Stages Of Treatment Research Articles

Transcriptome profiles reveal response mechanisms and key role of PsNAC1 in Pinus sylvestris var. mongolica to drought stress

BackgroundDrought stress severely impedes plant growth, and only a limited number of species exhibit long-term resistance to such conditions. Pinus sylvestris var. mongolica, a dominant tree species in arid and semi-arid regions of China, exhibits strong drought resistance and plays a crucial role in the local ecosystem. However, the molecular mechanisms underlying this resistance remain poorly understood.ResultsHere, we conducted transcriptome sequence and physiological indicators analysis of needle samples during drought treatment and rehydration stages. De-novo assembly yielded approximately 114,152 unigenes with an N50 length of 1,363 bp. We identified 6,506 differentially expressed genes (DEGs), with the majority being concentrated in the heavy drought stage (4,529 DEGs). Functional annotation revealed enrichment of drought-related GO terms such as response to water (GO:0009415: enriched 108 genes) and response to water deprivation (GO:0009414: enriched 106 genes), as well as KEGG categories including MAPK signaling pathway (K04733: enriched 35 genes) and monoterpenoid biosynthesis (K21374: enriched 27 genes). Multiple transcription factor families and functional protein families were differentially expressed during drought treatment. Co-expression network analysis identified a potential drought regulatory network between cytochrome P450 genes (Unigene4122_c1_g1) and a core regulatory transcription factor Unigene9098_c3_g1 (PsNAC1) with highly significant expression differences. We validated PsNAC1 overexpression in Arabidopsis and demonstrated enhanced drought resistance.ConclusionsThese findings provide insight into the molecular basis of drought resistance in P. sylvestris var. mongolica and lay the foundation for further exploration of its regulatory network.

Trends in the surgical treatment of glaucoma in recent decades

The analysis of trends in the surgical treatment of primary open-angle glaucoma (POAG) allows assessing changes in the indications for surgical treatment, the number of glaucoma surgery and their modifications, as well as the demographic characteristics of patients, duration of preoperative therapy and the effectiveness of treatment.The results indicate that over the past 20 years in the Russian Federation there was a shift towards an increasingly long-term therapeutic strategy used before the surgical stage of treatment, and, in general, a decrease in the number of performed glaucoma surgeries. There is much concern about late surgical treatment, which is confirmed by the established increase in the age of first-time operated patients, and the tendency to increase the number of operations at a far advanced stage of the disease. Most of the published studies on the postoperative hypotensive efficacy of surgery are of limited duration, which does not allow an adequate assessment of the results of treatment. Early appointment of medical hypotensive therapy after surgical intervention indicates a low interaction between outpatient and inpatient specialists, which hinders the possibility of early correction of postoperative problems. The recent increase in the number of scientific works, especially patents, focusing on the search for new technologies that can be implemented in glaucoma surgery, the development of modern drainage devices and the methods for prolonging the hypotensive effect after surgery gives a reason for optimism. The performed analysis dictates the need to develop and implement measures aimed at clearly defined indications for timely surgical treatment and creation of conditions for a complex relationship between the patient, outpatient ophthalmologist and glaucoma surgeon.

Bronchial carcinoid. Stages of treatment

Carcinoids are tumors of the diffuse endocrine system that arise from hormone-producing cells of nervous origin (secretory neurocytes). Bronchial carcinoid was first described by R. Leannec [3] in 1831. Among all lung neoplasms, carcinoid tumors occur in 2%. CONCLUSION This method allowed the first stage to stop inflammatory processes in the lung tissue, which contributed to the effective implementation of the main stage of treatment. Lobectomy was performed without complications.

ВИЗНАЧЕННЯ РАЦІОНАЛЬНОГО СКЛАДУ РЕАГЕНТІВ ДЛЯ ЗДІЙСНЕННЯ ПРОЦЕСІВ КОМПЛЕКСНОГО РАФІНУВАННЯ РІДКОГО ЧАВУНУ НА ЕТАПІ ПОЗАПІЧНОЇ ОБРОБКИ

The paper is devoted to the issue of complex treatment of cast iron. Possible chemical transformations that can occur when reagents are introduced into liquid cast iron are analyzed, and expressions for calculating the equilibrium constant Kr, depending on temperature, are obtained. Graphical dependences of the equilibrium constants on temperature for these reactions were also constructed. The calculations were performed for desulfurization reactions, carbonate dissociation reactions, oxidation of cast iron impurities due to interaction with carbon dioxide, and for the interaction of liquid cast iron components with iron oxides. Thermodynamic calculations have established that the mixture for the complex refining of liquid cast iron at the out-of-furnace treatment stage should belong to the chemical system CaO - Na2CO3 - FeO(Fe2O3) - Al. The specific ratio of components is determined by the required refining result.

