Control Subgroups Research Articles

Metallomic Profiling of Autism Spectrum Disorder in Sarajevo Canton, Bosnia and Herzegovina: Insights from Hair Sample Analysis.

The rising prevalence of autism spectrum disorder (ASD) in Bosnia and Herzegovina over the past decade is a pressing concern that underscores the urgent need to investigate its etiology. While this issue is recognized globally, there is a significant lack of data specific to Bosnia and Herzegovina, making comprehensive analysis essential. To address this gap, this study analyzed 41 hair samples from children categorized into three age subgroups (3-5years, 6-9years, 10-12years) and differentiated by gender within both control and ASD groups. The concentrations of essential metals (Cu, Fe, Mn, Zn) as well as potentially toxic metals (Cd, Co, Ni, Pb) were measured using atomic absorption spectrometry (AAS). This research aims to provide valuable insights into the metallomic differences that may contribute to the understanding of ASD in this population. Females with autism spectrum disorder (ASD) exhibited elevated levels of Fe, Ni, and Cd across all age subgroups, surpassing reference values, while ASD males also showed increased Cd content. The control subgroup of 3-5-year-olds and all ASD female subgroups had Co levels exceeding the reference limit. Alarmingly, elevated Pb levels were found in all hair samples, with ASD males showing values that were twice as high as the reference. Statistically significant differences were identified in the concentrations of Cd, Fe, and Zn in females, as well as Pb in males, between the control and ASD groups. These findings underscore the urgent need for further research to elucidate the role of heavy metals in the etiology of ASD.

Significance of N-terminal pro-B-type natriuretic peptide levels in lung cancer

High blood levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) have been shown in various malignancies. In lung cancer, the importance of NT-proBNP is not clear. In this study, we aimed to investigate the significance of the correlation of NT-proBNP levels in lung cancer with tumor stage, tumor diameter, histopathology, and specific sites of mediastinal metastasis: lymphadenopathy; pericardial, cardiac, major vessel, other mediastinal organ or lymphatic involvement/invasion. A total of 105 lung cancer and 120 control patients (chronic obstructive lung disease, interstitial lung disease, pulmonary thromboembolism, and pneumonia; 30/subgroup) with measured NT-proBNP levels were included retrospectively. Demographics, comorbidities, and echocardiographic findings in all patients, as well as histologic subtype, diameter, stage, and radiologic and/or pathologic mediastinal involvement/invasion of the tumor to the mediastinum in patients with lung cancer, were studied with regards to blood NT-proBNP levels. When lung cancer and control groups were compared globally or as subgroups with comorbidities, NT-proBNP levels did not show meaningful differences. However, NT-proBNP levels were determined to be 249 pg/mL and 88 pg/mL in lung cancer (n=68) and control subgroups (n=58) without comorbidities, respectively (p=0.001). Among lung cancer patients without comorbidities and those with cardiac, pericardial, major vascular, or other mediastinal involvement/invasion (lymphadenopathy, lymphatic, or other organ invasion) (n=27), the NT-proBNP level was 303 pg/mL, whereas it was 166 pg/mL in those without these mediastinal invasions (n=41) (p=0.031). There is a need for much larger, randomized studies to obtain evidence for the potential role of NT-proBNP as a helpful diagnostic biomarker for lung cancer. Clinical suspicion of malignancy may be posed if high NT-proBNP levels cannot be explained by all other risk factors and disorders or diseases. Furthermore, pericardial, cardiac, major vessel, or other mediastinal invasion/involvement should be sought when high NT-proBNP levels are determined in lung cancer patients without any comorbidities or risk factors for high NT-proBNP levels.

Bond strength of self-adhesive resin cement to definitive resin crown materials manufactured by additive and subtractive methods

The aim was to compare different surface pretreatments on definitive resin crown materials manufactured additively or subtractively in terms of shear bond strength (SBS) values. Seven subgroups (n=10) were formed from additively manufactured VarseoSmile Crown Plus (VS) and subtractively manufactured Cerasmart270 blocks (CS) according to different surface pretreatments applied; sandblasting (subgroup SB), hydrofluoric acid (subgroup HF), Multi Primer (subgroup MP), subgroup SB-HF, subgroup SB-MP, subgroup SB-HF-MP, and control subgroup. A 3-mm-diameter composite was cemented onto each sample by self-adhesive resin cement. SBS values were measured and failure modes were analyzed after thermocycling. Data were analyzed with two-way ANOVA and Tukey HSD tests. The mean SBS value of VS was found significantly higher than CS (p<0.001). Subgroups SB-HF-MP, HF, SB-MP, and MP of VS exhibited the highest SBS values (p<0.001). The VS exhibited mostly cohesive failure, while CS exhibited mostly adhesive failure.

