Peripheral Part Research Articles

Climate change and its health effects - an optional subject for medical students

Abstract The Standing Committee of European Doctors urged to include training on the impact of climate change on health for health professionals. Currently, in the curriculum of most medical schools, the health-related impacts of climate change represent a peripheral part. The teaching of health effects of climate change should be made part of the training of health professionals and should be introduced in the curriculum of medical schools. ClimateMed is an Erasmus project that improves the curriculum and expands knowledge about the health effects of climate change at medical universities. The World Café method, based on round table discussions, was applied to assess the needs, summarize the proposals, and develop the necessary strategy. At the same time, a questionnaire was applied to those medical students from UMFST Targu Mureș who chose this subject as an optional subject. Students related the importance of understanding the diseases caused directly or indirectly by climate change, and reported what kind of topics should be included in a new course, in which semester/module and in what format it would be appropriate to teach it. The most frequently reported topics were: excessive heat and heat-related illnesses, extreme weather, vector-borne diseases, food safety, air pollution, and mental health. According to the goals of the project and students’ opinions, since 2023 medical students can choose Climate Change and Health Effects as an elective course. Based on the demand for medical universities to include in their curriculum knowledge related to the health effects of climate change, ClimateMed project can facilitate this integration and can promote the increase of teacher motivation and the development of methodological guidelines for university teachers. The project contributes to the preparation of some educational materials and the introduction of an optional subject in the training curriculum of the students of the Faculty of Medicine, UMFST Targu Mureș. Key messages • There must be made efforts to include training on the impact of climate change on health for health professionals, to introduce this subject in the curriculum of medical schools. • ClimateMed project can facilitate the integration of knowledge about the health effects of climate change into curriculum and can promote the practical use.

Humoral serotonin and neuropsychological status of patients with dizziness

Dizziness is often accompanied by affective disorders such as anxiety and depression, in the occurrence of which the role of the serotonergic system is discussed.Objective: to investigate the serotonin content in blood serum and neuropsychological status in patients with vestibular and non-vestibular dizziness.Material and methods. The study included 97 patients. Two observation groups were formed according to the type of dizziness complaints. The first group (n=47) comprised patients with vestibular (systemic) dizziness against a background of peripheral vestibulopathy, the second group (n=35) comprised patients with non-vestibular (non-systemic) dizziness with a diagnosis of probable persistent postural-perceptual dizziness (PPPD). The control group (n=15) consisted of patients without complaints of dizziness. Neurological and otoneurological status, psychoemotional parameters (level of anxiety and depression) and cognitive functions were analyzed, and the quantitative level of serotonin in blood serum was determined by enzyme immunoassay.Results. The study revealed a significant decrease in the serum serotonin levels in vestibular and non-vestibular dizziness; a lower serotonin level was found in non-vestibular dizziness (p<0.05). The presence of affective disorders did not correlate with a decrease in serotonin levels in vestibular dizziness against a background of peripheral vestibulopathy. It is assumed that a decrease in serotonin content plays a role in pathogenesis of vestibular dizziness on the background of peripheral part of vestibular system involvement.Conclusion. We demonstrated possibility of using the level of serotonin in peripheral blood as an objective laboratory marker of vestibular and non-vestibular dizziness in general clinical medical practice.

Identification of prospective oil-bearing areas in the peripheral parts of productive horizons U-12 and U-13 of the Zhetybai field

