal excision: Understanding indications, managing complications, and effective prevention methods

AbstractTransanal total mesorectal excision (TaTME) has emerged as a surgical method for treating rectal malignancies in the middle and lower third of the rectum over the past 15 years. This approach was adopted because of the challenges encountered in secure total mesorectal excision (TME). Patient selection criteria and the rationale for TaTME have evolved, leading to improved oncological outcomes and patient quality of life. The procedure includes inserting a unique platform through the anus, forming a purse‐string closure, and endoscopically sealing the lower rectum. The mesorectum is then removed laparoscopically following a ‘down‐to‐up’ approach, finalised with a transabdominal laparoscopic phase and anastomosis. Pelvic anatomy complexity poses challenges, including potential injuries to the urinary tract, surgical site leakage, sinus damage, sagittal vein harm, nerve injury, carbon dioxide embolism, bowel function disturbance, sphincter mechanism issues, and rectal abscess formation. Proficient anatomy knowledge, precise surgical techniques, and advanced technologies contribute to their prevention. In conclusion, TaTME offers a promising approach to rectal surgery with satisfactory oncological outcomes. However, vigilance is required to eliminate potential complications.

High-intensity pulse magnetic therapy and drinking mineral water in rehabilitation treatment of patients with chronic pancreatitis at inpatient stage

BACKGROUND: Sanogenetic effects of physical factors, providing restoration of disturbed functions of the organism, are the basis for their inclusion in the standardised programme of restorative treatment of patients with chronic pancreatitis. AIM: To study the effectiveness of high-intensity pulse magnetic therapy and low-mineralized drinking mineral waters in the restorative treatment of patients with chronic pancreatitis at the inpatient stage. MATERIALS AND METHODS: There has been carried out an open-label, randomized, controlled, prospective study of 125 patients with chronic pancreatitis. The patients were divided into 3 groups using the simple randomization method. In the control group (n=40) the patients underwent restorative treatment in accordance with federal clinical guidelines; in the group of comparison (n=42) he patients were additionally prescribed low-mineralized drinking mineral water; in the main group (n=43) the patients had high-intensity pulse magnetic therapy in addition to the treatment of the group of comparison. The effectiveness of rehabilitation measures was monitored using a visual analogue scale, a carbolene test, a hospital scale of anxiety and depression. RESULTS: The statistical analysis showed that the inclusion of drinking mineral water and high-intensity pulse magnetic therapy contributed to a significant reduction of pain (p 0.01) and dyspeptic syndromes (p 0.01), an improvement in motor evacuation function of intestine (p 0.01), a decrease in enzymatic activity and the severity of anxiety-depressive manifestations (p 0.01). The effectiveness of the developed programmes of restorative treatment of the patients suffering from chronic pancreatitis was 87.8–92.5%, the standardized programme ― 78.5%. CONCLUSION: The inclusion of drinking mineral waters and high-intensity pulse magnetic therapy in the standardized program of restorative treatment of the patients suffering from chronic pancreatitis at the inpatient stage provides a significant restoration of pancreatic external secretory function.

GENERAL CLINICAL AND CYTOLOGICAL METHODS FOR STUDYING THE URINARY SYSTEM ORGANS

The lecture covers general clinical and cytological methods for urine analysis, specifically the determination of its physical properties, chemical analysis for the presence of protein, glucose, ketone bodies, and pigments, which allow for the assessment of kidney function, urinary system condition, and metabolic disorders. It also includes microscopic analysis of sediment to identify cellular elements, casts, and salts, aiding in the diagnosis of infectious and inflammatory processes in the kidneys and urinary system. Methods for qualitative and quantitative examination of urine sediment are discussed for diagnosing renal function disturbances, urinary system issues, as well as metabolic and systemic diseases. The lecture emphasizes the importance of these studies in clinical practice for detecting various pathological conditions and monitoring patient treatment.