Salivary IL-6 as a Biomarker for Early Childhood and Rampant Caries: Insights from a Cross-Sectional Study

Objectives: This study aimed to explore the levels of salivary interleukin-6 (IL-6) in children diagnosed with Early Childhood Caries (ECC) and Rampant Caries (RC). Additionally, it sought to determine whether salivary IL-6 levels vary with the increased activity or number of carious lesions in children with ECC and RC. Methods: A cross-sectional study was conducted at RAK College of Dental Sciences (RAKCODS), Ras Al Khaimah, UAE. Ethical approval was obtained, and 100 children aged 4 to 12 years were selected. Participants were divided into ECC and RC groups, each containing study and control subgroups of 25 children each. The study groups were children who had active carious lesions and the control groups were those children who had no active carious lesions. All of these children were screened and included as a part of the community engagement of the clinics. Saliva samples were collected and analyzed for IL-6 levels using an ELISA kit. Dental examinations and data collection adhered to standardized procedures, including specific clinical criteria for diagnosing ECC and RC and calibrated examiners to ensure consistent clinical assessments. Statistical analyses were conducted to compare salivary IL-6 levels between the study and control groups of each RC and ECC group and a test was also performed to assess the relationship between salivary IL-6 levels and the severity of dental caries. Results: This study found significantly higher mean salivary IL-6 levels in children with ECC (19.023 pg/mL) and RC (21.45 pg/mL) compared to their respective control groups (ECC: 6.42 pg/mL, RC: 11.43 pg/mL), with p-values &lt; 0.0001. Strong positive correlations were observed between IL-6 levels and increased caries activity or severity, with Pearson’s correlation coefficients of 0.961 for ECC and 0.954 for RC. Conclusions: This study concludes that significantly elevated salivary IL-6 levels are observed in children with ECC and RC. Furthermore, salivary IL-6 levels were found to rise in correlation with the increase in number of carious lesions. These findings support the potential of salivary IL-6 as a biomarker for assessing caries severity and highlight the need for future research to explore diverse populations and additional clinical parameters.

Assessing Glenoid Defects in Anterior Shoulder Instability: Comparison of a Simple Linear Formula Method With Traditional Methods Using 3-Dimensional Computed Tomography.

Anterior glenoid bone defects significantly influence surgical outcomes in shoulder instability cases. Various measurement methods based on 3-dimensional computed tomography (3D-CT) have been developed. Recently, the simple linear formula method, which establishes a correlation between glenoid height and width, has emerged as a promising technique. This study aimed to assess the differences in glenoid morphology between patients with anterior shoulder instability and healthy controls within a specific East Asian population (Han Chinese). The objectives included establishing linear formulas specific to both groups and comparing the efficacy of the simple linear formula method with traditional methods for measuring glenoid defects using 3D-CT. Cohort study (diagnosis); Level of evidence, 3. 3D-CT images of both the affected and unaffected shoulders of patients with anterior shoulder instability, as well as one shoulder of healthy controls, were analyzed. Glenoid height and width were measured, and linear formulas were established for this specific Han Chinese population. P values were determined using linear regression analysis to assess the statistical significance of the relationship between glenoid height (H) and width (W). A P value <.05 indicated a statistically significant relationship. R2 values were calculated to determine the strength of the relationship, with higher values (closer to 1) indicating a stronger correlation. The glenoid defect ratio was calculated using the simple linear formula method and compared with traditional methods: the Griffith, linear-based best-fit circle, and area-based best-fit circle methods. Interrater agreement was assessed using intraclass correlation coefficients (ICCs). There were 206 patients in the patient group and 206 participants in the healthy control group. In the patient group, the mean glenoid height and width of the unaffected shoulders were 35.21 ± 3.39 and 24.26 ± 2.74 mm, respectively (formula: W = 0.75H - 2.12; R2 = 0.86; P < .001). In the male patient subgroup, they were 37.57 ± 1.35 and 26.23 ± 0.91 mm, respectively (formula: W = 0.47H + 8.60; R2 = 0.79; P < .001). In the female patient subgroup, they were 31.63 ± 2.21 and 21.26 ± 1.65 mm, respectively (formula: W = 0.52H + 4.78; R2 = 0.74; P < .001). In the healthy control group, the mean glenoid height and width were 33.48 ± 3.32 and 24.18 ± 3.02 mm, respectively (formula: W = 0.86H - 4.58; R2 = 0.89; P < .001). In the male healthy control subgroup, they were 36.43 ± 1.35 and 26.89 ± 1.17 mm, respectively (formula: W = 0.67H + 2.63; R2 = 0.58; P < .001). In the female healthy control subgroup, they were 30.54 ± 1.70 and 21.47 ± 1.49 mm, respectively (formula: W = 0.61H + 2.90; R2 = 0.69; P < .001). The actual glenoid defect in the entire patient cohort averaged 12.3% ± 5.9%. The simple linear formula method demonstrated an ICC of 0.82, with a glenoid defect ratio averaging 15.7% ± 6.9%. The Griffith method had an ICC of 0.85, yielding a glenoid defect ratio of 16.5% ± 5.8%. The linear-based and area-based best-fit circle methods had ICCs of 0.73 and 0.77, respectively, with glenoid defect ratios of 16.9% ± 6.0% and 13.1% ± 6.2%, respectively. Glenoid morphology in patients with anterior shoulder instability, particularly among male patients, was characterized by elongation and narrowing compared with healthy participants. The simple linear formula method demonstrated excellent reliability and accuracy, comparable with traditional methods, offering an efficient approach to measuring glenoid defects. Further validation across diverse populations is warranted.