Background: To date, a comprehensive range of scientific, geological exploration, and appraisal work has been conducted at the Zhetybai field. The overall structural map of the field has been relatively well established. However, several critical issues remain insufficiently studied or entirely unexplored. Based on the results of seismic exploration (3D common depth point method) and additional appraisal work, peripheral (edge) zones of the field structure have been identified, including its cross-faults, as well as transverse flexures and longitudinal faults on the southern wing of the structure, which require further investigation. Aim: To further study the field structure, identify new potential hydrocarbon areas in the peripheral parts of the field, and assess the oil potential of the U-12 and U-13 horizons in the Zhetybai field. Materials and methods: This study involved a qualitative assessment of the informativeness of seismic attributes, analysis of reflection geometry (configuration), dynamic amplitude parameters, continuity of frequency, and other indicators. The analysis of reflection characteristics, in conjunction with all available data, primarily geophysical survey data, allowed for hypothesizing sedimentary conditions and obtaining acceptable lithological assessments. Results: The evaluation wells J-1, J-2, and J-3, drilled in 2023-2024 in the peripheral parts beyond the approved boundary of hydrocarbon-bearing horizons U-12 and U-13, yielded positive results. The productivity of the new reservoir was also confirmed by newly drilled production wells 5333, 5652, and 5367. Conclusion: To further study the structure of the Zhetybai field and identify new potential hydrocarbon-bearing areas in the peripheral parts, as well as structural uplifts and sandstone bodies of horizons U-12 and U-13, evaluation wells J-1, J-2, and J-3 were drilled. The detailed identification of sandstone bodies allows for the prediction of prospective areas not covered by drilling. The positive results from drilling evaluation wells have refined the geological structure of horizons U-12 and U-13 and confirmed the productivity of the peripheral parts of the reservoirs.

Comparative assessment of neurotrophic proteins in vibration disease

Introduction. The problem of health impairment due to the impact of physical factors, including vibration disease (VD), retains medical and social relevance due to the significant specific gravity in the structure of occupational morbidity and high prevalence. Under vibration exposure, the acid-base equilibrium, immune status are disturbed, rheological properties and properties of the neurohumoral system, as well as functional indices of the central and peripheral nervous system change. Neurotrophins are known to play an important role in regulating the development and functioning of the central and peripheral nervous systems. In this regard, research is needed to determine in VD patients the levels of neurospecific proteins, which may serve as one of the markers for tracing changes in the nervous system in workers. The aim of the study was to identify the peculiarities of changes in neurospecific proteins (BDNF, S100β, and MBP) in the serum of patients with VD of different genesis. Materials and methods. Serum concentrations of neurotrophic proteins: brain neurotrophic factor – BDNF, S100β protein and myelin basic protein (MBP) were studied by solid-phase enzyme-linked immunoassay. Results. There was an increase in serum BDNF, S100β protein, and MBP concentrations in persons with VD due to combined exposure to local and general vibration, and an increase in MBP was observed in patients with VD due to exposure to local vibration. Limitations. The limitations of this work are small groups of employees. Conclusion. As a result of studies, it can be assumed that in VD due to exposure to combined vibration, changes are observed in the peripheral and central parts of the nervous system, and in VD due to local vibration, disorders seem to be mainly associated with the peripheral nervous system. The general pattern of the revealed disorders in the content of MBP lies in the neurodestructive processes occurring in the nerve fibers in patients with VD, regardless of genesis. Summarizing the above mentioned, the validity of studying the concentration of neurospecific proteins in vibration disease occurring with damaging processes in the nervous tissue should be recognized.

Features of the formation of natural-technical systems within the injection areas of the Daldyn kimberlite field (Western Yakutia)

Relevance. Primary diamond deposits mined by PJSC ALROSA in Western Yakutia have widespread watering of varying intensity with sub-permafrost and inter-permafrost strong and very strong brines. Currently, the resulting drainage waters are pumped back into the depths of the permafrost, which leads to the formation of natural-technogenic aquifers that require constant control, monitoring and study. Aim. Identification of the features of the formation of natural-technogenic systems within the injection areas of the Daldyn kimberlite field, determination of the volume of permafrost waters involved in this process, as well as their characteristics to confirm the environmental friendliness of the method of handling drainage brines. Methods. Field work consisted of quarterly routine testing of observation and injection wells. Assessment of technogenic influence, as well as subsequent forecasting of the dynamics of changes in cryohydrogeological conditions and hydrodynamic regime, was carried out using modeling methods in Feflow software. An additional method was analytical balance calculation based on the parameter of changing mineralization. Results and conclusions. The interaction of drainage waters with permafrost waters leads to areal changes in mineralization without significant changes in the dominant anions and cations within the studied objects, forming an equilibrium natural-technogenic system in the peripheral parts relative to background temperature conditions. The volume of formed man-made aquifers will exceed 300 million m3. The process of involving cryogenic waters, despite the significant volumes, has a positive impact on the ecological state of the territory, because in the peripheral parts of the resulting aquifers, equilibrium cryohydrogeological conditions are formed, characteristic of natural cryopegs in the region of study.