Machine learning and deep learning for the diagnosis and treatment of ankylosing spondylitis- a scoping review

Background and objectivesMachine Learning (ML) and Deep Learning (DL) are novel technologies that can facilitate early diagnosis of Ankylosing Spondylitis (AS) and predict better patient-specific treatments. We aim to provide the current update on their use at different stages of AS diagnosis and treatment, describe different types of techniques used, dataset descriptions, contributions and limitations of existing work and ed to identify gaps in current knowledge for future works. MethodsWe curated the data of this review from the PubMed database. We searched the full-text articles related to the use of ML/DL in the diagnosis and treatment of AS, for the period 2013–2023. Each article was manually scrutinized to be included or excluded for this review as per its relevance. ResultsThis review revealed that ML/DL technology is useful to assist and promote early diagnosis through AS patient characteristic profile creation, and identification of new AS-related biomarkers. They can help in forecasting the progression of AS and predict treatment responses to aid patient-specific treatment planning. However, there was a lack of sufficient-sized datasets sourced from multi-centres containing different types of diagnostic parameters. Also, there is less research on ML/DL-based AS treatment as compared to ML/DL-based AS diagnosis. ConclusionML/DL can facilitate an early diagnosis and patient-tailored treatment for effective handling of AS. Benefits are especially higher in places with a lack of diagnostic resources and human experts. The use of ML/DL-trained models for AS diagnosis and treatment can provide the necessary support to the otherwise overwhelming healthcare systems in a cost-effective and timely way.

Post-COVID-19 Cognitive Dysfunction: Methodological Foundations for Prevention and Correction Model

The article introduces a comprehensive review of theoretical and experimental studies in the field of psychophysiological predictors of cognitive impairments in post-COVID-19 patients. The data obtained made it possible to design a model of psychological correction and prevention of post-COVID-19 cognitive dysfunction. This condition affects cognitive, behavioral, and psycho-emotional areas of mental activity. Functional changes involve poor mobility of nervous processes and short attention span, as well as changes in coping behavior and personality characteristics. Unlike older patients, teenagers experience fewer consequences for cardiovascular system and cognitive functions. As for gender differences, men restored their cognitive functions better when they came to grasp with their past experience. For women, recovery was associated with life meaning, planning, and goal setting. The resulting model for the prevention and psychological correction of post-COVID-19 cognitive dysfunction integrated the principles of systemic, information, cognitive, and personality-oriented approaches. It consisted of several structural elements that made it possible to support COVID-19 patients through all treatment stages, i.e., psychodiagnostics, psychocorrection, psychotherapy, and social and lifestyle adaptation.

Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth.

Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait-like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within-person processes of elevated risk in clinically meaningful time periods. The present study used clinical data from 689 adolescents aged 12-19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self-report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. Overall, two-thirds of variance in weekly irritable mood was accounted for by between-person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression.

Understanding microplastic presence in different wastewater treatment processes: Removal efficiency and source identification

Municipal effluents discharged from wastewater treatment plants (WWTPs) are a considerable source of microplastics in the environment. The dynamic profiles of microplastics in treatment units in WWTPs with different treatment processes remain unclear. This study quantitatively analyzed microplastics in wastewater samples collected from different treatment units in two tertiary treatment plants with distinct processes. The influents contained an average of 15.5 ± 3.5 particles/L and 38.5 ± 2.5 particles/L in the two WWTPs with in the oxidation ditch process and the integrated fixed-film activated sludge process, respectively. Interestingly, microplastic concentrations in the influent were more influenced by the population density in the served area than sewage volume or served population equivalent. Throughout the treatment process, concentrations were reduced to 1.5 ± 0.5 particles/L and 1.0 ± 1.0 particles/L in the final effluents, representing an overall decrease of 90% and 97%, in WWTPs with the oxidation ditch process and integrated fixed-film activated sludge process, respectively. A significant proportion of the microplastics were removed during the primary treatment stage in both WWTPs, with better performance for foam, film, line-shaped and large-sized microplastics. Most microplastics were accumulated in activated sludge, indicating its key role as the primary sink in WWTPs. The multiple correspondence analysis identified laundry washing and daily necessities such as packaging and containers as the major contributors to microplastics in WWTPs. The study proposed recommendations for upgrading WWTPs, modifying designs, and implementing strategies to reduce microplastic sources, aiming to minimize the release of microplastics into the environment. These findings can shed lights on the sources of microplastics in WWTPs, and advance our understanding of the mechanisms for more effective microplastic removals in wastewater treatment technologies in future applications.