Methodological Insights on Biomarker-Based Patient Selection: A Review of Scientific Advice Procedures at the European Medicines Agency.

Biomarkers play a pivotal role in the selection and enrollment of trial participants. Particularly, predictive biomarkers help tailor medical care to individual patients; however, also prognostic biomarkers require consideration at the design stage. At the time of initiating a clinical trial, there may be uncertainty about whether a biomarker is predictive or prognostic, and the trial design may need to account for this. Relevant discussions between drug developers and regulators on the role of a biomarker in a specific drug development program are expected to take place during Scientific Advice (SA) procedures. SA procedures at the European Medicines Agency from January 1, 2018, to December 31, 2020, were systematically searched for methodological discussions around the use of predictive or prognostic biomarkers. The final analysis included 45 SA procedures for which key characteristics were summarized quantitatively. Selected methodological issues such as the cutoff selection of continuous biomarkers or study design considerations were elaborated in a qualitative summary. Our results identify commonly encountered points for discussion between drug developers and the European Medicines Agency for biomarker-informed patient selection and enrollment. Identified topics addressed during SA procedures include cutoff selection, study design, multiplicity control, and data-driven subgroup selection. The majority of the identified 45 SA procedures concern development programs in oncology. Addressing these issues upfront will allow for an improved dialogue between drug developers and regulators and support the drug development program and ultimately patient-centered access to medicines.

MR T2* Map to Predict Worsening Hypertension Control: A Preliminary Study.

Blood pressure measurement is important in monitoring hypertension. However, blood pressure does not provide much information about renal condition in treated hypertension. This study aimed to evaluate renal oxygenation in hypertensive patients using T2* mapping. Subgroup analysis explored whether R2* values can guide adjustments in antihypertensive treatment. A total of 140 consecutive subjects were recruited: 87 hypertensive subjects and 53 normotensive subjects. Hypertensive subjects were classified into non-medication (non-med), angiotensin II receptor blocker (ARB), and non-ARB-treated groups. Each group was divided into good and poor control subgroups based on blood pressure at enrollment. T2* mapping was utilized to assess renal cortical and medullary R2* values. After a 2-year follow-up, subjects were categorized into stable and unstable based on the need for treatment modifications. The unstable subgroup had higher medullary R2* values than the stable subgroup in all followed patients (p < 0.05). Additionally, the unstable merged non-med with ARB subgroup had higher medullary R2* values overall (p < 0.05) and within the good control subgroup (p < 0.05). Patients with stable hypertension, especially those with good control managed through lifestyle modifications or ARBs, exhibited lower renal medullary R2* values, suggesting higher renal oxygenation.

Tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), positively impacts the altered microbiota of obese, diabetic, ovariectomized mice.

The study aimed to verify the effect of Tirzepatide (Tzp, a dual agonist GIP/GLP-1) on intestinal health and microbiota balance in an obese diabetic ovariectomized (Ovx) mice model. Female C57BL/6 mice with Ovx and diet-induced obesity with diabetes were treated with Tzp (10 nmol/kg) for four weeks. Control (C) and obese-diabetic subgroups (Od) were formed (group abbreviations: O, Ovx; T, Tzp; n = 30/group): C, CT, CO, COT, Od, OdT, OdO, OdOT. The ileum was structurally and molecularly studied, and cecal feces had microbial DNA determined. Tzp improved the intestinal barrier structure and protection. Cldn12 (Claudin 12) increased, and Muc2 (Mucin 2) decreased. JamA (junctional adhesion molecules) and Ocln (Occludin) increased. Tzp mitigated macrophage activation and inflammation, altered composition, and the contribution to microbiota: Firmicutes decreased, and Bacteroidetes increased, changing the Firmicutes / Bacteroidetes ratio. Proteobacteria, Actinobacteria, Bifidobacterium, and Clostridium increased. In addition, Bacteroides, Prevotella, and Akkermansia increased. PCA indicated a significant action of Cd14, Muc2, and Tlr4 on CO and Il17 on OdO; Il10, Cd206, Cd12, Ocln, and JamA in Od. Bacteroides, Bifidobacterium, Clostridium, Actinobacteria, and Bacteroides were enhanced in CT and COT, Provotella, Proteobacteria, and Firmicutes in CO, Od, OdT, OdO, and Akkermansia in OdOT. In conclusion, the intestinal barrier function in our model is compromised by alterations in phylogenetic diversity and intestinal microbiota, which characterize dysbiosis and potentially enable the influx of toxins into other tissues. Treatment with Tzp demonstrated the ability to reverse intestinal dysbiosis, help repair intestinal barrier integrity, and mitigate possible endotoxemia through anti-inflammatory signaling pathways.

