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36196261

Mitigating the spread of COVID-19 during extubation: Assessing the impact of a barrier device.

COVID-19 is a novel virus spread via airborne particles. Given the inherent risk to the anesthesia provider, intubation and airway management guidelines have been recently established. Various studies have been published advocating and detailing the results of different intubation devices designed to decrease the number of airborne particles. Currently, little literature exists regarding devices designed to mitigate the spread of COVID-19 airborne particles during extubation. The purpose of this prospective

36196262

Size-dependent adsorption performance of ZnO nanoclusters for drug delivery applications.

We have investigated the size-dependent adsorption performance of ZnO nanoclusters (NCs) as drug delivery carriers for the first time. Our results show that the adsorption energy of the favipiravir drug on the ZnO NCs is predicted in the range of - 26.69 and - 34.27 kcal/mol. The adsorption energy (- 34.27 kcal/mol) between (ZnO)

36196263

Analytical methods for microplastics in the environment: a review.

Microplastic pollution is a recently discovered threat to ecosystems requiring the development of new analytical methods. Here, we review classical and advanced methods for microplastic analysis. Methods include visual analysis, laser diffraction particle, dynamic light scattering, scanning electron microscopy, Fourier-transform infrared spectroscopy, Raman spectroscopy, thermal analysis, mass spectrometry, aptamer and in vitro selection, and flow cytometry.

36196264

Data-driven analysis of a validated risk score for ovarian cancer identifies clinically distinct patterns during follow-up and treatment.

Ovarian cancer is the eighth mon cancer among women and due to late detection prognosis is poor with an overall 5-year survival of 30-50%. Novel biomarkers are needed to reduce diagnostic surgery and enable detection of early-stage cancer by population screening. We have previously developed a risk score based on an 11-biomarker plasma protein assay to distinguish benign tumors (cysts) from malignant ovarian cancer in women with adnexal ovarian mass.

36196265

Short-term and long-term interest rate spread's dynamics to risk and the yield curve.

The yield curve is perceived to be an indicator of the future state of the economy. For example, an inverted yield curve is considered to be a signal of a ing economic slowdown. Does risk explain the slope of the yield curve as well? In this paper, we explore the dynamics of short-term and long-term interest rate spread to changes in risk and government debt using time-series data. Government-issued bonds are perceived to be risk-free assets. Financial intermediaries consider government-issued securities as a secondary reserve, and they are also used during open market operations. We explore the dynamics while controlling for a potential mon trend between the interest rate spread and government debt. We employ the bounds test for cointegration in an auto-regressive distributed lag model and evaluate impulse responses to develop insights into the dynamics. The ARDL bounds test finds evidence of cointegration between the measures interest rate spreads and government debt. A shock to government-issued bonds indicates that the short-term spread decreases, whereas the long-term spread rises by a small margin. We conjecture an upward sloping yield curve resulting from a shock to government debt. A shock to the financial market risk index indicates that the short-term spread decreases for a brief period before returning to its pre-shock level, whereas the long-term spread more or less remains unchanged. We conjecture a downward sloping yield curve resulting from a shock to risk. This conjecture on the impact of risk on short-term and long-term interest rate spreads make the prediction about the inverted yield curve based on the expectation hypothesis and the segmented market theory somewhat weak.

36196266

Forecasting volatility in Asian financial markets: evidence from recursive and rolling window methods.

The present paper examines the relative out-of-sample predictive ability of GARCH, GARCH-M, EGARCH, TGARCH and PGARCH models for ten Asian markets by using three different time frames and two different methods, considering the features of volatility clustering, leverage effect and volatility persistence phenomena, for which the evidence of existence is found in the data. Five measures parison are employed in this research, and a further dimension is investigated based on the classification of the selected models, in order to identify the existence or lack of any differences between the recursive and rolling window methods. The empirical results reveal that asymmetric models, led by the EGARCH model, provide better pared to symmetric models in higher time frames. However, when es to lower time frames, symmetric GARCH models tend to outperform their asymmetric counterparts. Furthermore, linear GARCH models are penalized more by the rolling window method, while recursive method places them amongst the best performers, highlighting the importance of choosing a proper approach. In addition, this study reveals an important controversy: that one error statistic may suggest a particular model is the best, while another suggests the same model to be the worst, indicating that the performance of the model heavily depends on which loss function is used. Finally, it is proved that GARCH-type models can appropriately adapt to the volatility of Asian stock indices and provide a satisfactory degree of forecast accuracy in all selected time frames. These results are also supported by the Diebold-Mariano (DM) parison test.

36196267

The role of resource orchestration in humanitarian operations: a COVID-19 case in the US healthcare.

This paper investigates the role of resource allocation in alleviating the impact on from disruptions in healthcare operations. We draw on resource orchestration theory and analyse data stemming from US healthcare to discuss how the US healthcare system structured, bundled and reconfigured resources (i.e. number of hospital beds, and vaccines) during the COVID-19 pandemic. Following prehensive and robust econometric analysis of two key resources (i.e. hospital beds and vaccines), we discuss its effect on the es of the pandemic measured in terms of confirmed cases and deaths, and draw insights on how the learning curve effect and other factors might influence in the efficient and effective control of the pandemic es through the resource usage. Our contribution lies in revealing how different resources are orchestrated ('structured', 'bundled', and 'leveraged') to help planning responses to and dealing with the disruptions to create resilient humanitarian operations. Managerial implications, limitations and future research directions are also discussed.

36196268

Using machine learning in prediction of ICU admission, mortality, and length of stay in the early stage of admission of COVID-19 patients.

The recent COVID-19 pandemic has affected health systems across the world. Especially, Intensive Care Units (ICUs) have played a pivotal role in the treatment of critically-ill patients. At the same time however, the increasing number of admissions due to the vast prevalence of the virus have caused several problems for ICU wards such as overburdening of staff and shortages of medical resources. These issues might have affected the quality of healthcare services provided directly impacting a patient's survival. The objective of this research is to leverage Machine Learning (ML) on hospital data in order to support hospital managers and practitioners with the treatment of COVID-19 patients. This is plished by providing more detailed inference about a patient's likelihood of ICU admission, mortality and in case of hospitalization the length of stay (LOS). In this pursuit, the e variables are in three separate models predicted by five different ML algorithms: eXtreme Gradient Boosting (XGB), K-Nearest Neighbor (KNN), Random Forest (RF), bagged-CART (b-CART), and LogitBoost (LB). With the exception of KNN, the studied models show good predictive capabilities when evaluating relevant accuracy scores, such as area under the curve. By implementing an ensemble stacking approach (either a Neural Net or a General Linear Model) on top of the aforementioned ML algorithms the performance is further boosted. Ultimately, for the prediction of admission to the ICU, the ensemble stacking via a Neural Net achieved the best result with an accuracy of over 95%. For mortality at the ICU, the vanilla XGB performed slightly better (1% difference with the meta-model). To predict large length of stays both ensemble stacking approaches parable results. Besides it direct implications for managing COVID-19 patients, the approach presented serves as an example how data can be employed in future pandemics or crises.

36196269

Face mask detection and social distance monitoring system for COVID-19 pandemic.

Coronavirus triggers several respirational infections such as sneezing, coughing, and pneumonia, which transmit humans to humans through airborne droplets. According to the guidelines of the World Health Organization, the spread of COVID-19 can be mitigated by avoiding public interactions in proximity and following standard operating procedures (SOPs) including wearing a face mask and maintaining social distancing in schools, shopping malls, and crowded areas. However, enforcing the adaptation of these SOPs on a larger scale is still a challenging task. With the emergence of deep learning-based visual object detection networks, numerous methods have been proposed to perform face mask detection on public spots. However, these methods require a huge amount of data to ensure robustness in real-time applications. Also, to the best of our knowledge, there is no standard outdoor surveillance-based dataset available to ensure the efficacy of face mask detection and social distancing methods in public spots. To this end, we present a large-scale prising of 10,000 outdoor images categorized into a binary class labeling i.e., face mask, and non-face masked people to accelerate the development of automated face mask detection and social distance measurement on public spots. Alongside, we also present an end-to-end pipeline to perform real-time face mask detection and social distance measurement in an outdoor environment. Initially, existing state-of-the-art single and multi-stage object detection networks are fine-tuned on the proposed dataset to evaluate their performance in terms of accuracy and inference time. Based on better performance, YOLO-v3 architecture is further optimized by tuning its feature extraction and region proposal generation layers to improve the performance in real-time applications. Our results indicate that the presented pipeline performed better than the baseline version, showing an improvement of 5.3% in terms of accuracy.

36196270

An image forensic technique based on JPEG ghosts.