An in vivo tumour organoid model based on the chick embryonic chorioallantoic membrane mimics key characteristics of the patient tissue: a proof-of-concept study

BackgroundPatient-derived tumour organoids (PDOs) are highly advanced in vitro models for disease modelling, yet they lack vascularisation. To overcome this shortcoming, organoids can be inoculated onto the chorioallantoic membrane (CAM); the highly vascularised, not innervated extraembryonic membrane of fertilised chicken eggs. Therefore, we aimed to (1) establish a CAM patient-derived xenograft (PDX) model based on PDOs generated from the liver metastasis of a colorectal cancer (CRC) patient and (2) to evaluate the translational pipeline (patient – in vitro PDOs – in vivo CAM-PDX) regarding morphology, histopathology, expression of C-X-C chemokine receptor type 4 (CXCR4), and radiotracer uptake patterns.ResultsThe main liver metastasis of the CRC patient exhibited high 2-[18F]FDG uptake and moderate and focal [68Ga]Ga-Pentixafor accumulation in the peripheral part of the metastasis. Inoculation of PDOs derived from this region onto the CAM resulted in large, highly viable, and extensively vascularised xenografts, as demonstrated immunohistochemically and confirmed by high 2-[18F]FDG uptake. The xenografts showed striking histomorphological similarity to the patient’s liver metastasis. The moderate expression of CXCR4 was maintained in ovo and was concordant with the expression levels of the patient’s sample and in vitro PDOs. Following in vitro re-culturing of CAM-PDXs, growth, and [68Ga]Ga-Pentixafor uptake were unaltered compared to PDOs before transplantation onto the CAM. Although [68Ga]Ga-Pentixafor was taken up into CAM-PDXs, the uptake in the baseline and blocking group were comparable and there was only a trend towards blocking.ConclusionsWe successfully established an in vivo CAM-PDX model based on CRC PDOs. The histomorphological features and target protein expression of the original patient’s tissue were mirrored in the in vitro PDOs, and particularly in the in vivo CAM-PDXs. The [68Ga]Ga-Pentixafor uptake patterns were comparable between in vitro, in ovo and clinical data and 2-[18F]FDG was avidly taken up in the patient’s liver metastasis and CAM-PDXs. We thus propose the CAM-PDX model as an alternative in vivo model with promising translational value for CRC patients.Graphical

Residual stress induced granular bright facets around inclusions in high-strength steels under high-cycle fatigue

Granular bright facets (GBFs) are frequently observed adjacent to inclusions and within fish-eye areas in the fatigue fractures of high-strength steels under very-high-cycle fatigue (VHCF), considered as a characteristic fracture feature of VHCF. Previous understanding on GBF formation emphasizes the occurrence of nanocystallization in microstructure. In this study, however, the same morphology can also be observed under high-cycle fatigue (HCF). GBF, although closer to fatigue crack initiator and experiencing more stress cycles than the peripheral part of fish-eye (PPFE), exhibits rougher surface morphology in the absence of accumulated plastic strain in microstructure, manifesting relieved crack surface wear. This indicates that the traditional theories on GBF formation for VHCF becomes invalid for HCF. The root cause for GBF formation under HCF is analyzed to be the presence of residual stress around inclusions, which reduces the contact pressure of fatigue crack surfaces inducing wear relief. Accordingly, an analytical model capable of predicting GBF thickness with the effects of HCF conditions and steel properties taken into consideration is established. The model yields accurate predictions of GBF thickness with various loading stresses and inclusion diameters, validated by experimental observations. This study provides theoretical guidance for HCF fracture analysis and fatigue life prediction.