The efficacy of remote ischemic conditioning for outcomes in ischemic stroke patients with or without prior stroke: A post hoc analysis of the RICAMIS trial.

To investigate the impact of a history of ischemic stroke or transient ischemic attack (TIA) on the effectiveness of remote ischemic conditioning (RIC) for outcomes in acute ischemic stroke patients. We conducted a post hoc analysis of the Remote Ischaemic Conditioning for Acute Moderate Ischaemic Stroke (RICAMIS) trial. Patients in RICAMIS were categorized into two groups according to a history of stroke. The primary outcome was an excellent functional outcome, defined as a modified Rankin Scale (mRS) score of 0-1 at 90 days. Instead of comparing patients receiving usual care alone, we investigated the association of the RIC effect with functional outcomes in each group and the interaction between the RIC effect and a history of ischemic stroke or TIA. We included a total of 1695 patients, of whom 562 patients had a history of ischemic stroke or TIA and 1133 patients without prior ischemic stroke or TIA. In the Never Stroke or TIA group, a higher proportion of excellent functional outcomes was found in the RIC subgroup compared to the control subgroup (adjusted OR = 1.557 [95% CI 1.187-2.043], p = 0.001) but not in Prior Stroke or TIA group (adjusted OR = 1.299 [95% CI 0.893-1.888], p = 0.171). However, no significant interaction between the RIC effect and a history of ischemic stroke or TIA was found among the groups. This is the first report suggesting that the RIC effect may be influenced by the history of ischemic stroke or TIA for patients with acute ischemic stroke.

THE LEVEL OF IMMUNOGLOBULINS IN THE ORAL FLUID OF PATIENTS WITH SECRETORY IMMUNOGLOBULIN A DEFICIENCY AND GENERALIZED PERIODONTITIS

One of the major challenges in dentistry is generalized periodontitis (GP). Periodontitis is characterized by the destruction of connective tissue, loss of periodontal attachment, and resorption of alveolar bone. Tissue destruction in periodontal diseases occurs as a result of the action of pathogenic microflora and the interaction of the immune and inflammatory response. The immune system is activated to protect against local microbial attack and the products of their destruction as a result of the spread or penetration into the gingival tissues. Materials and methods. We examined 85 patients who visited the dental clinic with generalized periodontitis and, based on clinical manifestations of secondary immunodeficiency, conducted a study of the state of their humoral immunity of the oral cavity. During the study, two research groups were established: the control group (group I), which consisted of 10 individuals with clinically healthy periodontal tissues, and the main group (group II). The main group was further divided into two subgroups: subgroup 1 included patients with stage II-III GP and normal levels of sIgA (10 individuals), while subgroup 2 comprised patients with stage IIIII GP and sIgA deficiency in oral fluid (15 individuals). The levels of sIgA, IgG, and IgM in oral fluid were measured using an immunoenzymatic method. Results. The level of sIgA in the oral fluid of patients in the second subgroup was reduced 58.0 87.83 μg/ml, the concentration of this immunoglobulin in the first subgroup was 173.43-258.82 μg/ml, in the control group this indicator was 192.6-278.18 μg/ml. Detecting a deficiency of secretory immunoglobulin A (sIgA) in the oral fluid of patients with GP enables the appropriate adjustment of treatment regimens. All patients with AP received comprehensive treatment. The treatment of the second subgroup was supplemented with a complex periodontal dressing, which included an immunomodulatory drug, a solution of sodium deoxyribonucleate 0.25%, ascorbic acid, rutin, calendula ointment, etc. It was prescribed in the form of periodontal dressings on the gums for 2-3 hours 5 days. In patients with GP, there is a significant decrease in sIgA levels, along with an increase in IgG and IgM levels, compared to individuals in the control group and subgroup 1. Implementing the proposed treatment regimen to correct humoral protection deficiencies results in a significant increase in sIgA levels in the oral fluid, along with the normalization of IgG and IgM levels. Conclusions. The implementation of targeted immunocorrection enhances the clinical effectiveness of chronic GP treatment, as evidenced by long-term results demonstrating stable remission in patients.