The unprecedented growth in the easy availability of photo-editing tools has endangered the power of digital images. An image was supposed to be worth more than a thousand words, but now this can be said only if it can be authenticated or the integrity of the image can be proved to be intact. In this paper, we propose a digital image forensic technique for JPEG images. It can detect any forgery in the image if the forged portion called a ghost image is having pression quality different from that of the cover image. It is based on resaving the JPEG image at different JPEG qualities, and the detection of the forged portion is maximum when it is saved at the same JPEG quality as the cover image. Also, we can precisely predict the JPEG quality of the cover image by analyzing the similarity using Structural Similarity Index Measure (SSIM) or the energy of the images. The first maxima in SSIM or the first minima in energy correspond to the cover image JPEG quality. We created a dataset for varying pression qualities of the ghost and the cover images and validated the scalability of the experimental results. We also, experimented with varied attack scenarios, e.g. high-quality ghost image embedded in low quality of cover image, low-quality ghost image embedded in high-quality of cover image, and ghost image and cover image both at the same quality. The proposed method is able to localize the tampered portions accurately even for forgeries as small as 10 × 10 sized pixel blocks. Our technique is also robust against other attack scenarios like copy-move forgery, inserting text into image, rescaling (zoom-out/zoom-in) ghost image and then pasting on cover image.

36196271

C282Y/H63D Compound Heterozygosity Is a Low Penetrance Genotype for Iron Overload-related Disease.

Hereditary hemochromatosis (HH) occurs due to mutations in the HFE gene. While the C282Y mutation is the mon genotype reported in HH, other genotypes are found less frequently, indicating variable degrees of penetrance. We studied the penetrance of the pound heterozygote genotype in developing clinically significant iron overload.

36196273

A Randomized Controlled Pilot Study of Topical Ropivacaine for Prevention of Post-POEM Pain.

Although usually mild to moderate in severity, postoperative pain after peroral endoscopic myotomy (POEM) mon. There are no studies that have addressed minimizing postoperative pain in patients undergoing POEM for achalasia. We hypothesized that intraoperative topical intra-tunnel irrigation with ropivacaine would result in a significant reduction in pain scores in the postoperative period.

36196272

Financial Conflicts of Interest in Propensity Score-Matched Studies Evaluating Biologics and Biosimilars for Inflammatory Bowel Disease.

Propensity score matching (PSM), a statistical technique that estimates a treatment effect by accounting for predictor covariates, has been used to evaluate biologics for inflammatory bowel disease (IBD). Financial conflicts of interest are prevalent in the marketing of biologic medications. It is unclear whether this burden of conflicts is present among authors of PSM paring IBD biologics and biosimilars.

36196274

High Diagnostic Yield of Endoscopic Retrograde Cholangiopancreatography Brush Cytology for Indeterminate Strictures.

Endoscopic retrograde cholangiopancreatography (ERCP) brush cytology is used frequently for sampling indeterminate biliary strictures. Studies have demonstrated that the diagnostic yield of brush cytology for malignant strictures is estimated to be 6%-70%. With improved diagnostic tools, sampling techniques and specimen processing, the yield of ERCP brush cytology may be higher. This study aimed to assess the yield of brush cytology and determine factors associated with a positive diagnosis.

36196275

Perceived Barriers to Professional Equality Among Women in Gastroenterology.

Although significant progress relating to professional equality among men and women in medicine has been made over the past few decades, evidence derived from the medical literature suggests that inequity persists with respect to e, attainment of leadership positions, and professional advancement. These inequities have been observed to be more pronounced in gastroenterology. Literature relating to gender-specific barriers to professional equity in gastroenterology is limited. This qualitative study explored perceived barriers to professional equality among women in gastroenterology in Canada through focus groups using a World Café Approach. Several perceived barriers to professional equality were identified. Identification of barriers to professional equality is an important first step to creating meaningful interventions that address the root causes of gender-related inequity in gastroenterology.

36196277

Efficacy of Intravenous Ustekinumab Reinduction in Patients With Crohn's Disease With a Loss of Response.

In patients receiving ustekinumab (UST) for treatment of Crohn's disease, there is no proven strategy to enhance or re-capture response. We assessed the utility of UST intravenous (IV) reinduction (~6 mg/kg) to achieve clinical, biochemical and endoscopic response or remission, in patients with partial or loss of response to UST maintenance therapy.

36196278

A heterometallic [LnLn'Ln] lanthanide complex as a qubit with embedded quantum error correction.

We show that a [Er-Ce-Er] molecular trinuclear pound is a promising platform to implement the three-qubit quantum error correction code protecting against pure dephasing, the most important error in magnetic molecules. We characterize it by preparing the [Lu-Ce-Lu] and [Er-La-Er] analogues, which contain only one of the two types of qubit, and bining magnetometry, low-temperature specific heat and electron paramagnetic resonance measurements on both the elementary constituents and the trimer. Using the resulting parameters, we demonstrate by numerical simulations that the proposed molecular device can efficiently suppress pure dephasing of the spin qubits.

36196279

Increasing Pre-pregnancy Body Mass Index and Pregnancy Outcomes in the United States.

 As many Americans are ing overweight or obese, increased body mass index (BMI) is fast ing normalized. There is a need for more research that highlights the association between pre-pregnancy obesity and adverse pregnancy es.

36196280

The Efficiency of Extracorporeal Shock Wave Lithotripsy (ESWL) in the Treatment of Distal Ureteral Stones: An Unjustly Forgotten Option?

Introduction The optimal management of distal ureteral stones remains a matter of debate since current guidelines favor ureteroscopy over extracorporeal shock wave lithotripsy (ESWL). We aimed to evaluate the efficiency of ESWL for distal ureteral stones and to identify factors that affect treatment es. Materials and methods The retrospective study included records of 115 patients with distal ureteral stones, 5 mm to 18 mm in size, undergoing 223 ESWL sessions as an outpatient procedure. Early fragmentation and three-month follow-up stone-free rate (SFR) was assessed through radiographic imaging. Treatment was successful if there were no residual fragments or they were ≤4 mm, three months after the last session. Results The mean ±standard deviation (range) stone size was 9.68 ±3.10 (5.00-18.0) mm. The mean body mass index (BMI) was 24.3 ±2.67 (18.4-29.8) kg/m² with a significant correlation between BMI and stone size (r

36196281

Reverse Abdominoplasty for Reconstruction Following Oncologic Resection of Extensive Breast Disease.

We present two cases of patients with extensive breast disease who underwent a reverse abdominoplasty for closure following resection: one of Paget's disease extending beyond the breast borders and another of a locally recurrent triple-negative invasive ductal carcinoma following mastectomy in a patient who previously had an ipsilateral thoracotomy. The reverse abdominoplasty flap is a reconstructive option not readily considered for closure following mastectomy. However, we believe that the reverse abdominoplasty flap should be considered when evaluating patients for anterior chest wall reconstruction because it is a simple and versatile coverage option.

36196282

Ureteral Hematoma: A Case Report on Complications During Anticoagulant Therapy.

Ureteral hematoma is a plication occurring during anticoagulant therapy, with fewer than 10 cases reported in the literature. plications are underestimated. They affect about 10% of patients treated with long-term anti-vitamin K (AVK). The appearance of macroscopic hematuria may indicate the presence of underlying organic damage. Clinically, ureteral hematoma is manifested by lumbar or abdominal pain often associated with macroscopic hematuria. Imaging plays a major role in its diagnosis. Clinical and radiological evolution is always rapidly favorable after the correction of coagulation disorders and the immediate discontinuation of anticoagulant treatment. We report in this work the case of a patient in her 50s who presented a ureteral hematoma during her anticoagulant treatment.

36196283

Rupture of Bilateral Theca Lutein Cysts During Pregnancy: A Case Report.

Hyperreactio luteinalis is a rare condition characterized by the presence of bilateral theca lutein cysts, which occur rarely in a singleton normal pregnancy. Bilateral multicystic ovarian enlargement occurs due to elevated beta-human chorionic gonadotropin. We present a rare case of a 23-year-old primigravida in her tenth week of gestation, presenting with an acute abdomen, with increasing abdominal girth, diagnosed with a rupture of theca lutein cyst, and posted for laparotomy. Theca lutein cyst doesn't affect the course of pregnancy and has a spontaneous regression after delivery. Our case is different due to the occurrence of cysts in a singleton pregnancy and the rupture of these cysts during pregnancy. plicated by torsion, rupture, or hemorrhage, most theca lutein cysts are managed conservatively.

36196284

Role of Endotracheal Tube Cuff Deflation in Facilitating Passage of Nasogastric Tube.