Characteristics of the fetus in pregnant women with thyroid diseases

BACKGROUND: Thyroid dysfunction can cause adverse effects on metabolic changes in the body and disturbances during the gestational period and intrauterine development of the fetus. In developing prevention methods, it is crucial to objectively substantiate and re-confirm theoretical assumptions. AIM: To assess the functional state of the fetus in pregnant women with certain thyroid diseases. MATERIAL AND METHODS: The results of instrumental studies in 118 pregnant women, who were divided into three clinical groups, were analyzed. Group 1 (44 people) consisted of patients with autoimmune thyroiditis (AIT). Group 2 (52 people) included patients with diffuse toxic goiter. Group 3 (control group) consisted of 22 pregnant women who had no somatic pathology and gestational complications. Thyroid diseases were diagnosed by an endocrinologist during a consultation in the third trimester of pregnancy based on laboratory and instrumental data. The functional state of the fetus was assessed using the total result of cardiotocographic and ultrasound studies, for which Partecust (Siemens, Germany) and Aloka-1700 (Hitachi, Japan) were used. Statistical processing of clinical material was performed using StatSoft software (Russia). RESULTS: A comprehensive assessment of the adaptive capabilities of the fetus showed changes in its functional state in pregnant women with thyroid pathology. Prognostically, the most crucial characteristic in pregnant women with autoimmune thyroiditis and diffuse toxic goiter is a decrease to 0–1 point in indicators that determine motor activity and tone, respiratory movements, and reaction to a non-stress test. Among patients with autoimmune thyroiditis and diffuse toxic goiter, a high assessment of the biophysical profile of the fetus occurred 4 and 3.4 times, respectively, less often than among women with a normal pregnancy (among pregnant women without somatic pathology and gestational complications). CONCLUSION: Disturbances in thyroid gland function during the gestational period can have an adverse effect on the development of the fetus, which is a theoretical basis for the development of treatment and preventive methods aimed at improving perinatal outcomes in this group of patients.

Unveiling the Interplay: Antioxidant Enzyme Polymorphisms and Oxidative Stress in Preterm Neonatal Renal and Hepatic Functions.

To explore the relationship between oxidative stress biomarkers and the occurrence of acute kidney injury (AKI) alongside notable liver function disturbances in preterm neonates. Given the immaturity of kidneys and incomplete liver development in preterm neonates, oxidative stress poses a considerable threat to their renal and hepatic health. To find out the association between various oxidative stress biomarkers and polymorphisms of antioxidant enzymes with renal and live functions. In this cross-sectional study, we gathered umbilical cord blood and peripheral blood samples for assessing oxidative stress biomarkers and identifying single nucleotide polymorphisms (SNPs) in antioxidant enzymes. Utilizing enzyme-linked immunosorbent assay kits, we quantified these oxidative stress biomarkers. Receiver-operating characteristics curve analysis was employed to ascertain the predictive capacity of these biomarkers, denoted by the area-under-the-curve (AUC). Our findings revealed that umbilical cord heat-shock proteins emerged as robust predictors of neonatal AKI (AUC: 0.92; 95% CI: 0.8-1) with a defined cut-off concentration of 1.8 ng/mL. Likewise, umbilical cord 8-hydroxy-2-deoxy guanosine demonstrated significant predictability for liver function alterations (AUC: 0.7; 95% CI: 0.6-0.9) at a cut-off concentration of 2487.6 pg/mL. We observed significant associations between SNPs in endothelial nitric oxide synthase and catalase with both AKI and impaired liver functions. Prospective studies are warranted to validate these findings, with a particular focus on exploring potential antioxidant interventions aimed at mitigating AKI and liver function abnormalities.