Flow Structure and Periodic Processes in a Disc-Shaped Vortex Chamber of a Hydrodynamic Cavitator

Introduction. The essence of the acoustic – cavitation processes is that the liquid is passed through sound with a pressure at the wave surface of more than 3 bar that causes local breaks of the liquid in the vacuum phase of the wave and the collapse in the manometric phase. The opposite walls of each cavern in the collapse approach at a speed exceeding two speed of sound, due to which a high energy density is achieved at the meeting point, and what is especially valuable is the mutual transitions of energies from one form to another, unattainable under normal conditions, and, moreover, as inside cavitation area and near it. The novelty of the work is confirmed by the results of a periodic information and patent analysis, and by four patents received for inventions on the topic under consideration.Aim of the Study. The study is aimed at improving the acoustic-cavitation qualities of a disk-shaped vortex chamber used as a liquid whistle.Materials and Methods. In the study, there were used numerical modeling of flows in the FlowVision program, experimental determination of flow rates using a pitot tube, film method, removal of frequency response using SpectraPLUS 5.0, and visualization of flows and processes on optically transparent devices by the method of color indicators in stroboscopic lighting high-speed video shooting.Results. The mechanism of sound generation and noise in the flow transiting through the device has been found. The corrective effect of pump pulsations f = 300 Hz on the sound generation mechanism was revealed. The disc-shaped character of the device, which encloses the input flow in cross section from three directions, contributes to creating a more expressive acoustic signal, forming two conjugate torus vortices along the shell that ensures uniformity of the circumferential flow, attenuation of longitudinal high-frequency oscillations f = 200 kHz, and the creation of periodic zones of increased pressure along the shell. The concentrated tangential entrance to the device determines the central asymmetry of the flows in it and a number of processes that create acoustic noise.Discussion and Conclusion. The frequency of the useful acoustic signal in the vortex chamber is proportional to the speed of the transit flow, and the amplitude is proportional to the dimensions of the device. Along with the useful signal created by the interaction of the peripheral and input parts of the transit flow, noise of similar frequencies is created in the device. Other sources of noise generation are due to the presence of a concentrated tangential input. The formation of two conjugate torus vortices along the shell can be used as a means of controlling the process of interaction between parts of the transit flow. The disc-shaped vortex chamber combines the functions of sound generation and the ability to create a centrifugal field, which expands its technological capabilities.

Imaging Neural Activity in Intact, Semirestrained Drosophila Larvae.

The Drosophila larval nerve cord, which is the equivalent of the vertebrate spinal cord, houses the circuits required to process somatosensory stimuli (e.g., tactile, temperature, vibration, and self-movement) and generate the patterned muscle contractions underlying movement and behavior. Within this complex structure reside many cell types and cellular processes, making it difficult to experimentally access, when compared to peripheral parts of the nervous system (i.e., primary sensory neuron dendrites, motor neuron axons and synapses, and muscles). Additionally, the neurons in the larval nerve cord have small cell bodies, precluding traditional electrophysiological approaches. As such, the function of neurons in the nerve cord is less well studied than other parts of the nervous system, severely limiting our understanding of how larvae process sensory information and generate movement. Ca2+-sensitive fluorescent proteins enable the study of neuronal activity in live, genetically tractable animals, even those with small neuronal cell bodies. In addition, live imaging of neurons within the nerve cord in whole, intact animals is possible because larvae are translucent, and the use of intact animals allows for the peripheral sensory neuron circuits to remain intact. Ca2+-sensitive fluorescent proteins increase their fluorescence when voltage-gated Ca2+ channels are opened in depolarized neurons. Here, we describe an assay where a Ca2+-sensitive fluorescent protein (GCaMP6m) is expressed under the control of a GAL4 driver in a subset of neurons that reside in a circuit for vibration sensation. External vibration (sound) stimulates sensory neurons that activate the cells expressing the Ca2+-sensitive fluorescent protein. Visualization of the calcium-induced fluorescent signal with microscopy allows for quantification of neuronal activity.