Background Nasogastric tube insertion is a routinely performed technique in anesthetized and intubated patients. However, failure leads to repeated insertion attempts causing injury, which makes the situation cumbersome. Therefore, we introduce a simple technique of deflating endotracheal tube cuff for nasogastric tube insertion in such patients. Methods Eighty adult patients scheduled for elective abdominal surgeries were randomly allocated into two groups, Group A (nasogastric tube insertion without endotracheal cuff deflation) and Group B (nasogastric tube insertion with endotracheal tube cuff deflation) along with lateral pressure application at cricoid in both groups. The number of attempts required, overall success rate, the time taken, rescue maneuvers, and incidence plications pared between the groups. Results In Group B, the total success rate for nasogastric tube placement was significantly higher than in Group A (80% vs 55%, p=0.016). Group B had a 55% first attempt success rate, but only 25% of patients in Group A had a first attempt success rate (p=0.014). The overall time for successful nasogastric tube placement was longer in Group A than in Group B (65.4 ± 28.72 seconds vs 43.5 ± 25.37 seconds, p=0.0005). The differences in nasogastric tube kinking and coiling between Group B and Group A were not statistically significant (20% vs 22.5%, 10% vs 27.5%, p = 0.78 and 0.08, respectively). Mucosal bleeding was substantially higher in Group A than in Group B (30% vs 10%, p=0.025, respectively). Conclusions This study showed that endotracheal tube deflation significantly increased the first-attempt success rate, overall successful placement of the nasogastric tube in intubated patients, and incidence plications like mucosal bleeding decreased.

36196285

The Status of Women in Emergency Ultrasound Fellowships: A Potential Light for the Future of Gender Inclusion in Academic Medicine.

The objective of this study is to investigate gender differences in the percentage of men and women who pleted an Emergency Ultrasound (EUS) fellowship over a four-year period. Secondary objectives of this study include evaluation of the career paths and plishments of women who have pleted an EUS fellowship. We will also be assessing program characteristics as reported by the program directors.

36196286

Comparative Evaluation of Shear Bond Strength of Nanohybrid Composite Restoration After the Placement of Flowable Compomer and Composite Using the Snowplow Technique.

Based on the importance of bonding during restoration, this in vitro study aimed to evaluate the difference in shear bond strength of posite restoration in molars after the placement of pomer posite using the snowplow technique.

36196287

Simulation-Based Outreach Program Improves Rural Hospitals' Team Confidence in Neonatal Resuscitation.

Neonatal resuscitation is a high acuity, low occurrence event (HALO), and in munity hospitals, low birth rates prevent providers from regular opportunities to maintain essential resuscitation skills. Simulation is an effective training modality for medical education, although resources for simulation are often limited in rural hospitals. Our primary objective was to test the hypothesis that in situ neonatal resuscitation simulation training improves rural hospitals' delivery room team confidence in performing key Neonatal Resuscitation Program

36196288

Efficacy of Combined Desensitization Therapy Based on Protein A Immunoadsorption on Anti-human Leukocyte Antigen Antibodies in Sensitized Kidney Transplant Recipients: A Retrospective Study.

Background and objectives Protein A immunoadsorption (PA-IA) therapy is an immunoglobulin selective apheresis for pre-transplantation desensitization therapy and treatment of post-transplantation antibody-mediated rejection. There is no unified protocol for the timing of PA-IA therapy or bination with other drug therapy. This study aimed to investigate and analyze the clearance effects of desensitization therapy on human leukocyte antigen (HLA) antibodies to provide a reference for the formulation of clinical desensitization therapy regimens. Materials and methods Overall, 27 kidney transplant recipients who received preoperative/postoperative desensitization therapy based on PA-IA therapy bination with drug therapy were enrolled. The pre-treatment mean fluorescence intensity (MFI) of 1324 human leukocyte antigen (HLA) antibody specificities (MFI >2000) and the post-treatment MFI of the corresponding antibody specificities (after one, four, seven, and 10 sessions) were recorded to analyze the changes in antibody level reduction for the different antibody classes and MFI ranges. Results After 10 sessions of PA-IA therapy, the MFI of class I antibodies decreased from 8298.56 to 3196.15 (reduction of 66.80%), while the MFI of class II antibodies decreased from 13,521.09 to 2773.29 (reduction of 71.14%). The pre-treatment level of class II antibodies was significantly higher than that of class I antibodies (p<0.001), whereas the post-treatment levels of class I and II antibodies parable (p>0.05). The clearance effects of PA-IA therapy were greater for strongly positive (MFI>10,000) class II antibodies than for strongly positive class I antibodies, showing a reduction of 62.59% (25.17% to 91.04%) and 45.13% (32.70% to 73.94%), respectively (p=0.015). Conclusions We confirmed the removal efficacy of PA-IA for HLA antibodies. The removal efficacy of class II antibodies on PA-IA is not inferior to that of class I. Under an adequate number of treatment sessions, the clearance effect of PA-IA therapy for strongly positive class II antibodies may be greater than that for strongly positive class I antibodies.

36196289

Surgical Management of Acute Rockwood Grade III Acromioclavicular Joint Dislocations: A Systematic Review.

Injuries of the acromioclavicular joint (ACJ) occur frequently in young and active people. The best management of acute grade III injuries has been a source of controversy and extensive debate. When surgery is indicated, there is still no gold standard surgical technique for treating acute grade III ACJ injuries. The methodology of this review was prehensive search of PubMed, Medline, Cochrane, and EMBASE databases using binations of the keywords "Rockwood," "type III," "grade III," "treatment," "surgery," "acromioclavicular joint," and "dislocation," since the inception of the databases to December 2020. Surgical techniques were divided into two groups. In group 1 were ACJ fixation techniques using hardware such as the hook plate, Kirschner wires, and wire cerclage; group 2 included coracoclavicular (CC) ligament fixation/reconstruction techniques using double buttons, TightRope®, suture anchors, Endobuttons, the Infinity-Lock

36196291

Does Health Insurance Eligibility Improve Child Health: Evidence From the National Health Insurance Scheme (NHIS) in Nigeria.

Favorable child health es are important for sustainable growth and development, especially for developing economies. However, Nigeria has some of the worst health indicators. The problem seems to be inadequate access to affordable healthcare, especially for children. To improve policies aimed at improving access to affordable healthcare for children in Nigeria through health insurance, it is important to measure the extent to which health insurance affects child health. This study examines the effects of health insurance on child health and healthcare utilization in Nigeria using the implementation and expansion of the National Health Insurance Scheme (NHIS) to introduce the exogenous variation in health insurance eligibility, a natural experiment that fits a difference-in-difference model. The findings suggest that health insurance increases birth weight. It also increases the probability that children receive polio and diphtheria vaccines. The findings suggest that the NHIS in Nigeria is effective in improving the health es of children. Policies strengthening the take-up of the NHIS should be encouraged across all sectors and socio-economic groups in the economy.

36196290

Superior Replacement of Medicinal Gel With Ayurvedic Nanogel as a Coupling Medium for Electrotherapeutic Treatment of Osteoarthritis: A Review Article.

Osteoarthritis is a disabling condition globally, affecting a major population. The non-invasive conservative management of osteoarthritis is majorly catered to by physical therapy rehabilitation. Research has been conducted to evaluate the impact of the monly used electrotherapy modality, therapeutic ultrasound, on reducing pain and increasing functional activities in individuals suffering from osteoarthritis, but the condition is still, after over two decades of research, growing rapidly in its prevalence. Therefore, the aim of our study was to analyze the literature pare the evolving trends in coupling medium used for the application of therapeutic ultrasound in arthritic conditions of musculoskeletal origin. Databases of PubMed, Web of Science, Embase, Pedro, and Cochrane were searched till June 2022. The e measures used were to detect the status of pain and improvement in functional status. Overall ultrasound therapy adjunct to exercise program was found to be superior to either ultrasound therapy or exercise program alone for the management of pain and functional status of the patients. Additionally, phonophoresis was deduced to have shown better pain relief than conventional ultrasound. Phonophoresis was done using non-steroidal anti-inflammatory drugs and Ayurvedic medicinal herbs in the form of Nano gel.

36196292

Determining the Site of Upper Airway Narrowing in Snorers Using a Noninvasive Technique.

Background In this study, we aimed to determine the site of obstruction if surgical treatment is considered. Flexible nasopharyngoscopy is an invasive procedure currently used for the assessment of snoring and the level of obstruction. Here, we examine the role of Somnoscreen™ plus, a noninvasive cardiorespiratory polysomnographic device, in identifying the site of obstruction in patients presenting with snoring. Methodology This cross-sectional study was conducted in the Sleep Research Center at King Abdulaziz University Hospital. Polysomnography was conducted using Somnoscreen™ plus. All participants underwent flexible nasopharyngoscopy after polysomnography. Results Nasopharyngoscopy revealed that the mon site of obstruction was the nose and the soft palate (35.4%), followed by the soft palate alone (25%). Somnoscreen revealed that the site of obstruction was the nose and the soft palate in 18 (37.5%) patients and the nose alone in 16 (33.3%) patients. However, distal obstructions were not detected using Somnoscreen. The concordance of nasopharyngoscopy and Somnoscreen was 52.9%. However, it showed a discrepancy in identifying distal obstructions, which Somnoscreen™ plus failed to detect. Conclusions Somnoscreen appears to be sensitive for identifying proximal airway obstructions. The audio signal recordings can potentially be used as a tool to detect the site of airway obstruction in snoring; however, further studies are needed.