Microeukaryotic communities diversity with a special emphasis on protozoa taxa in an integrated wastewater treatment system

This study developed an integrated wastewater treatment system that combines an upflow anaerobic sludge blanket (UASB), downflow hanging non-woven fabric (DHNW), and anaerobic baffled reactor (ABR) to explore the effect of treatment stages on the diversity of microeukaryotic communities. This study aimed to bridge the knowledge gap regarding the influence of integrated system stages on microeukaryotic community diversity. Through 18S rRNA amplicon sequencing, we identified unique microeukaryotic communities across different stages, with the aerobic phase hosting 35.77% of unique amplicon sequence variants (ASVs). The results of principal component analysis (PCA) and non-multidimensional scale analysis (nMDS) demonstrated the significant influence of wastewater treatment on both environmental factors and the microeukaryotic communities. Ciliophora was notably abundant in the effluent (42.09%) and sludge (17.11%). The aerobic stage was dominated by Ochrophyta, a diverse group of algae instrumental in nutrient removal, such as nitrogen and phosphorus, through biological processes. A redundancy analysis (RDA) revealed a positive correlation between chemical and biochemical oxygen demand and Cryptomycotina, highlighting its potential as a bioindicator for treatment efficacy. The detection of protozoan species, such as Acanthamoeba castellanii and Vermamoeba vermiformis, in the outlet stage poses health risks, whereas Cryptosporidium sp. was found in both the inlet and aerobic stages but not in the outlet. Our study reveals the complex nature of microeukaryotic diversity in the wastewater treatment system and its implications for treatment performance and public health.

The Arabic EAT-10 and FEES in dysphagia screening among cancer patients: a comparative prospective study.

Head and neck cancer treatments, such as radiotherapy, chemotherapy, and surgery, have diverse effects on patients, leading to dysphagia as a significant post-treatment issue. This study aims to evaluate the effectiveness of the Arabic version of the EAT-10 screening instrument (A-EAT-10) using Fiber-Optic Endoscopic Evaluation of Swallowing (FEES) as an imperfect gold standard. Additionally, we seek to establish a correlation between A-EAT-10 and PEG tube insertion in head and neck cancer (HNC) patients. Our sample comprised 130 head and neck cancer patients with varying cancer types at King Hussein Cancer Center (KHCC). We followed these patients throughout their distinct treatment plans up to one month after their final treatment session. During follow-up visits, we administered the A-Eat-10 instrument to monitor dysphagia. FEES were conducted at the initial and concluding visits to compare results with A-EAT-10 scores. The results in our tests, assuming independence or dependence, demonstrated excellent agreement. A-EAT-10 exhibited outstanding predictive capabilities with an AUC ranging from 93 to 97%. A-EAT-10 tended to slightly overestimate dysphagia at later treatment stages by approximately 20% compared to FEES, with an RR of 1.2 (95% CI 0.91, 1.56, p-value = 0.21), indicating statistical insignificance. In conclusion, A-EAT-10 is an excellent option for dysphagia evaluation, offering non-invasive, straightforward, and cost-effective advantages compared to FEES. Its utility extends to predicting the need for PEG tube insertion at initial patient visits, making it a valuable tool for informed treatment decisions. Notably, A-EAT-10 demonstrates a diminishing correlation with FEES over time.