The Right to Use Cash: A Case Study of India

India is facing a shift towards a cashless society using alternative methods for payment transactions based on electronic and digital means. It is a country with the fastest growing economy in the world and a heterogeneous population. The country's digitalisation of money transactions is growing and is applied in all government transactions and has taken a big leap in many spheres of its operations, which brings inclusiveness in society. The important motives behind this is to provide basic banking services to hitherto unbanked masses and to curb black money, tax evasion and the threat of terrorism. However, the peripheral parts of the society like, poor, elderly, physically challenged and others may be deprived of the benefits of financial systems due to their limitations in benefitting from the digital transformation. A cashless society may not be in the interests of these groups and it may result in social exclusion rather than inclusion. However, consumers need to have the right to choose their preferred payment method and there should be adequate availability of cash and ATMs. Eliminating cash would have negative consequences and may have adverse effects on these populations. This paper takes a look into the aspects of the right of the public as a consumer in choosing cash as the payment method of her convenience and choice.

Mechanisms of adaptation of the hypothalamic-pituitary-adrenal axis in male mice under chronic social defeat stress

The hypothalamic-pituitary-adrenal axis (HPA) plays an important role in the mechanisms of adaptation to chronic stress. A model of chronic social defeat stress (CSDS), based on the experience of defeat in daily agonistic interactions, causes the development of a depressive-like state in mice, which is often accompanied by an increase in blood corticosterone levels. In this work, we assessed what changes occur in the central (hypothalamus) and peripheral (adrenal glands) parts of the HPA axis under the influence of chronic social stress, which can affect the regulation of corticosterone synthesis and its level in the blood. The experience of chronic social stress causes an increase in the relative weight of the adrenal glands, an increase in the expression level of Crh gene in the hypothalamus and the expression of the genes for the corticosterone synthesis enzymes Star, Cyp11a1, Cyp11b1 in the adrenal glands. At the same time, in the hypothalamus the expression of Fkbp5 and Nr3c1 decreases and the expression of Crhbp increases, and in the adrenal glands the expression of the Mc2r and Hsd11b1 genes decreases, which is ultimately aimed at reducing the amount of corticosterone secreted by the adrenal glands, and thus limiting the glucocorticoid response. Thus, chronic stress leads to an imbalance of the activating and stabilizing mechanisms of HPA axis regulation and a possible inadequate response to additional stress stimuli.

Impact of wetland health and provisioning services on the livelihood of the fishing community.

The present study aimed to explore the linkage between wetland health, provisioning service value (PsV) and livelihood vulnerability of the dependent fishermen community taking examples from the Moribund deltaic wetlands of India. Wetland health including hydrological strength, habitat state, and the water quality of the wetland was assessed using a random forest (RF) and XGBoosing machine learning approach, and the Livelihood Vulnerability Index (LVI) was computed using balanced weighted approach. Ordinary least square (OLS) regression, correlation matrix, and rank correlation matrix were done to make the relationship between wetland health and LVI. Wetland health was found poor (28.38%) in the isolated, smaller, and peripheral parts of the wetland with agricultural and built-up area proximity. Hydrological strength (with r2 of 0.67) was found as the most dominant health determinant followed by habitat state (with r2 of 0.62). OLS reported that in most of the cases, the standard regression residual is low (0.5 to - 0.5) which indicates that there is a strong relation between wetland health and LVI. KDE plot and correlation matrix also figured out the same. From the field survey, it was found that the wetlands with good habitat health are promising for providing more provisioning services like fish which in turn supports the livelihood of the dependent communities. The findings of this study have a deeper insight into livelihood management through wetland management. Hence, it would inspire policymakers and stakeholders to conserve wetlands not only for the sake of ecology but also for society.