36196293

Gastroesophageal Reflux Disease in a One-Week-Old Infant Presenting With Cyanosis and Respiratory Distress.

Gastroesophageal reflux (GER) is mon occurrence in infancy and early childhood. While GER is considered physiologic, gastroesophageal reflux disease (GERD) can result when extensive GER leads to troublesome symptoms such as choking, gagging, vomiting, refusal to feed, and poor weight gain. In extreme cases, GERD can cause severe plications such as apnea and aspiration pneumonia. We present the case of a one-week-old Amish female who had no prenatal care and presented with severe hypoxemia, tachypnea, and costal retractions. Further history from the family revealed persistent irregular breathing, sweating during feeds, and episodic perioral cyanosis. The patient required stabilization in the intensive care unit and received an extensive workup to rule out sepsis, cyanotic heart disease, other infectious etiologies, and mon causes of respiratory distress. The patient underwent a modified barium swallow study and was diagnosed with aspiration pneumonitis resulting from GERD and oropharyngeal dysphagia. Infantile cyanosis and respiratory distress can be manifestations of a variety of underlying illnesses. mon causes of cyanosis have been excluded, GERD or disordered feeding should be considered as a potential etiology.

36196294

Recent advances in biopolymer-based hemostatic materials.

Hemorrhage is the leading cause of trauma-related deaths, in hospital and prehospital settings. Hemostasis is plex mechanism that involves a cascade of clotting factors and proteins that result in the formation of a strong clot. In certain surgical and emergency situations, hemostatic agents are needed to achieve faster blood coagulation to prevent the patient from experiencing a severe hemorrhagic shock. Therefore, it is critical to consider appropriate materials and designs for hemostatic agents. Many materials have been fabricated as hemostatic agents, including synthetic and naturally derived polymers. Compared to synthetic polymers, natural polymers or biopolymers, which include polysaccharides and polypeptides, have greater patibility, biodegradability and processibility. Thus, in this review, we focus on biopolymer-based hemostatic agents of different forms, such as powder, particles, sponges and hydrogels. Finally, we discuss biopolymer-based hemostatic materials currently in clinical trials and offer insight into next-generation hemostats for clinical translation.

36196295

Thermoresponsive and antibacterial two-dimensional polyglycerol-

Two-dimensional polymeric networks are a new class of polymers with interesting physicochemical and biological properties. They promise a wide range of future biomedical applications including pathogen interactions, drug delivery, bioimaging, photothermal, and photodynamic therapy, owing to their unique features, such as high surface area and multivalent interactions at nano-biointerfaces. In this work, a thermosensitive two-dimensional polymeric network consisting poly(

36196296

Inhibitory effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.

To evaluate the effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system.

36196297

COVID-19 Vaccine Effectiveness Against Progression to In-Hospital Mortality in Zambia, 2021-2022.

Coronavirus disease 2019 (COVID-19) vaccines are highly effective for reducing severe disease and mortality. However, vaccine effectiveness data are limited from Sub-Saharan Africa. We report COVID-19 vaccine effectiveness against progression to in-hospital mortality in Zambia.

36196298

Low Sensitivity of

We evaluated healthcare facility use of

36196299

Effectiveness and Optimal Duration of Adjunctive Rifampin Treatment in the Management of

Rifampin is mended as adjunctive therapy for patients with a

36196301

Mechanistic and recent updates in nano-bioremediation for developing green technology to alleviate agricultural contaminants.

The rise in environmental pollutant levels in recent years is mostly attributable to anthropogenic activities such as industrial, agricultural and other activities. Additionally, these activities may produce excessive levels of dangerous toxicants such as heavy metals, organic pollutants including pesticide and herbicide chemicals, and sewage discharges from residential mercial sources. With a focus on environmentally friendly, sustainable technology, new technologies such bined process of nanotechnology and bioremediation are urgently needed to accelerate the cost-effective remediation process to alleviate toxic contaminants than the conventional remediation methods. Numerous studies have shown that nanoparticles possess special qualities including improved catalysis and adsorption as well as increased reactivity. Currently, microorganisms and their extracts are being used as promising, environmentally friendly catalysts for engineered nanomaterial. In the long term, bination of both technologies called nano-bioremediation may significantly alter the field of environmental remediation since it is more intelligent, safe, environmentally friendly, economical and green. This review provides an overview of soil and water remediation techniques as well as the use of nano-bioremediation, which is made from various living organisms. Additionally, current developments related to the mechanism, model and kinetic studies for remediation of agricultural contaminants have been discussed.

36196302

Epidemiology and clinical characteristics of burns in mainland China from 2009 to 2018.

Burn injuries place a heavy burden on the global healthcare system. However, there is still a lack of nationwide studies on the epidemiological characteristics of burn patients in mainland China. The present study aims to accurately analyze the clinical characteristics of burn patients by collecting data in mainland China from 2009 to 2018, which will provide effective strategies for healthcare systems and the government in mainland China.

36196303

Bioactive glass-based fibrous wound dressings.

Since the discovery of silicate bioactive glass (BG) by Larry Hench in 1969, different classes of BGs have been researched over decades mainly for bone regeneration. More recently, validating the beneficial influence of BGs with positions on angiogenesis, immunogenicity and bacterial infection, the applicability of BGs has been extended to soft tissue repair and wound healing. Particularly, fibrous wound prising BG particle reinforced polymer nanofibers and cotton-candy-like BG fibers have been proven to be successful for wound healing applications. Such fibrous dressing materials imitate the physical structure of skin's extracellular matrix and release biologically active ions e.g. regenerative, pro-angiogenic and antibacterial ions, e.g. borate, copper, zinc, etc., that can provoke cellular activities to regenerate the lost skin tissue and to induce new vessels formation, while keeping an anti-infection environment. In the current review, we discuss different BG fibrous materials meant for wound healing applications and cover the relevant literature in the past decade. The production methods for BG-containing fibers are explained and as fibrous wound dressing materials, their wound healing and bactericidal mechanisms, depending on the ions they release, are discussed. The present gaps in this research area are highlighted and new strategies to address them are suggested.

36196305

Impact of Neuro Physiotherapeutic Reformation in a Teenager Agonizing With Guillain-Barre Syndrome Linked With COVID-19 Infection.

Coronavirus disease 2019 (COVID-19) has spread around the globe. The mon symptoms associated with this are usually respiratory, but different central nervous system manifestations have been reported. There are many cases of Guillain-Barre syndrome (GBS) post-COVID-19. However, only a few simultaneous afflictions of COVID-19 with GBS have been reported. Therefore, our study aims to investigate a case of GBS along with COVID-19 infection in India. A 22-year-old male with no medical history presented with fever along with global weakness and breathing difficulty. There was no history of travel. At the time of admission, he had developed quadriparesis and had muscular strength of 2/5 in bilateral lower limbs and 3/5 in bilateral upper limbs. When the patient developed breathing difficulty, he was transferred to the intensive care unit. The cerebrospinal fluid evaluation showed albumin-cytological dissociation, and a nerve conduction study was done. The patient was managed by neuro physiotherapy 34 days after COVID-19 exposure. After proper physiotherapy and rehabilitation, the patient was able to return to his college life.

36196304

Regular Use of Ivermectin as Prophylaxis for COVID-19 Led Up to a 92% Reduction in COVID-19 Mortality Rate in a Dose-Response Manner: Results of a Prospective Observational Study of a Strictly Controlled Population of 88,012 Subjects.