An explainable machine learning framework for predicting the risk of buprenorphine treatment discontinuation for opioid use disorder among commercially insured individuals

ObjectivesBuprenorphine is an effective evidence-based medication for opioid use disorder (OUD). Yet premature discontinuation undermines treatment effectiveness, increasing the risk of mortality and overdose. We developed and evaluated a machine learning (ML) framework for predicting buprenorphine care discontinuity within 12 months following treatment initiation. MethodsThis retrospective study used United States (US) 2018–2021 MarketScan commercial claims data of insured individuals aged 18–64 who initiated buprenorphine between July 2018 and December 2020 with no buprenorphine prescriptions in the previous six months. We measured buprenorphine prescription discontinuation gaps of ≥30 days within 12 months of initiating treatment. We developed predictive models employing logistic regression, decision tree classifier, random forest, extreme gradient boosting, Adaboost, and random forest-extreme gradient boosting ensemble. We applied recursive feature elimination with cross-validation to reduce dimensionality and identify the most predictive features while maintaining model robustness. For model validation, we used several statistics to evaluate performance, such as C-statistics and precision-recall curves. We focused on two distinct treatment stages: at the time of treatment initiation and one and three months after treatment initiation. We employed SHapley Additive exPlanations (SHAP) analysis that helped us explain the contributions of different features in predicting buprenorphine discontinuation. We stratified patients into risk subgroups based on their predicted likelihood of treatment discontinuation, dividing them into decile subgroups. Additionally, we used a calibration plot to analyze the reliability of the models. ResultsA total of 30,373 patients initiated buprenorphine and 14.98% (4551) discontinued treatment. C-statistic varied between 0.56 and 0.76 for the first-stage models including patient-level demographic and clinical variables. Inclusion of proportion of days covered (PDC) measured after one month and three months following treatment initiation significantly increased the models’ discriminative power (C-statistics: 0.60 to 0.82). Random forest (C-statistics: 0.76, 0.79 and 0.82 with baseline predictors, one-month PDC and three-months PDC, respectively) outperformed other ML models in discriminative performance in all stages (C-statistics: 0.56 to 0.77). Most influential risk factors of discontinuation included early stage medication adherence, age, and initial days of supply. ConclusionML algorithms demonstrated a good discriminative power in identifying patients at higher risk of buprenorphine care discontinuity. The proposed framework may help healthcare providers optimize treatment strategies and deliver targeted interventions to improve buprenorphine care continuity.

Proteomic profiling of antibiotic-resistant Escherichia coli GW-AmxH19 isolated from hospital wastewater treated with physical plasma.

Microorganisms which are resistant to antibiotics are a global threat to the health of humans and animals. Wastewater treatment plants are known hotspots for the dissemination of antibiotic resistances. Therefore, novel methods for the inactivation of pathogens, and in particular antibiotic-resistant microorganisms (ARM), are of increasing interest. An especially promising method could be a water treatment by physical plasma which provides charged particles, electric fields, UV-radiation, and reactive species. The latter are foremost responsible for the antimicrobial properties of plasma. Thus, with plasma it might be possible to reduce the amount of ARM and to establish this technology as additional treatment stage for wastewater remediation. However, the impact of plasma on microorganisms beyond a mere inactivation was analyzed in more detail by a proteomic approach. Therefore, Escherichia coli GW-AmxH19, isolated from hospital wastewater in Germany, was used. The bacterial solution was treated by a plasma discharge ignited between each of four pins and the liquid surface. The growth of E. coli and the pH-value decreased during plasma treatment in comparison with the untreated control. Proteome and antibiotic resistance profile were analyzed. Concentrations of nitrite and nitrate were determined as long-lived indicative products of a transient chemistry associated with reactive nitrogen species (RNS). Conversely, hydrogen peroxide served as indicator for reactive oxygen species (ROS). Proteome analyses revealed an oxidative stress response as a result of plasma-generated RNS and ROS as well as a pH-balancing reaction as key responses to plasma treatment. Both, the generation of reactive species and a decreased pH-value is characteristic for plasma-treated solutions. The plasma-mediated changes of the proteome are discussed also in comparison with the Gram-positive bacterium Bacillus subtilis. Furthermore, no effect of the plasma treatment, on the antibiotic resistance of E. coli, was determined under the chosen conditions. The knowledge about the physiological changes of ARM in response to plasma is of fundamental interest to understand the molecular basis for the inactivation. This will be important for the further development and implementation of plasma in wastewater remediation.