Spatiotemporal forecasting of water change trends in Urmia Lake through to 2030, using STC-based models

ABSTRACT The purpose of this paper is to forecast the spatiotemporal water change trends in Urmia Lake through 2030. Three space–time cube-based models were applied. The forest-based forecast model, with a mean of 0.14 forecast root mean square error (RMSE) and 0.39 validation RMSE, had a better performance. According to the model’s results, the peripheral parts of the lake will mainly stay completely arid with a 42.5% extension in the entire period, 21.7% in spring, and a 27% reduction in winter. In the middle parts, the aridity will increase by 121% in summer, 93% in fall, and 38% in spring. Eventually, the centric areas will not be completely arid; however, the water patterns’ extent will decrease by 53.46% in fall, 34.6% in spring, and 28.5% in summer. Additionally, southern, eastern, western, and northern areas will experience drier conditions, respectively. The findings can be used for water resource management and water restoration plans for the lake.

Integrated On-Slide Positive Controls for Immunocytochemistry on Cytology Slides.

Integrated on-slide positive controls are a standard quality assurance and quality control measure for immunohistochemistry on formalin-fixed paraffin-embedded tissue sections. They ensure identical analytical conditions for the control and patient samples. Our aim was to develop a procedure for preparing integrated on-slide positive controls for immunocytochemistry (ICC) on methanol-fixed cytospins. Leftover diagnostic cytology samples with sufficient cells and confirmed expression of Calretinin, MOC31, TTF1, and hormone receptors were used as control samples. Cells from the control samples were deposited on the peripheral part of objective slides using standard cytocentrifuge equipment. Cytospins were immediately fixed in methanol for at least 30 min and then covered with polyethylene glycol (PEG). Completely dry and solid PEG was removed from the central part of the objective slides and stored at room temperature. Patient samples were subsequently added to the central part of a PEG-protected slide, with an appropriate positive control placed on the peripheral part, and then fixed in methanol. ICC was performed on the Ventana/Roche automated platform ULTRA, using optimized and validated protocols for TTF1, hormone receptors, and double immunostaining for Calretinin/MOC31. The quality of ICC reactions for both deposits on the same slide and potential cell carryover was evaluated retrospectively. In the period from October 2021 to December 2023, the majority of integrated positive controls (364/368, 99%) consistently exhibited unequivocally positive reactions for TTF-1 (n = 93), hormone receptors (n = 84), and double staining for Calretinin/MOC31 (n = 191), with easily interpretable ICC reactions on corresponding patient samples. No obvious carryover of cells from the control sample to the patient sample was observed during this period. A novel approach developed for preparing integrated on-slide positive controls for ICC on methanol-fixed cytospins using standard cytocentrifugation is low-cost and can be widely applied in diagnostic cytology laboratories. Simultaneous ICC procedures for the control and patient samples on the same slide ensure identical analytical conditions for both samples, providing the highest level of quality control while reducing costs. Interpreting both ICC reactions on the same slide is time-efficient and convenient.

Cybersickness Reduction via Gaze-Contingent Image Deformation

Virtual reality has ushered in a revolutionary era of immersive content perception. However, a persistent challenge in dynamic environments is the occurrence of cybersickness arising from a conflict between visual and vestibular cues. Prior techniques have demonstrated that limiting illusory self-motion, so-called vection, by blurring the peripheral part of images, introducing tunnel vision, or altering the camera path can effectively reduce the problem. Unfortunately, these methods often alter the user's experience with visible changes to the content. In this paper, we propose a new technique for reducing vection and combating cybersickness by subtly lowering the screen-space speed of objects in the user's peripheral vision. The method is motivated by our hypothesis that small modifications to the objects' velocity in the periphery and geometrical distortions in the peripheral vision can remain unnoticeable yet lead to reduced vection. This paper describes the experiments supporting this hypothesis and derives its limits. Furthermore, we present a method that exploits these findings by introducing subtle, screen-space geometrical distortions to animation frames to counteract the motion contributing to vection. We implement the method as a realtime post-processing step that can be integrated into existing rendering frameworks. The final validation of the technique and comparison to an alternative approach confirms its effectiveness in reducing cybersickness.