Background We have previously demonstrated that ivermectin used as prophylaxis for coronavirus disease 2019 (COVID-19), irrespective of the regularity, in a strictly controlled citywide program in Southern Brazil (Itajaí, Brazil), was associated with reductions in COVID-19 infection, hospitalization, and mortality rates. In this study, our objective was to determine if the regular use of ivermectin impacted the level of protection from COVID-19 and related es, reinforcing the efficacy of ivermectin through the demonstration of a dose-response effect. Methods This exploratory analysis of a prospective observational study involved a program that used ivermectin at a dose of 0.2 mg/kg/day for two consecutive days, every 15 days, for 150 days. Regularity definitions were as follows: regular users had 180 mg or more of ivermectin and irregular users had up to 60 mg, in total, throughout the program. Comparisons were made between non-users (subjects who did not use ivermectin), and regular and irregular users after multivariate adjustments. The full city database was used to calculate pare COVID-19 infection and the risk of dying from COVID-19. The COVID-19 database was used and propensity score matching (PSM) was employed for hospitalization and mortality rates. Results Among 223,128 subjects from the city of Itajaí, 159,560 were 18 years old or up and were not infected by COVID-19 until July 7, 2020, from which 45,716 (28.7%) did not use and 113,844 (71.3%) used ivermectin. Among ivermectin users, 33,971 (29.8%) used irregularly (up to 60 mg) and 8,325 (7.3%) used regularly (more than 180 mg). The remaining 71,548 participants were not included in the analysis. COVID-19 infection rate was 49% lower for regular users (3.40%) than non-users (6.64%) (risk rate (RR): 0.51; 95% CI: 0.45-0.58; p < 0.0001), and 25% lower than irregular users (4.54%) (RR: 0.75; 95% CI: 0.66-0.85; p < 0.0001). The infection rate was 32% lower for irregular users than non-users (RR: 0.68; 95% CI: 0.64-0.73; p < 0.0001). Among COVID-19 participants, regularusers were older and had a higher prevalence of type 2 diabetes and hypertension than irregular and non-users. After PSM, the matched analysis contained 283 subjects in each group of non-users and regular users, between regular users and irregular users, and 1,542 subjects between non-users and irregular users. The hospitalization rate was reduced by 100% in regular pared to both irregular users and non-users (p < 0.0001), and by 29% among irregular pared to non-users (RR: 0.781; 95% CI: 0.49-1.05; p = 0.099). Mortality rate was 92% lower in regular users than non-users (RR: 0.08; 95% CI: 0.02-0.35; p = 0.0008) and 84% lower than irregular users (RR: 0.16; 95% CI: 0.04-0.71; p = 0.016), while irregular users had a 37% lower mortality rate reduction than non-users (RR: 0.67; 95% CI: 0.40-0.99; p = 0.049). Risk of dying from COVID-19 was 86% lower among regular users than non-users (RR: 0.14; 95% CI: 0.03-0.57; p = 0.006), and 72% lower than irregular users (RR: 0.28; 95% CI: 0.07-1.18; p = 0.083), while irregular users had a 51% pared to non-users (RR: 0.49; 95% CI: 0.32-0.76; p = 0.001). Conclusion Non-use of ivermectin was associated with a 12.5-fold increase in mortality rate and a seven-fold increased risk of dying from pared to the regular use of ivermectin. This dose-response efficacy reinforces the prophylactic effects of ivermectin against COVID-19.

36196306

A Case Report and 31-Case Study: Does Takotsubo Cardiomyopathy in Myasthenia Gravis Patients Have a High Mortality Rate?

Myasthenia gravis is an autoimmune disorder in which antibodies are formed against post-synaptic nicotinic acetylcholine receptors that lead to impeded muscle contraction monly affects the oculomotor muscles. Takotsubo cardiomyopathy (TTC) is a dilated cardiomyopathy that can mimic a myocardial infarction and causes reversible systolic dysfunction. This is a case of a 66-year-old Caucasian male with a known history of ocular myasthenia gravis that presented to the emergency room with worsening dyspnea secondary to a myasthenic crisis. One day, following admission, his shortness of breath failed to improve and was found to meet the diagnostic criteria for takotsubo cardiomyopathy. A brief review of 31 previous cases summarizes the current case reports, patterns, and mortality associated with the myasthenic crisis associated with TTC.

36196307

Sporadic Creutzfeldt-Jakob Disease With Status Epilepticus: Molecular Mechanisms and a Scoping Review of the Literature.

Creutzfeldt-Jakob disease (CJD) is a rapidly progressing neurodegenerative disorder and is a spongiform encephalopathy. A 59-year-old male presented with subacute-onset worsening encephalopathy and was found to be in non-convulsive status epilepticus (NCSE) requiring intubation and a midazolam infusion for refractory seizures. Electroencephalogram (EEG) revealed triphasic repeats with focal epileptogenic originating from the left parietal region. The patient continued to have up to 25-40 non-convulsive seizures per day. Cerebrospinal fluid (CSF) analysis revealed elevated 14-3-3 and tau protein. A real-time quaking-induced conversion assay in CSF was positive. The patient was diagnosed with probable sporadic CJD based on criteria from the Centers for Disease Control. Supportive treatment was provided. Cellular prion protein (PrP

36196308

Impact of COVID-19 Vaccination on Menstrual Cycle: A Cross-Sectional Study From Karachi, Pakistan.

Background The coronavirus disease 2019 (COVID-19) disease triggered a worldwide health catastrophe. To deal with this deadly situation multiple vaccines were developed and a mass immunization program started globally. However, vaccine hesitancy was seen, especially among women of reproductive age, having concerns that the vaccine might affect their menstrual cycle. This study investigated the link between COVID-19 vaccination and menstrual abnormalities. It is essential for us to understand the effects of vaccines on menstruation as menstrual distress can have effects on everyday life, and mental and reproductive health. Methods A cross-sectional study was performed using self-administered online forms to collect data from all over Karachi. The sample included 384 females aged 18 years and above. The data were collected from November 2021 to February 2022. Results Majority of the participants were aged 21 years and had a normal body mass index (BMI). Most were moderately stressed (n=245) with 146 reporting menstrual changes post-vaccination. The difference between the post-vaccine menstruation affected (n=146) and the unaffected cohort (n=238) was significant. Other factors which likely contributed to the post-vaccine menstrual changes included Perceived Stress Scale (PSS) score, strenuous physical activity, and the pre-vaccine menstrual flow. Conclusions Among the women vaccinated for COVID-19, strenuous physical activity and high perceived stress levels affected the menstrual cycle. There is no denying that existing data are inadequate, which is one of the grounds for vaccination apprehension, particularly among menstruating women. To minimize this hesitation, the spread of disinformation about the vaccine's influence on the menstrual cycle must be avoided. In future research and clinical trials, menstruation-related side effects should also be investigated when developing vaccines.

36196309

Crash Course in Orthopaedics: Development and Evaluation of a 12-Week Online Trauma and Orthopaedics Teaching Program for Medical Students During the COVID-19 Pandemic.

Introduction The COVID-19 pandemic caused significant disruption in clinical placements of medical students in the United Kingdom (UK), including trauma and orthopaedic surgery (T&O) rotations. Based on the British Orthopaedic Association (BOA) undergraduate syllabus, a 12-week online teaching program was designed to supplement T&O teaching for medical students across the UK while lockdown and social-distancing restrictions were in place. This study aims to describe the process of designing an online teaching program, evaluate the effectiveness of online education, explore medical student perceptions of the virtual learning environment, and report the lessons learned from this 12-week online program. Methods The "Crash Course in Orthopaedics" consisted of 12 webinars, with topics covering a range of acute and chronic T&O conditions, and was delivered through the online platform Zoom. Attendees were invited plete a post-course questionnaire retrospectively and the results were used in this study. Qualitative data was assessed using thematic analysis. Quantitative data were presented as descriptive statistics.  Results The webinar series was attended by approximately 5150 participants, with the largest demographic group being clinical medical students (49%). Results from the survey revealed three broad themes which were: 1). Interactivity: question + answer (Q+A), multiple choice questions (MCQs), online tools 2). Content: case examples, orthopaedic examinations, objective structure clinical examination (OSCE) tips  3). Accessibility: slides, recordings, duration of the session. Our study found that the online teaching program improved students' clinical knowledge of T&O and they found learning through interactive methods such as polls, the chat function on zoom, and case-based discussions to be most useful. Also, from the results of this study, a guide on "How to Run a Successful Webinar Series for Medical Students" was developed. Conclusion Online webinars effectively supplement T&O teaching and experience for medical students whose T&O placements were disrupted during the COVID-19 pandemic. The results will be a helpful guide to those planning medical education webinars in the future.

36196310

Surface-Guided Patient Setup Versus Traditional Tattoo Markers for Radiation Therapy: Is Tattoo-Less Setup Feasible for Thorax, Abdomen and Pelvis Treatment?

In this study, patient setup accuracy pared between surface guidance and tattoo markers for radiation therapy treatment sites of the thorax, abdomen and pelvis.

36196311

A Rare Case of Neglected Fifth Metatarsophalangeal Joint Dislocation.

The dislocation of the metatarsophalangeal joint of lesser toes is a rare entity. There is a dearth of literature on the same. Also, there is no case described for neglected fifth metatarsophalangeal dislocation in the literature. We present a case of neglected lesser toe dislocation, its natural course, and its e after surgical management. Our patient is an eight-year-old child with a neglected dislocation of the fifth metatarsophalangeal joint two years back. The patient did not seek treatment because he has no problem walking. Gradually, there is an abnormal growth of the metatarsal which causes pressure soreness and difficulty walking. The patient was managed surgically with open reduction and K-wire fixation with good long-term results. The dislocation of fifth metatarsophalangeal dislocation is rare and may not cause difficulty in walking due to less weight-bearing. But prompt treatment is necessary, especially in children as the bones have remaining growth potential and may lead to abnormal bone growth.