The benefit of inhibitory control training for insomnia with short sleep duration phenotype: a pilot randomized trial

BackgroundTwo phenotypes of insomnia disorder (ID) have been identified based on objective total sleep duration (TST): one with short sleep duration (ISSD) and another with normal sleep duration (INSD). Recent proposals suggested that insomnia with objective short-sleep duration (TST < 7 h) is associated with impaired inhibitory function, leading to a dysregulation of cortical inhibition, which may underlie its prevalence. This study investigated the status of impaired response inhibition in these two phenotypes and examined the potential different effect of response inhibition training on these two phenotypes.MethodsTwenty-two healthy controls (HC) and eighty-one patients with ID were recruited, with IDs further categorized into ISSD and INSD (with TST ≥ 7 h). Clinical behavior measures, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Pre-sleep Arousal Scale (PSAS), objective sleep characteristics assessed by all-night sleep electroencephalography, and the accuracy of NoGo trials in the Go/NoGo task were compared among the three groups. Subsequently, within each ID phenotype, participants were divided into training and blank control sub-groups. The two training sub-groups completed Adaptive Go/NoGo training task (Through adaptive difficulty adjustment, the task trains participants' inhibitory control) 15 times over 3 weeks, and all IDs were assessed using sleep-related subjective and objective measures and Go/NoGo task before and after the intervention.ResultsISSD patients exhibited significantly longer sleep latency (p = 0.003) compared to HC, while wakefulness duration (p = 0.004) and light sleep duration (p < 0.001) were shorter than INSD. No significant differences in objective sleep characteristics were observed between INSD and HC. Following adaptive training, the ISSD training sub-group showed decreased scores in PSQI (p = 0.039) and ISI (p = 0.053) compared to their blank control sub-group. In the INSD groups, both training and blank control sub-groups demonstrated reductions in PSQI (p < 0.001), ISI (p < 0.001), and the cognitive arousal sub-dimension of the PSAS scores (p = 0.003) in the post-session test.ConclusionsImpaired response inhibition is a characteristic of ISSD, potentially indicating dysfunctional cortical inhibition, whereas INSD pathogenesis may be related to cognitive-emotional arousal. Response inhibition training effectively alleviates sleep problems in ISSD. These findings provide new insights for developing precise intervention strategies in ID.Trial registrationThe study was prospectively registered on May 30, 2024, in Chinese Clinical Trials registry (ChiCTR2400085063).

New generation of monofocal intraocular lens for cataract surgery in comorbid conditions

Purpose: to evaluate the functional results of using the Monofocal+ intraocular lens for cataract surgery in comorbid conditions of the eye.Material and methods. The study included 31 patients (45 eyes) with cataracts. Patients underwent cataract phacoemulsification with implantation of ICB00 Eyhance IOL. The operation was performed on the TECNIS platform (Johnson &amp; Johnson), based on Em, according to the Kane and Barrett Universal II formulas. Patients were divided into 3 study groups (15 eyes each) according to concomitant ocular pathology: primary open-angle glaucoma IIa, age-related macular degeneration, non-proliferative diabetic retinopathy, dry form of intermediate stage. Each study group, using a retrospective analysis of data from patients operated on over the past 2 years, was divided into two control subgroups: in one of them, patients underwent implantation of a monofocal IOL (SA60AT AcrySof, Alcon), and in the other — an EDOF IOL (DFT015 AcrySof IQ Vivity, Alcon).Results. Uncorrected visual acuity of 66 cm in patients with the Eyhance IOL was significantly higher than with the SA60AT IOL for all considered comorbid conditions (p &lt; 0.05). Uncorrected visual acuity at near distance (33 cm) had a clear advantage in patients with the Vivity IOL compared to others (p &lt; 0.05). The Eyhance IOL had uncorrected visual acuity of 0.23, and the SA60AT IOL had a value of 0.2. Uncorrected visual acuity at 33 cm in patients with Eyhance IOL with concomitant glaucoma was significantly higher than in patients with SA60AT IOL (p &lt; 0.05), however, no different from those with age-related macular degeneration and non-proliferative diabetic retinopathy (p&gt;0.05). All patients with the IOL Monofocal+ expressed their satisfaction with the vision they received, which was reflected in the results of the VF test-14 QOL questionnaire.Conclusion. New generation monofocal IOLs showed good functional results in patients with cataracts and the considered comorbid pathology of the eye: primary open-angle glaucoma II a, intermediate stage of the dry form of age-related macular degeneration, non-proliferative diabetic retinopathy. There is a relatively high visual acuity at distance and at intermediate distances, and good patient satisfaction with the resulting vision. To clarify the indications and contraindications for the IOL Monofocal+ use in patients with various concomitant ophthalmopathologies more long-term clinical observations and analysis of implantations are required.