Mechanisms of functional asymmetry of the face formation in patients with dysfunctional condition of temporomandibular joint

Objective. To give a detailed description of clinical manifestations, diagnosis and treatment of functional asymmetry of the face in patients with dysfunctional condition of temporomandibular joint (TMJ). Materials and methods. A complete examination of 34 (25 %) patients with symptomatic facial asymmetry of the 3rd type according to H.S. Hwang classification was carried out. The group consisted of 5 males (14,71 %) and 29 females (85,29 %). Screening protocol included standard dental care, cone beam computer tomography of both jaws and TMJ, MRI of TMJ with functional load. Results. 24 patients (70.59 %) completed complex dental treatment; 10 (29.41 %) people stopped treatment for various reasons and were excluded from further study. Complete restoration of facial symmetry was achieved in 21 people (87.5 %), partial restoration in 3 (12.5 %) patients. The height of the lower facial part and the synchrony of occlusal contacts were restored in all patients. Noise in the joint area persisted in 3 (8.8 %) cases, which is associated with arthrosis in the articular heads. In patients with unreducible dislocations, the intensity of the clicks decreased, and there was no pain at the end of treatment. It should be noted that all patients of this group refused subsequent surgical treatment. Conclusion. Functional asymmetry of the face results from multifactorial impact on the human organism and is multimorbid by nature. This condition is accompanied by complicated dental pathology, such as increased hard tooth tissues attrition, functional overload with traumatic nodes formation, disturbance of muscles and TMJ functions. It requires following diagnostic and treatment algorithm under the supervision of internal medicine specialists to correct sleep, postural stability, impaired psychoneurological status.

Assessing the reliability and validity of sleep assessments in patients seeking metabolic and bariatric surgery

BackgroundMore than 80% of patients seeking metabolic and bariatric surgery (MBS) report disturbance in sleep function. No studies have assessed the psychometric properties of sleep measures in MBS samples. ObjectivesThis study assessed the reliability and validity of the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) in a large sample of patients seeking MBS. SettingTwo academic medical centers. MethodsMeasures of sleep (PSQI and ISI) and psychological functioning, including the Quick Inventory of Depressive Symptomatology (QIDS), were administered presurgically. Internal consistency was assessed with mean inter-item correlations and item-total correlations. Construct validity was assessed using confirmatory factor analyses (CFAs) based on models identified in the literature and by measuring convergent and discriminant validity. ResultsParticipants (N = 939) were primarily female (83.4%) with a mean age of 41.7 (SD = 11.5) years and mean body mass index (BMI) of 47.5 kg/m2 (SD = 8.5). CFAs indicated excellent fit for 2-factor solutions for the PSQI and ISI. Internal consistency for the PSQI and ISI were acceptable. Convergent validity was demonstrated by large correlations between the PSQI and ISI (r = .80, P < .001), and moderate correlation between the PSQI, ISI, and QIDS (rs > .50, ps < .001). The PSQI and ISI were moderately correlated with QIDS items assessing sleep function (P < .001), but correlations with items assessing appetite change were small (r < .10), demonstrating good discriminant validity. ConclusionsResults support the reliability and validity of the PSQI and ISI for patients undergoing MBS.

Facial pore refining by targeting dermal and epidermal functions: Assessment across age and gender.

Conspicuous facial pores are benign but represent a cosmetic concern for men and women. Recent works described dermal and epidermal impairments as clinical causes of enlarged pores. Morphological modifications of skin at the site of pores were associated with collagen density loss, possible alteration of extracellular matrix and abnormal differentiation of keratinocytes. A composition containing mannose-6-phosphate (Active Complex) was designed to address these different aspects of pore enlargement. Invitro and exvivo evaluations were conducted in different models mimicking disturbance of dermal and epidermal functions. The pore refining activity of Active Complex was assessed in two clinical trials studying a Caucasian women cohort and an Asian men cohort. At the dermal level, Active Complex upregulated collagen I and decorin synthesis, and genes encoding collagens I, III, V, VII, XVII; suggesting its ability to favor collagen fiber organization and anchorage. The downregulation of matrix metalloprotease, involved in extracellular matrix degradation, reinforced the protective effect of Active Complex in the dermis. Active Complex down modulated differentiation markers in keratinocytes as well as genes involved in cell renewal. Study of reconstructed human epidermis modeling keratinocyte hyperproliferation revealed that Active Complex mitigated two markers of this state: number of nuclei in the stratum corneum and involucrin expression. Clinical trials confirmed the pore refining activity of Active Complex on men and women of different ages and ethnicities; -24% total skin pore area after 56 days of application on women, and -30.2% on men after 7 days. This work demonstrates the interest to target dermal and epidermal modifications described in conspicuous pore area, especially dermis fiber organization, to address this cosmetic concern.