36196312

Hutchinson-Gilford Progeria Syndrome: A Literature Review.

Hutchinson-Gilford progeria syndrome (HGPS) is a premature aging condition that involves genetic mutations, resulting in debilitating phenotypic features. The present state of knowledge on the molecular pathways that contribute to the pathophysiology of HGPS and the techniques being tested 

36196313

Paraesophageal Hernia in a Newborn Mimicking Esophageal Atresia.

A defect of the esophageal hiatus can lead to herniation of the stomach or other abdominal organs into the thoracic cavity, a condition called hiatal hernia. They constitute a rare clinical entity during infancy and childhood and their symptoms can be non-specific or subtle, making the diagnosis difficult even for experienced clinicians. In all cases, surgical treatment of the defect is necessary because of plications. We present a rare case of a newborn with congenital paraesophageal hernia (CPEH) and microgastria, who was initially referred to our center with the diagnosis of esophageal atresia due to the inability to pass an orogastric tube beyond 15 cm from the gum margin. A contrast study revealed the CPEH. The patient underwent emergent surgery and has had no signs of recurrence until now. Although the diagnosis can be very tricky and mimic other conditions, a high level of suspicion should exist especially in patients with persistent symptoms of gastroesophageal reflux or recurrent respiratory infections. In neonates, signs and symptoms can be indicative of esophageal obstruction which should be ruled out with an upper gastrointestinal (GI) study.

36196314

Glycosylated Hemoglobin as an Independent Prognostic Marker in COVID-19 Patients With Diabetes Mellitus.

Objective The main objective of this study is to analyze the severity of coronavirus disease 2019 (COVID-19) among patients with diabetes mellitus using glycosylated hemoglobin (HbA1c) as a prognostic marker in predicting the e among these individuals. Methods This was a retrospective, observational study conducted in a tertiary care center during the first and second waves of COVID-19 in Salem, Tamil Nadu, for a period of one year (September 2020-September 2021). Numerous variables, including socio-demographic data, vitals, laboratory and radiological investigations, and end variables like mortality and morbidity due to COVID-19, were studied. Results Out of the 754 people admitted, 253 were diabetic, among which only 65 individuals fulfilled the criteria for participation. Among the 65 patients in the study, 21 had mild disease, 28 had moderate disease, among whom, two patients had HbA1c less than 7, 10 had between 7 and 8, 11 had between 8 and 10, and five had above 10, and 16 had severe disease, among whom one patient had HbA1c less than 7, 4 between 7 and 8, seven between 8 and 10, and four above 10. This was statistically significant (0.005). Conclusion The incidence of mortality was high among patients with prolonged uncontrolled diabetes mellitus with high HbA1c and among patients presenting plications like diabetic ketoacidosis (DKA), euglycemic ketoacidosis, and hyperglycemic hyperosmolar syndrome (HHS).

36196315

A Noteworthy Case of Bilateral Idiopathic Optic Perineuritis With No Perception to Light Eye.

The aim of this study is to report an interesting case of bilateral idiopathic optic perineuritis (OPN) presented with severe visual loss. A 64-year-old male with underlying hypertension, hypercholesterolemia, and schizophrenia presented with consecutively sudden onset of the right eye (RE) painless blurring of vision for two weeks and left eye (LE) painless blurring of vision for three days. The patient has no other symptoms such as red-eye, floaters, or headache. The patient had constitutional symptoms of loss of weight for the past three months; otherwise, he has no loss of appetite or persistent low-grade fever. Upon examination, RE visual acuity was no perception to light (NPL) at all quadrants, LE 6/36, and not improved with pinhole. The relative afferent pupillary defect (RAPD) was positive over the RE. Optic nerve functions of the RE were absent; meanwhile, over LE was reduced. The anterior segment was unremarkable, with no evidence of uveitis or dense cataract. Fundus examination showed diffuse 360-degree optic disk swelling with peripapillary splinter hemorrhage, mild tortuous vessel, and minimal vitreous hemorrhage inferiorly, with no evidence of neovascularization. The LE showed diffuse 360-degree optic disk swelling with normal macula and vessel. Magnetic resonance imaging (MRI) of the brain and orbit showed bilateral optic nerve sheath (ONS) enhancement with doughnut sign and tram-track sign. The patient was treated with bilateral OPN and started on intravenous methylprednisolone 1 g OD for five days followed by oral prednisolone 1 mg/kg OD with a tapering dose for one month. Patient visual acuity regained to RE 6/18 but did not improve with pinhole and LE 6/9 with full recovery of optic nerve function. Bilateral idiopathic OPN is a rare idiopathic inflammatory condition of ONS that typically presents with recurrent painless loss of vision with good recovery es with intravenous steroids.

36196316

Physiatrists' Attitudes and Knowledge About Cancer Rehabilitation.

Objective We aim to assess the awareness and evaluation pattern among physiatrists regarding cancer rehabilitation and associated barriers to access. Design The present study is a cross-sectional study in the Physical Medicine and Rehabilitation (PMR) Association Annual Meeting in Puerto Rico that used a 10-item questionnaire to summarize physiatrists' clinical patterns with their persons diagnosed with cancer (PDWCs). Results Thirty-eight (66.7%) participants answered they received minimal to no education about cancer rehabilitation benefits. Cancer patients represented 10% or less of the weekly patient load for 47 (82.5%) physiatrists surveyed. The mon type of cancer encountered was breast cancer for the management of adverse effects. Twenty-nine (50.9%) physiatrists answered that a multifactorial barrier was the cause for limited services within this population group. All participants agreed that rehabilitation is at least sometimes beneficial for cancer patients, and 54 (94.7%) believed these services are needed. Conclusion Although rehabilitation specialists learn about the benefits of rehabilitation for PDWCs, there continues to be a limited number of PDWCs evaluated, mainly due to poor access, lack of information about cancer rehabilitation, and economic difficulties. Further efforts should be made to emphasize the importance of integrating rehabilitation techniques in the care of PDWCs.

36196317

Patient Parameters Associated With a Positive Blood Culture Using NeuroShell: A Retrospective Chart Review.

Bacteremia is mon and life-threatening condition. It has an incidence of 140 to 160 per 100,000 person-years in the United States. Since bacteremia has many presentations, it can be challenging to diagnose. Subsequently there are very few guidelines on when to order a blood culture in an emergency setting. Neural networks are a means of machine learning and are presently being used in medicine to aid in decision making. With the use of machine learning, 22 variables that have been associated with infection and bacteremia were used to build a neural network to determine which variables associated with bacteremia are most associated with a positive blood culture.

36196318

Injectable Platelet-Rich Fibrin - A Revolution in Periodontal Regeneration.

As of a few years ago, platelet concentrates have been applied in a variety of medical and dental procedures. A notable aspect is that platelet-rich fibrin (PRF) is the monly utilized platelet concentrate in the field of dentistry. The most significant modification that was used over the years but had the biggest impact was injectable platelet-rich fibrin (I-PRF), which has more special properties. Additionally, the results of this I-PRF have been useful. The solid platelet-rich fibrin (PRF), which is a noticeable feature and has a low speed and duration in centrifugation, is the main advantage of I-PRF. I-PRF is primarily found in liquid form as PRF. It facilitates the quickening of increased vascularization and aids in accelerating the healing of wounds. An autologous blood concentration known as I-PRF has been known for many years. The advantage of I-PRF is that it exhibits constant release of growth factors and promotes cell migration by announcing the expression of type I collagen and transforming growth factor mRNA. The majority of the time, plastic and orthopedic operations use injectable platelet aggregates. It also reduces adverse reactions to transplanted material pared to other grafting techniques. Additionally, it makes numerous other operations, like regenerative ones, much better options. In circumstances where it has been noticed, I-PRF is helpful and crucial in periodontics for bone regeneration and wound healing. It is therefore not difficult to predict that this fully autologous blood concentrate, which is now being utilized in numerous applications and requires little invasiveness, will e even more frequently used in the future. This review paper contains the differences between platelet-rich plasma (PRP) and PRF, the development of diverse platelets, and the use of I-PRF in periodontal therapy.

36196319

Spica Casting of Pediatric Femur Fractures: The Pain Management Experience at One Institution.