Human Visual System applied to Facial Recognition

Research in the field of biometrics is constantly expanding. Numerous studies have been carried out to develop different techniques with the aim of ensuring reliable and efficient recognition systems. Of our five senses, vision takes up the most of the neurons in our brain. This makes the visual approach challenging. This paper proposes to develop a new facial recognition technique based on the concept of Human Visual System in order to simulate or imitate human perception. Our approach exploits the behavior of the Human Visual System in biometric systems to improve individual recognition. It focuses on Perceptual Channel Decomposition in order to generate images, confined around a certain frequency range, perfectly uncorrelated. For the extraction of characteristic vectors, our technique uses the Principal Component Analysis. The principle of the visual approach consists of exploiting one or more characteristics of the peripheral parts of the Human Visual System. These characteristics can integrate the sensitivity of the Human Visual System to spatial frequencies, its sensitivity to local contrast. The Principal Component Analysis uses a set of seventeen channels, each adjusted to a band of given radial frequencies and orientation. The seventeen output images contain the same spatial information but are perfectly uncorrelated from a spectral point of view. In the implementation phase, we limited ourselves to explore this technique by using only four frequency rings. The results obtained are conclusive and satisfactory.

Risk of thromboembolism after intraosseous implantation of metallic devices with extracellular vesicles derived from multipotent stromal cells: preliminary results

Background. New implantation methods are of great importance due to the development of endoprostheses in traumatology and orthopedics, restorative medicine and dentistry. Equally important is the early detection and description of the implant-associated complications. The aim of the study is to find and describe thrombi and emboli in the heart and lungs formed after experimental implantation of metallic devices in the peripheral part of limb using extracellular vesicles of mesenchymal stromal cells. Methods. Outbred rabbits of both genders at the age from 4 to 6 months and of weight from 3 to 4 kg underwent experimental implantation. The study enrolled 57 species in total. They were divided into two groups: 30 animals underwent implantation of metallic devices using extracellular vesicles of mesenchymal stromal cells (EV MSCs), 27 — without their use. The rabbits’ hearts and lungs were studied by light microscopy methods at different stages after integration of screw titanium implants into the proximal condyle of the tibia using EV MSCs. Results. After implantation of metallic devices into the proximal condyle of the tibia, we detected fibrin, detritus and even the red bone marrow structures (various blast forms of hematopoietic cells: megakaryocytes, cells of the erythroid and myeloid lineages) in the right cavities of the heart. In the pulmonary arteries, we also found thrombi and emboli, which either led to the obliteration of the involved vessel or to gradual lysis, not disappearing completely within 10 days of follow-up. Conclusions. After intraosseous implantation of the metallic devices, there is an embolism risk in the right atria and ventricle of the heart and the pulmonary arteries and veins due to the debris migration with the bloodstream from the surgery site. At the same time, one cannot exclude a thrombotic risk in the heart and pulmonary arteries as a reaction to the presence of detritus. It is advisable to take measures aimed at preventing both debris releasing into the bloodstream and pulmonary embolism during any implantations into the bone tissues, even of relatively small devices. Using EV MSCs to affect the implant engraftment processes has no significant effect on the severity and frequency of thromboembolic complications.

Efficacy of Intravenous Low-Dose Ketamine for Prevention of Post-Spinal Anesthesia Shivering in Cesarean Section: A Double-Blind, Randomized Controlled Study

Background: Post-spinal anesthesia shivering in cesarean section is a common complication owing to sympatholysis, resulting in vasodilation and heat redistribution from the core to peripheral parts of the body. The physiological consequences of shivering include an increase in cardiac and systemic energy expenditure, oxygen consumption, and carbon dioxide production. Ketamine, a N-methyl D-aspartate (NMDA) receptor antagonist, has been reported to have anti-shivering effects. The aim of this study is to determine the effectiveness of prophylactic low-dose intravenous (IV) ketamine (0.25 mg/kg) in preventing shivering after spinal anesthesia as compared to placebo in elective cesarean sections. Methods: A randomized, double-blind study was conducted on 80 patients aged 18 to 40 years and American Society of Anesthesiologists grade II undergoing elective cesarean section under spinal anesthesia. Groups K and group S received IV ketamine 0.25 mg/kg diluted to 5 ml in normal saline and 5 ml normal saline IV, respectively, 10 minutes after spinal anesthesia. The incidence and duration of shivering, tympanic membrane temperature, sedation score, hemodynamic parameters, and side effects were recorded. Results: The incidence of shivering in group K was 12.5% compared to 32.5% in group S (P = 0.030). The mean duration of shivering was only 0.75 ± 2.02 min in group K as compared to 2.38 ± 3.57 min in group S (P = 0.014). Mean arterial pressure and heart rate were stable in group K without any significant sedative effect. Conclusion: The use of prophylactic low-dose ketamine (0.25 mg/kg) significantly reduces the incidence and duration of spinal anesthesia-induced shivering compared to placebo.