Treating wastewater for microplastics to a level on par with nearby marine waters

Retention of microplastics (MPs) at the third largest wastewater treatment plant (WWTP) in Sweden was investigated. The plant is one of the most modern and advanced of its kind, with rapid sand filter for tertiary treatment in combination with mechanical, biological, and chemical treatment. It achieved a significantly high treatment efficiency, which brought the MP concentration in its discharge on par with concentrations measured in marine waters of the same region. This novel data shows that properly designed modern WWTPs can reduce the MP content of sewage down to background levels measured in the receiving aquatic environment. Opposite to current understanding of the retention of MP by WWTPs, a modern and well-designed WWTP does not have to be a significant point source for MP. MPs were quantified at all major treatment steps, including digester inlet and outlet sludge. MPs sized 10–500 µm were analyzed by a focal plane array based micro-Fourier transform infrared (FPA-µFTIR) microscopy, a hyperspectral imaging technique, while MPs above 500 µm were analyzed by Attenuated Total Reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy. Mass was estimated from the hyperspectral images for MPs <500 µm and from microscope images >500 µm. The overall treatment efficiency was in terms of MP counts 99.98 %, with a daily input of 6.42 × 1010 and output of 1.04 × 107 particles. The mass removal efficiency was 99.99 %. The mechanical part of the treatment, the pre-treatment, and primary stages, reduced both the MP counts and mass by approximately 71 %. The combined biological treatment, secondary settling, and final polishing with rapid sand filtration removed nearly all the remaining 29 %. MPs became successively smaller as they passed the different treatment steps. The digester inlet received 1.04 × 1011 MPs daily, while it discharged 9.96 × 1010 MPs, causing a small but not significant decrease in MP counts, with a corresponding MP mass reduction of 9.56 %.

Sustained Effectiveness of Upadacitinib in Moderate-to-Severe Atopic Dermatitis: A 48-Week Real-World Study.

Clinical trials and real-world studies have shown the effectiveness of upadacitinib for treating rash and pruritus in patients with atopic dermatitis (AD). This study aimed to determine whether the early reduction in rash or pruritus at week 12 of upadacitinib treatment could be maintained at later treatment stages. This retrospective study involved 227 and 73 patients with moderate-to-severe AD treated with 15 and 30 mg upadacitinib daily, respectively. The eczema area and severity index (EASI) scores, peak pruritus numerical rating scale (PP-NRS), and investigator's global assessment (IGA) were analyzed. At week 12, patients were divided into achievers and non-achievers of EASI 75, 90, 100, absolute EASI ≤ 2, IGA0/1, PP-NRS4, or absolute PP-NRS ≤ 1. Achievement rates for each endpoint were assessed at later time points (weeks 24, 36, and 48) in both groups. Week 12 achievers largely maintained their endpoint achievements until week 48, regardless of dosage (15 mg or 30 mg). Week 12 non-achievers saw an increasing achievement rate of EASI 75 until week 48. The initial reduction in rash and pruritus at week 12 persisted until week 48 with upadacitinib treatment, suggesting potential benefits for patients requiring prolonged treatment despite not achieving EASI 75 at week 12.

Psychological and social features of patients with tuberculosis and HIV infection in modern conditions

Despite the measures taken by WHO to combat tuberculosis, the level of morbidity and mortality from it throughout the world still remains quite high. The effectiveness of treatment also does not reach the target indicators, which forces TB specialists to wonder about the reasons for the ineffectiveness of the treatment and ways to solve them. The medical and social characteristics of patients and their personal characteristics certainly influence the therapy and adherence to it, and subsequently its effective[1]ness and the outcome of the disease. At present, a holistic psychosocial portrait of a patient with tuberculosis, including those combined with HIV infection, has not yet been developed. Knowledge of the psychological and social characteristics of tuberculosis patients will allow us to identify their personal characteristics and existing problems, which will further allow them to carry out psychological adaptation of the therapy at all stages of treatment.

Changes in Testing and Treatment Methods in Osteoporosis Care.

Osteoporosis treatment plays a crucial role in preventing fractures, particularly in bedridden patients. We conducted a questionnaire survey presenting hypothetical clinical cases in 2015 and 2020 to investigate trends over a 5-year period. The target population included physicians working in clinics and hospitals within our neighbourhood. The cases were presented, and the questionnaire was administered in a confidential format. The orthopaedic surgeons were matched for age and practice, resulting in 74 cases being included in the analysis. Comparing the 2015 and 2020 results, we observed a notable increase in physicians who would perform "bone mineral density measurements of the lumbar spine and hip." Furthermore, there was a significant rise in the percentage of respondents willing to test for bone metabolic markers, such as serum type I collagen cross-linked N-telopeptide (NTX), procollagen I N-terminal propeptide (P1NP), and tartrate-resistant acid phosphatase 5b (TRACP-5b). Regarding therapeutic agents, bisphosphonates decreased in usage, whereas parathyroid hormone and romosozumab witnessed an increase. In conclusion, the percentage of physicians requesting bone mineral density measurements of the lumbar spine and hip increased over the five-year period. In addition, more physicians chose to utilise bone metabolic markers due to their ease of measurement through blood tests and reduced diurnal variation. Finally, there was a marked trend towards the administration of drugs capable of rapidly and effectively increasing bone mineral density at an early stage of treatment.

Guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance in Japan: A tiered approach for the assessment of clinically meaningful driving impairment.

In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance.

Simultaneous decomplexation of Pb-EDTA and elimination of free Pb ions by MoS2/H2O2: Mechanisms and applications

The critical challenge of effectively removing Pb-EDTA complexes and Pb(II) ions from wastewater is pivotal for environmental remediation. This research introduces a cutting-edge bulk-MoS2/H2O2 system designed for the simultaneous decomplexation of Pb-EDTA complexes and extraction of free Pb(II) ions, streamlining the process by eliminating the need for subsequent treatment stages. The system exhibits outstanding efficiency, achieving 98.1% decomplexation of Pb-EDTA and 98.6% removal of Pb. Its effectiveness is primarily due to the generation of reactive oxygen species, notably •OH and O2•- radicals, facilitated by bulk-MoS2 and H2O2. Key operational parameters such as reagent dosages, Pb(II): EDTA molar ratios, solution pH, and the presence of coexisting ions were meticulously evaluated to determine their impact on the system's performance. Through a suite of analytical techniques, the study confirmed the disruption of Pb–O and Pb–N bonds, further elucidating the decomplexation process. It also underscored the synergistic role of bulk-MoS2’s adsorption properties and the formation of PbMoO4-like precipitates in enhancing Pb elimination. Demonstrating the bulk-MoS2/H2O2 system as a robust, one-step solution that meets stringent Pb emission standards, this study provides in-depth insights into the removal mechanisms of Pb-EDTA, affirming its potential for broader application in wastewater treatment practices.

Epidemiology, Diagnosis and Reconstruction of Anterior Cruciate Ligament Injury

Both female athletes and physically active persons are susceptible to anterior cruciate ligament (ACL) rupture, a common sports-related injury. The ACL is structurally complex and is considered to be an important proprioceptor, as well as limiting tibial translation. The standard test for ACL tears is magnetic resonance imaging (MRI); however, there is currently no suitable method to accurately determine the severity of the injury. Numerous factors, including gender, muscle strength, and exercise habits, are linked to the causes of ACL tears. ACL tears prevent athletes from playing sports in the near future. They could eventually develop psychological problems, chronic knee disease, and blocked nerve signals, all of which would lower their post-ACL repair return numbers and performance. Reconstruction and recovery are the two stages of ACL treatment, and the therapy plan should be tailored to each patient's unique needs. Athletes' leg muscles should be strengthened as the primary means of preventing ACL injuries, but venues and coaches should also be taken into account.

Our Experience in Using Extracorporeal Membrane Oxygenation in Patients with Refractory Cardiogenic Shock

Background Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is a critical care treatment option for patients with refractory cardiogenic shock. This method of temporary support of the cardiorespiratory system gives us and the patient time to restore organ function or is a «bridge» to other methods of treatment. Nevertheless, the issue of identifying the optimal time for VA ECMO implantation in patients with acute myocardial infarction complicated by refractory cardiogenic shock remains relevant.Aim To evaluate the efficiency of extracorporeal membrane oxygenation in various clinical situations in patients with acute myocardial infarction complicated by refractory cardiogenic shock and post-infarction damage to the valves of the heart.Material and method We present 3 patients with acute coronary syndrome complicated by refractory cardiogenic shock, of different age groups and comorbidities, who underwent veno-arterial extracorporeal oxygenation in various SCAI shock stages, and mechanical complications associated with acute myocardial infarction.Results In all the cases, stabilization of hemodynamics and heart function was achieved, and there were no hypoxic disorders of organs. In one case, a hemorrhagic complication associated with the VA ECMO procedure was noted. In one case, VA ECMO was performed as an intermediate stage for the correction of post-infarction mitral valve injury.Conclusion These clinical cases demonstrate the efficiency of the timely start of VA ECMO before the development of organ dysfunction, which allows restoring myocardial function, and helps maintain hemodynamic normalization before the cardiac surgical stage of treatment.