Objectives Currently, very little literature exists regarding the "fifth vital sign" in pediatric orthopedics, pain. Multiple studies have highlighted the utility of non-narcotic pain medications in treating acute pain. The objective of this study is to determine the type and amount of pain medication(s) administered and subsequently prescribed to pediatric patients ages six months to five years old with femur fractures treated with spica casting in the ER (emergency room) and OR (operative room). We also determined the incidence of spica cast change necessary for the two groups as a secondary e. Methods A retrospective review pleted at a single level 1 pediatric trauma center, evaluating 82 patients who met the inclusion criteria between six months to five years of age with isolated femoral shaft fractures requiring intervention at one institution. Descriptive statistics and Wilcoxon Rank-Sum or Fisher'sFisher's Exact test were used to assess differences between OR and ER groups for either continuous or categorical variables, respectively. The electronic medical record was then queried for demographic information, location of spica cast placement, hours in the hospital, and amount and type of analgesic medications administered and prescribed. Results Overall, we noted a preponderance of femur fractures in young males (72%), with the mean age of our cohort being 2.3 years old. Our patients spent a median of 20.9 hours in the hospital and had a median worst pain score of 7/10 during their hospital stay. No difference was found between standardized amounts of morphine equivalent administration between groups in the hospital. Upon discharge from the hospital, most patients received opioid and acetaminophen prescriptions (72% and 83%), but few received an ibuprofen prescription (24.4%). More spica casts placed in the ER needed to be revised in the pared to spica casts placed in the OR (57% vs. 8%, p<0.01). Conclusions There are various medication regimens for patients with femoral shaft fractures treated with spica casting at one institution. Our study revealed that patients received more prescription opioids if treated in the OR. Additionally, spica casting in the ER did not significantly decrease hospital stay, and it significantly increased the risk of needing a reduction in the OR in our institution.

36196320

Listeria Monocytogenes Septicemia in the Setting of an Ulcerative Colitis Flare.

A 51-year-old patient with a history of ulcerative colitis was admitted after three days of bloody diarrhea and abdominal pain. The patient had been trialing different immunosuppressive therapies over the past year. An acute flare of ulcerative colitis was confirmed, and our patient began to improve upon IV methylprednisolone. Blood cultures on admission were positive for

36196321

Neurofibroma Within a Nevus Sebaceus: A Case Report.

Nevus sebaceus monly presents as a yellow, alopecic plaque on the head or neck in childhood and evolves into a verrucous plaque at puberty. Numerous secondary tumors may arise within nevus sebaceus lesions. Tumors of mesenchymal origin have been rarely documented. We present a unique case of a patient who presented with a nevus sebaceus on the scalp. Excision of the tumor and subsequent histopathology of the lesion revealed a nevus sebaceus with a desmoplastic trichilemmoma, a tumor of follicular infundibulum, and a neurofibroma. This case highlights a rare finding of a mesenchymal tumor, and the first reported neurofibroma, arising in association with a nevus sebaceus.

36196322

Application, Advancement, and Complication of Ureteral Stent and Encrustation: A Major Complication.

Three technological aspects have a significant impact on the functioning of an optimal stent. The substance it is made up of, model or design, and coating of the surface are important areas for research. To give recognition of an ideal stent, it summarizes some essential breakthroughs that occurred. Encrustation is a regular problem that can happen when a ureteral stent is implanted in the urinary tract, and it may be dangerous. The part of the paper covers the mechanism of encrustation, stent management, and the most recent technologies created to solve this problem. Encrustation has plicated and diverse mechanism that includes the time it stays inside, patient-specific risk factors, controlled film production, formation of biofilm, and deposition of minerals. A number of high-tech advancements in stent substances and coverings/coatings could help to reduce the danger of encrustation of stents. It's critical to determine the amount of encrustation of a stent so that therapy options can be tailored properly. For the care of ureteral stents, which are encrusted, we offer a unique therapeutic protocol. The duration of stent indwelling time has been repeatedly established to be a critical risk factor for the evolution of encrustation. The period of stent indwelling time has consistently been established to be a critical risk element for the evolution of encrustation. Patients who are predisposed to bacteriuria and urinary lithiasis are also predisposed to encrustation. Repeated urinary tract infections, diabetes, and chronic kidney failure are among the factors that might escalate urine bacterial load, which can lead to stent encrustation. Due to the prevalence of ureteral stents in urology, it's critical to keep up to date on the best ways to prevent stent encrustation, recognize high-risk patients, and remove them using multimodal techniques.

36196323

A Rare Case of Combined Langerhans Cell Histiocytosis and Adult-Onset Xanthogranuloma: A Case Report.

Langerhans cell histiocytosis (LCH) and adult-onset xanthogranuloma (AXG) are rare disorders characterized by the accumulation of macrophage, dendritic cells, or monocyte-derived cells in various tissues of the body. Many researchers now consider LCH a form of malignancy, but this classification remains controversial. As per our knowledge, there are only 36 cases of AXG reported so far in the English literature. Here, we report a case of AXG and single-system LCH found in the oral cavity and cervical lymph nodes, respectively. In this article, we intend to define a clear understanding of some classic clinical, radiological, and histopathological findings of LCH and AXG, to differentiate them from oral malignancies. The primary goal of this article is to increase awareness regarding conditions that closely resemble malignancies and to save patients from the burden of extensive treatment under the presumption of malignant disorders. In the medical field, reporting of rare cases is highly encouraged; however, proper treatment for the patient depends on the accurate diagnosis that, in this case, was made postoperatively, which only added more physical and mental distress for the patient and their family.

36196324

Accelerating Actions Against Malnutrition: A Call for Strengthening the Capacity of Health and Nutrition Program Staff in Devbhumi Dwarka, Gujarat.

Background The Integrated Child Development Services (ICDS), a flagship program of the Government of India, is addressing the malnutrition, health, and development needs of young children, pregnant and lactating women, and adolescent girls for more than four decades. Although the program has been implemented for the past four decades, it could not bring the expected es in terms of reducing malnutrition. The program's limited success can be attributed, among others, to insufficient skills of the program staff and inadequate convergence with the existing nutrition programs implemented through the health department. For the success of any program, advanced knowledge, improved skills, motivation, and the right attitude of the program staff are essential and can be instilled through the need-based training of the staff. The present study aimed at identifying gaps in existing training for health and ICDS program staff in the district and developing a capacity-building strategy to strengthen the implementation of the nutrition program in the district, including "Project Tushti," which aimed bating malnutrition in Devbhumi Dwarka district of the Gujarat state. Methods The training needs assessment (TNA) was conducted using a descriptive cross-sectional study design. TNA is a method to determine program gaps and training required to fill in programmatic gaps. Appropriate use of TNA can promote designing effective training and nurture program staff productivity, thereby ensuring efficient use of resources for achieving desired program es within the prescribed timeline. Considering the coronavirus disease 2019 (COVID-19)-led lockdown, convenient sampling was used to reach out to potential study participants. A total of 150 program staff from both health departments (particularly medical officers, taluka health officer, National Adolescent Health Program - Rashtriya Bal Swasthya Karyakram (RBSK) medical munity health officer from health and wellness center, female health workers, and Accredited Social Health Activists (ASHAs)) and ICDS team (chief district program officer, supervisor, Anganwadi workers, and helpers at Anganwadi center) were interviewed telephonically using a semi-structured interview guide. Interviews were conducted between May 10 and 16, 2020. Results Results reveal that about 49% of the health team and ICDS staff had not received nutrition-specific training in the last year. In terms of coverage, the training coverage was partial, and training content on nutrition was limited. Training contents were divided based on supervisory and implementing cadre feedback. Participants expressed the need for in-depth nutritional refresher training, including topics such munity-based management of acute malnutrition, identification of malnutrition, use of mon application software, and soft skills such munication skills and supportive supervision. Although 62% of participants preferred the face-to-face medium of training, they agreed with the online mode of training. Conclusion Findings indicate an urgent need for training, particularly in the district's nutrition domain for the staff involved in the implementation, and soft skills for supervisory level staff. Innovative training approaches using the digital platform can be explored for training delivery. The paper discusses innovative capacity-building strategies to address training needs effectively.

36196325

Prosthetic Rehabilitation of a Partially Dentate Patient With a Maxillary Cast Partial Denture and Mandibular Overdenture: A Case Report.

Using natural teeth as denture abutments can significantly slow the progression of residual ridge resorption. The abutments and the denture-bearing areas can share the stress concentration. By providing sensory feedback, occlusal stability loss, aesthetic loss, promised mastication, overdentures can help reduce residual ridge resorption. Overdentures have been shown to be effective in reducing residual ridge resorption and increasing retention and stability. When edentulous areas are too large or numerous for the fixed prosthesis and cross-arch stabilization is required, a cast partial denture (CPD) is preferred. The insertion and removal of the denture, as well as regular oral hygiene, are simple procedures. The current case report describes the prosthetic rehabilitation of a partially dentate patient using a maxillary CPD and mandibular overdenture.

36196326

The Role of Basal Ganglia and Its Neuronal Connections in the Development of Stuttering: A Review Article.