The Role of Computed Tomography in Ophthalmic Surgeon Tactics in Shrapnel Wounds to the Eyeball. Clinical Case

There is a clinical case of eyeball metallosis in the background of a foreign body of the posterior segment of the eye in the article. Patient N, 41, complained of a gradual decrease in vision of the right eye. A duration of open injury to the right eye about eight years ago. At the primary ophthalmic examination, the most corrected visual acuity of the right eye was 0.3. The visual acuity of the left eye was 1.0. Intraocular pressure according to pneumotonometry: OD — 13 mm Hg, OS — 14 mm Hg. According to biomicroscopy of the right eye, it was found: the skin of the eyelids is unchanged, the conjunctiva is hyperemic, the mixed reaction of the vessels, the cornea is transparent, spherical, shiny, the anterior chamber is transparent, uneven, the iris is changed in color, foci of stroma hyperpigmentation are observed, the pupil is deformed, narrowed, displaced along the meridian for 1 hour, artificial. Examination of the central and peripheral parts of the fundus is difficult due to deformation and narrowing of the pupil diameter. Due to difficulty performing ophthalmoscopy, the patient underwent the following studies: static perimetry, ultrasound biomicroscopy (UBM) of the anterior segment of the eyeball, electrophysiological examination, B-­scan, computed tomography of the eyeball and orbit. The static perimetry revealed a concentric narrowing of the OD field of view. According to the ultrasound biomicroscopy, the IOL dislocation was revealed anteriorly. В­-Scanning visualizes the blistering cystic edema of the retina, inside which the induration is determined, giving an acoustic shadow. The electrophysiological examination showed changes in the electrical sensitivity and lability of the retina. According to the results of CT in the vitreous cavity, a foreign body was detected in the lower segment along the meridian 6 hours. In accordance with this, the diagnosis was made: OD — metallosis of the eye. Foreign body of the eye.

Persistent Residual Lung Abnormalities (PRLAs) as Post COVID Lung Sequel in Recovered Severe Pneumonia Case with Lung Function Abnormality at Two Year Follow Up

Coronavirus related (SARS-CoV-2) global pandemic has caused significant mortality and morbidity globally in the last three years. Although, pandemic has waned since last year, we are not in great peace of relief due to lingering effects of COVID-19 persisted even after two years of illness. Radiological phenotypes are radiological patterns or observable characteristics of COVID-19 pneumonia. Radiological outcomes are initially interpreted as post covid lung fibrosis in short term follow-up of recovered COVID-19 cases in post covid care settings and during long term evaluation these abnormalities are defined as post covid sequalae’s. In present case report, 38-year male, presented in outdoor unit for shortness of breath on exertion with history of severe COVID-19 Pneumonia resulted into acute respiratory distress syndrome with hospitalization in intensive care unit one year back and required high flow nasal cannula (HFNC) with Non-invasive ventilatory support (NIV) for two weeks. He was offered oxygen supplementation at home with antibiotics for three months and no requirement of oxygen and some respiratory symptoms even after one year. His HRCT thorax documented at one year of discharge from hospital revealed typical interstitial opacities labelled as Persistent Residual lung abnormalities (RLAs) which are predominantly reticular and linear opacities in peripheral parts of lungs without honeycombing within typical pleural based areas with parenchymal bands and minimally altered lung architecture and preserved lung volume.