Comparison of Shear Bond Strength for Onestep Self-etch versus Universal Adhesives on Contaminated and Decontaminated Dentin Surfaces: An In-vitro Study

Introduction: Ensuring strong adhesion of composite resin to dentin requires isolation, as moisture contamination from gingival fluid, blood, or saliva can weaken the bond. This can lead to microleakage, restoration loss, recurrent caries, postoperative sensitivity and discolouration. Long-lasting restorations are crucial in adhesive dentistry, but contamination often results in adhesion failure. To restore bond strength, various decontamination procedures are recommended. Aim: To evaluate and compare the effects of different contaminants and ethanol decontamination on the shear bond strength of onestep self-etch versus universal adhesives to dentin. Materials and Methods: This in-vitro study, conducted in the Department of Conservative Dentistry and Endodontics at Sibar Institute of Dental Sciences in Guntur, Andhra Pradesh, India, from July 2023 to October 2023, utilised the buccal surfaces of 70 human molars. The molars were divided into two groups (n=35): Group 1 - One-step self-etch adhesive and Group 2 - Universal adhesive. Each group was further subdivided into five sub-groups (n=7): Control (Subgroup A), Saliva contamination (Subgroup B) Blood contamination (Subgroup C) Saliva contamination followed by ethanol decontamination (Subgroup D) and Blood contamination followed by ethanol decontamination (Subgroup E) followed by ethanol decontamination. A plastic tube loaded with composite resin was placed over the dentin surface and light-cured. Shear bond strength at the dentincomposite interface was evaluated using a Universal Testing Machine (UTM). One-way Analysis of Variance (ANOVA) for intergroup comparison followed by Tukey’s post-hoc test for multiple comparisons was performed. Differences were considered significant at p-value ≤0.05 between groups. Results: The average shear bond strength (MPa) for subgroups in both adhesive groups showed a statistically significant difference (p-value ≤0.05). Subgroup A had the highest bond strength (25.786 MPa and 46.943 MPa) and subgroup C had the lowest (8.986 MPa and 9.871 MPa). In both groups, the mean shear bond strength followed this order: Subgroup A &gt; D &gt; E &gt; B &gt; C. Comparison between Group 1 and Group 2 using an independent t-test showed no statistically significant difference in any subgroup (p-value &gt;0.05). Conclusion: The present in-vitro study found that blood and saliva contamination reduced shear bond strength to dentin, with blood having a greater impact. Decontamination with ethanol improved bond strength in both adhesive groups.

Assessment of Placental Antioxidant Defense Markers in Vaccinated and Unvaccinated COVID-19 Third-Trimester Pregnancies.

Pregnancy has been identified as a risk factor for severe COVID-19, leading to maternal and neonatal complications. The safety and effects of the SARS-CoV-2 vaccination during pregnancy, particularly on placental function and oxidative stress (OxS), remain underexplored. We investigated the impact of vaccination on third-trimester placental antioxidant defense markers. Ninety full-term pregnant women were divided into the following groups: vaccinated (n = 27) and unvaccinated (n = 25) COVID-19-positive pregnant women; control subgroups were composed of vaccinated (n = 19) or unvaccinated (n = 19) COVID-19-negative women with a healthy term singleton pregnancy with no signs of COVID-19. Placental samples were collected after delivery. Lipid peroxidation (TBARS), gene expression of HIF-1α, and catalase (CAT), superoxide dismutase-1 (SOD1) and CAT-SOD1 enzymatic activity were measured. COVID-19-positive placentae exhibited significantly higher TBARS and HIF-1α levels compared to controls, regardless of vaccination status. Vaccination significantly increased placental CAT and SOD1 expression and activity in COVID-19-positive women, suggesting enhanced antioxidant defense. Unvaccinated women showed a higher incidence of COVID-19 symptoms and lower antioxidant enzyme activity. SARS-CoV-2 infection induced placental OxS, which is countered by a placental adaptive antioxidant response. Vaccination during pregnancy enhances placental defense, further supporting the safety and benefits of COVID-19 vaccination in preventing complications and protecting fetal development.

Effects of clowning on anxiety, stress, pain, and hormonal markers in paediatric patients

BackgroundClowning has been used in many hospitals, particularly for children. Studies suggest the effectiveness of this methodology, but more evidence is needed. The aim of this study was to evaluate the impact of a humour therapy intervention on biological markers, pain and anxiety levels in paediatric patients.MethodsThree different clinical contexts were chosen to assess the effect of clowning interventions: patients who were subjected to venepuncture (group 1), patients undergoing general anesthesia for any cause (group 2)and patients hospitalized in the pediatric ward without distinction of their disease (group 3). Groups 1 and 2 were divided into control (C) and intervention (I) subgroups. A saliva sample was taken from all the children to measure oxytocin and cortisol levels by ELISAs. Validated scales and crying time were used to determine pain, stress, and anxiety levels. Children in group 3 were assessed before and after the intervention, employing the same methods.ResultsA total of 272 patients were included. The children in group 1 (n = 125) were 7.7 ± 3.2 years old, and 53.6% were females. 48% were in the I group, which showed decreased cortisol levels and increased oxytocin levels. The I group exhibited a decrease in perceived pain and crying time. The children in group 2 (n = 69) were aged 7.1 ± 3.5 years, and 36% were females. 51% were in the I group, which showed increased oxytocin levels and decreased cortisol levels, acute stress levels, perceived pain, and crying time. The children in group 3 (n = 78) were 8.6 ± 3.3 years old, and 54% of the children were females. There was an increase in oxytocin levels and a decrease in cortisol levels, stress levels and perceived pain following the intervention.ConclusionsThis study suggested that an intervention based on clowning is an effective strategy for decreasing pain, stress, and anxiety levels in paediatric patients in different clinical contexts. These findings support the implementation of humour therapy programs in paediatric units.