Lysosomal storage disorders - Fabry disease and Gaucher disease

Lysosomal storage disorders (LSD) are a heterogenous group of inborn errors of metabolism due to lysosomal malfunction. LSDs affect 1 in 5000 live births, albeit every LSD itself has a low incidence. The most common LSDs are Fabry disease and Gaucher disease. The underlying cause mainly is an enzyme deficiency but may also be due to defects in transport or activation proteins, which result in progressive intra- and extra-lysosomal accumulation of undegraded storage material. The lysosomes play a key role in degradation and cellular recycling of macromolecules. Besides disturbance of cellular function, substrate accumulation may result in secondary toxic and/or inflammatory processes. For treatment of Fabry and Gaucher disease, several therapeutic approaches are approved including enzyme replacement therapy, chaperon therapy for Fabry disease and substrate reduction therapy for Gaucher disease.

Low-Complexity Tracking Control of Unknown Strict-Feedback Systems With Quantitative Performance Guarantees.

This article is concerned with the prescribed performance tracking control problem for the strict-feedback systems with unknown nonlinearities and unmatched disturbances. The challenge lies in the realization of a complete performance specification for trajectory tracking in the sense of quantitatively regulating the peak value, overshoot, settling time, and accuracy while ensuring that the initial condition holds naturally. To this end, an error transformation, equipped with a shifting function, is introduced and incorporated with a new-type barrier function. Then, a class of performance functions is exploited to quantify the settling times and steady-state bounds of the intermediate errors. Moreover, to improve the flexibility of formulating performance specifications for the tracking error, a pair of asymmetric performance boundaries are further designed. With their combination, a novel robust prescribed performance control (PPC) approach is proposed in this article. It not only achieves the quantitative performance guarantees but also preserves the unique simplicity of PPC, evading the needs for function approximation, parameter identification, disturbance estimation, derivative calculation, or command filtering. The above theoretical findings are confirmed via three simulation studies.

Satisfaction questionnaire survey after surgical orthodontic treatment in patients with jaw deformities

ObjectiveSurgical orthodontic treatment leads to morphological, functional and psychological changes in patients with jaw deformities. For the evaluation of outcomes of surgical orthodontic treatment from the patient's point of view, a questionnaire survey was performed after treatment and factors affecting patient satisfaction were examined. MethodsA survey by mailing questionnaires that each consisted of 30 items was conducted in 250 patients with jaw deformities who underwent orthognathic surgery in our department during the period from January 2015 to December 2020. Eighty-four patients responded (response rate of 34.0%). The patients who responded included 24 males and 60 females. The mean age at the time of surgery was 26 years. ResultsFifty-four patients complained of morphological abnormalities such as facial appearance and malocclusion, and 30 patients complained of functional disturbances such as masticatory disabilities. Eighty-two patients were satisfied with the outcome of surgery, but there were two patients with postoperative paresthesia and residual facial asymmetry who were not satisfied with the outcome. Improvements were observed in mastication and pronunciation in 74 and 46 patients, respectively. Psychologically, 26 patients showed positive personality changes postoperatively. Thirty-three patients had TMJ symptoms before surgery, and the symptoms were resolved after surgery in 24 of those patients. Two patients developed snoring during sleep after surgery. ConclusionsThis survey showed that most patients with jaw deformities were satisfied with the results of surgical orthodontic treatment.