Myocardial contractile function in the post-traumatic period of cardiac contusion in rats with different stress resistance: A preclinical experimental randomized trial

Background. Pathogenesis of cardiac contusion involves primary traumatic and secondary hypoxic mechanisms of myocardial contractile function depression as well as body reactions aimed at adapting to altered environment. A significant part of these reactions is realized in the context of stress. The intensity of the stress component in myocardial dysfunction is largely determined by the individual stress reactivity of the body. Objectives. To assess the contractile function and functional reserves of the myocardium of rats with a high and low level of stress resistance in the post-traumatic period of cardiac contusion. Methods. A preclinical experimental randomized trial involved 134 white mature nonlinear male rats weighing about 270 g. The animals were divided by sequentially performed Open Field and Porsolt Forced Swim tests into 2 groups: group 1 — animals with low stress resistance, group 2 — animals with high stress resistance. Within each group, the animals were randomized into control and experimental subgroups. In the experimental subgroups, 6, 12 and 24 hours after simulating cardiac contusion, the force and rate indicators of myocardial contractility were evaluated using the Fallen isolated heart model. The summary measures of the study included assessing the contractile force and rate of isolated hearts of rats with low and high stress resistance, particularly under conditions of high-frequency rhythm load (ranging from 4.0 to 8.3 Hz) during the post-traumatic period of cardiac contusion. Data analysis was performed using software packages MS Office 2013 (Microsoft Corporation, USA) and Statistica, v. 10 (StatSoft, USA). The differences were considered to be statistically significant at p &lt; 0.05. Results. 6, 12 and 24 hours after simulating a cardiac contusion, contractile force and rate of isolated hearts decreased in group 1 and group 2. In low stress-resistant animals, immediately following the stabilization period and during high-frequency rhythm test, the contractility force and rate in isolated hearts were statistically significantly lower (p = 0.0008) compared to those recorded in highly stress-resistant individuals. During the stimulation of a high-frequency rhythm, isolated hearts in the experimental group revealed diastolic dysfunction at all time points. In highly stress-resistant animals, diastolic dysfunction occurred at a heart rate of 300 min-1 and above, whereas in low stress-resistant animals, it manifested at a heart rate of 240 min-1 and above. At the same heart rate, diastolic dysfunction in low stress-resistant animals was statistically significantly greater (p = 0.0008) compared to that of highly resistant animals. Conclusion. The post-traumatic period following experimental myocardial contusion is characterized by a reduction in the force and rate of myocardial contractility, as well as a decrease in functional reserves of the myocardium, regardless of stress resistance. High stress resistance is associated with better preservation of cardiac contractile function and contractility reserves, whereas low stress resistance correlates with a more pronounced degree of myocardial dysfunction and a significant reduction in functional reserves of the contused heart. Differences in the severity of contractile dysfunction under conditions of high and low body resistance to stress can be attributed to varying degrees of secondary myocardial damage in the contused area, resulting from the misbalance between stress-activating and stress-limiting mechanisms involved in the development of secondary damage.

Investigation of Long-Term CD4+ T Cell Receptor Repertoire Changes Following SARS-CoV-2 Infection in Patients with Different Severities of Disease.

The difference in the immune response to severe acute respiratory syndrome coro-navirus 2 (SARS-CoV-2) in patients with mild versus severe disease remains poorly understood. Recent scientific advances have recognised the vital role of both B cells and T cells; however, many questions remain unanswered, particularly for T cell responses. T cells are essential for helping the generation of SARS-CoV-2 antibody responses but have also been recognised in their own right as a major factor influencing COVID-19 disease outcomes. The examination of T cell receptor (TCR) family differences over a 12-month period in patients with varying COVID-19 disease severity is crucial for understanding T cell responses to SARS-CoV-2. We applied a machine learning approach to analyse TCR vb family responses in COVID-19 patients (n = 151) across multiple timepoints and disease severities alongside SARS-CoV-2 infection-naïve (healthy control) individ-uals (n = 62). Blood samples from hospital in-patients with moderate, severe, or critical disease could be classified with an accuracy of 94%. Furthermore, we identified significant variances in TCR vb family specificities between disease and control subgroups. Our findings suggest advantageous and disadvantageous TCR repertoire patterns in relation to disease severity. Following validation in larger cohorts, our methodology may be useful in detecting protective immunity and the assessment of long-term outcomes, particularly as we begin to unravel the immunological mechanisms leading to post-COVID complications.

Extracellular Volume and Fibrosis Volume of Left Ventricular Myocardium Assessed by Cardiac Magnetic Resonance in Vaccinated and Unvaccinated Patients with a History of SARS-CoV-2 Infection

Cardiac magnetic resonance (CMR) enables the assessment of tissue characteristics of the myocardium. Changes in the extracellular volume (ECV) and fibrosis volume (FV) of the myocardium are sensitive and early pathogenetic markers and have prognostic significance. The aim of the study was to assess ECV and FV of left ventricular myocardium in T1 mapping sequence in patients with a history of SARS-CoV-2 infection, considering vaccination status against COVID-19. The study group consisted of 97 patients (52.54 ± 8.31 years, 53% women and 47% men). The participants were divided into three subgroups: A) patients with a history of symptomatic SARS-CoV-2 infection, unvaccinated against COVID-19 (n = 39), B) patients with a history of symptomatic SARS-CoV-2 infection, with a full vaccination schedule against COVID-19 (n = 22), and C) persons without a history of SARS-CoV-2 infection constituting the control subgroup (C, n = 36). All patients underwent 1.5 T cardiac magnetic resonance. In subgroup A compared to subgroups B and C, both the ECV whole myocardium and ECV segments 2, 5–6, 8, and 10–11 were statistically significantly higher. In addition, the ECV segment 16 was statistically significantly higher in subgroup A than in subgroup C. Also, the FV whole myocardium was statistically significantly higher in subgroup A in comparison to subgroups B and C. There were no significant differences in ECV and FV between subgroups B and C. In summary, unvaccinated against COVID-19 patients with a history of symptomatic SARS-CoV-2 infection have higher myocardial ECV and FV values in the T1 mapping sequence, compared to those without COVID-19 and those suffering from COVID-19, previously vaccinated with the full vaccination schedule.

Efficacy of radial incision combined with tunnel floating line drainage in the treatment of high posterior horseshoe anal fistula and perianal flora: Randomized control trial.

Due to the high prevalence of posterior horseshoe anal fistula and causing numerous complications, this study aimed to investigate the clinical effect of radial incision combined with tunnel floating line drainage (RCTD) and arc incision internal drainage in the treatment of the disease and the influence on perianal flora. Ninety-six subjects treated with high posterior horseshoe anal fistula were stochastically assigned to a joint group (RCTD), and control group (arc incision internal drainage). The operation-related conditions, complication rate, anal function, and recurrence rate of 6 months after operation were compared, and perianal secretions were collected before operation and 1 day after operation to detect the changes of microbial flora. After operation, it was corroborated notable difference between joint group and control group in operation time, intraoperative blood loss, wound healing time, visual analogue scale score 6 hours after operation and phase I cure rate. Chi square test analysis showed notable difference between control group (27.08%) and joint group (10.40%) in incidence of complications, in terms of number of pathogens detected around anus, significantly smaller of the incremental change for the joint subgroup versus the control subgroup 1 day after operation. RCTD can be the best choice for patients with high posterior horseshoe anal fistula. This operation method has the advantages of short operation time, less trauma, fewer complications, fast recovery of anal function, and can also reduce perianal pathogenic bacteria infection.

Влияние рефлексии на электрофизиологическую активность мозга в зависимости от уровня тревожности

Introduction. High levels of anxiety are often associated with abnormal activity in the brain areas involved in emotional processing, cognitive control, and reduced connectivity in the default mode network (DMN). Studies also show that the activation of the DMN increases during self-reflection processes, especially positive self-reference, suggesting the possibility of using self-reflection to reduce anxiety. This study aims to test this hypothesis on the basis of EEG dynamic data before and after tasks that engage in self-reflection. Methods. The study population comprised 127 participants (mean age 25 ± 8 years). The sample was divided into low- and high-anxious groups and into experimental and control subgroups. Experimental subgroups were subjected to an Imaginary and Self-Reflective Resource (ISRR) technique developed by the author to engage participants in self-reflection. The control groups completed tasks in a disciplinary academic field – a standard cognitive load. EEG recordings were made before and after the tasks were completed. Results. The results showed that high levels of anxiety tend to lead to cognitive fatigue when completing typical cognitive tasks. At the same time, the self-reflection process combined with high levels of anxiety does not lead to a serious cognitive fatigue, but rather reflects the attention process. Low anxiety is generally associated with lower cognitive fatigue. In low-anxious subjects, the completion of self-reflection tasks involves a significant brain activation that characterizes attention processes. Discussion. The results obtained are consistent with those of other researchers and generally confirm the hypothesis of the study. Positive self-reflection can reduce high levels of anxiety due to the DMN activation.