Dysfluent speech has the potential to lower one's standard of living drastically. Although there is a lot of theoretical support for basal ganglia dysfunction in developmental stuttering, there isn't any imaging data to back it up. According to several studies, there is a difference in gray matter volume between people who stammer and those who don't. According to studies, the right inferior longitudinal fasciculus and the uncinate fasciculus have higher fractional anisotropy (FA) than fluent controls. A high fractional anisotropy means good white matter integrity in these areas. In children who stutter, grey matter volume was higher in the Rolandic operculum, middle frontal gyrus, superior temporal gyrus, and inferior parietal lobule. These regions are found to be more active in adults who stammer as their speech fluency improves. Stuttering is previously linked to structural deficiencies in the corpus callosum. However, there are differences in the directionality of the findings between studies, which are unknown. According to current theories, stuttering is caused by a breakdown in the integration of auditory data in speech motor planning, which affects behavior tasks that rely on basal ganglia structures. According to some studies, connectivity in the left inferior frontal gyrus (IFG) and basal ganglia of persons with stuttering (PWS) was significantly reduced. Still, it was more robust in the left supplementary motor cortex (SMC) and premotor cortex (PMC) (primary motor cortex). In the Broca's region, there was also decreased perfusion and spectroscopic indicators of neuronal density. Spontaneous speech is more affected by stuttering than conversation, reading, sentence repetition, or singing. As per the dual process theory of language formation, the basal ganglia are essential for formulaic phrases, but the left hemisphere is important for innovative, freshly constructed sentences. According to current theories on their functional traits and connections to cortical areas of control, the basal ganglia are plex networks in charge of organizing, initiating, carrying out, and controlling motor behaviors.  Given the distinct neuroanatomical characteristics of people who stutter, more research into this cohort is required to further our understanding of the illness. The primary goal of this review article is to fill in any knowledge voids between the neuroanatomical structure of the basal ganglia and the onset of stuttering.

36196327

Outcomes of Catheter-Delivered Thrombolytic Therapy and Resuscitative Measures in a Cardiac Arrest Patient With Massive Pulmonary Embolism: A Case Report.

Acute massive pulmonary embolism is the most critical presentation of venous thromboembolism that needs early detection and management for a better e. We present the case of a 42-year-old female who presented to the emergency department plaining of acute dyspnea and descended into cardiac arrest. Working through the advanced cardiac life support guidelines and appropriate resuscitative measures, having high clinical suspicion supported by bedside ultrasound findings, massive pulmonary embolism was the most likely diagnosis, and so the patient was treated with thrombolytic therapy delivered via a central venous catheter. Return of spontaneous circulation was achieved, and consequently, she made plete recovery with no adverse neurological or hemodynamic sequelae. The aim of presenting this topic is to review the literature available on approaches to thrombolytic doses in life-threatening cases of massive pulmonary embolism and to add to an already ongoing discussion about the effects and es of various dosing regimens. The above facts will lead us to conclude that any discussion seeks to remind us of the primary management principle. All physicians should bear this in mind while managing any case ("

36196328

Dysphagia Lusoria: A Rare Cause of Adult Dysphagia.

Dysphagia lusoria is an unusual condition characterized by difficulty swallowing secondary pression of the esophagus by the aberrant right subclavian artery (ARSA). It occurs due to embryologic anomalies of the brachial arches, which are often unrecognized. Dysphagia is the prime presenting symptom in the majority, in addition to the other tracheoesophageal symptoms. Dysphagia lusoria can be diagnosed using barium swallow and puted tomography (CT) scan. We report a case of a young male who presented plaints of dysphagia.

36196329

Hemothorax From an Anomalous Bronchial Artery Bleed in an Infected Intralobar Pulmonary Sequestration.

Pulmonary sequestration is a rare congenital malformation. It represents 0.15-6.4% of all congenital pulmonary malformations. It is characterized by non-functional, dysplastic mass of lung tissue that is not munication with the normal tracheobronchial tree and is associated with a systemic arterial supply. We report a young gentleman in his mid-thirties who presented munity-acquired pneumonia from an infected intralobar pulmonary sequestration which subsequently developed a hemothorax from an anomalous bronchial artery bleed.

36196330

Clinical Presentation and Platelet Profile of Dengue Fever: A Retrospective Study.

Dengue fever (DF) is a mosquito-borne viral illness carried worldwide by

36196331

COVID-19-Induced Seizures: A Meta-Analysis of Case Series and Retrospective Cohorts.

The adverse events plications of coronavirus disease 2019 (COVID-19) continue to challenge the medical profession despite the worldwide vaccination against the severe acute respiratory coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. Other than typical respiratory manifestations, COVID-19 also presents a wide range of neurological manifestations. This article underlines the pooled incidence of COVID-19-induced seizures in patients with epilepsy and without epilepsy. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols, we conducted a bibliographical search, and an initial search revealed 1,375 articles. In total, 21 articles were included in the final analysis by following the inclusion criteria. A total of 11,526 patients from 21 published articles that met the predetermined search criteria were included. The median age of the patients was 61.9 years, of whom 51.5% were males. A total of 255 patients presented with seizures as the first manifestation of COVID-19 with a prevalence of 2.2% (95% confidence interval = 0.05-0.24, 

36196332

Delayed Diagnosis of Severe Hypoglycemia in a Septic Patient With Chronic Renal Failure.

High-dose vitamin C therapy has gained increased interest as an adjunctive treatment of septic shock, although convincing evidence is still lacking. High blood levels of vitamin C may interfere with several point-of-care blood glucose meters. We describe the case of a 67-year-old septic patient known with chronic renal failure who developed truly severe hypoglycemia, which was masked by spuriously high glucose values measured on a capillary blood glucose meter. This initially led to the treatment of spurious hyperglycemia with high-dose insulin and a delayed correct diagnosis and treatment, rendering substantial risk for the patient. Awareness of this dangerous interference is warranted.

36196333

An Overview of the Current State and Perspectives of Pharmacy Robot and Medication Dispensing Technology.

It has been widely reported that a large number of patients die from cases of errors in the issuing of medication prescriptions. These cases occur due to a wide range of things, but mon denominator in all of the cases is humans. A hospital pharmacy has a very critical task, especially with growing patient numbers. The increasing number of prescriptions needed to be filled daily reduces the amount of time that the staff can use to focus on each individual prescription, which may increase the human error ratio. The need for robotic-assisted pharmacies is arising from here to distribute drugs to eradicate or substantially reduce human error. The pharmacy robot is one of the most significant technologies that play a prominent role in the advancement of hospital pharmacy systems. The purpose of this review paper is to cover the pharmacy robot concept and the published literature reporting on pharmacy robot technology as one of the most important applications of artificial intelligence (AI) in pharmacology. Although the es of the impact of the pharmacy robot have been increasingly beneficial in overall improvement, staff morale, and functionality of pharmacies, there are still mechanical errors occurring. The errors, in turn, require human intervention. The key takeaway from this study is that robots or machines cannot replace human duties in their entirety. This in turn means that those human interventions will have an impact on the workflow and throughput.

36196334

Role of Non-pharmacological Interventions and Weight Loss in the Management of Gastroesophageal Reflux Disease in Obese Individuals: A Systematic Review.

With the increasing prevalence of obesity, the worldwide risk of gastroesophageal reflux disease (GERD) has also increased. Abdominal obesity increases intragastric pressure, disturbing the integrity of the gastroesophageal junction, thus facilitating reflux. Other than obesity, some lifestyle factors also cause GERD, including smoking, consumption of alcohol and caffeine, late-night meals, and high fat intake. This review study aimed to assess the impact of weight loss and lifestyle modifications on GERD. In this systematic review, the databases used were PubMed, PubMed Central (PMC), Science Direct, and Google Scholar. Boolean system and Medical Subject Headings (MeSH) strategy were used to form suitable keywords. Patients from the pediatric and geriatric populations were excluded from the study and quality assessment was done using different assessment tools. A positive association between obesity and GERD was found. It was also found that the long-term use of proton pump inhibitors (PPIs) plications, so lifestyle interventions should be used more than PPIs for treating GERD, especially in obese patients. We concluded that weight loss could lead to the resolution of gastroesophageal reflux disease, and therefore, conservative measures, including dietary modifications such as reducing the consumption of alcohol, caffeine, and chocolate, behavioral changes such as smoking cessation and elevation of the head of the bed, and weight loss, should be used as first-line management for GERD. Although awareness has increased regarding the adverse effects of proton pump inhibitors, future studies are required to assess these negative effects.

36196335

Clinical, Radiological and Pathological Appraisal of Acute Appendicitis in Al Qassim, Saudi Arabia: A Single-Center Retrospective Analysis.

Background Acute appendicitis can occur at any age but is rare among people of extreme age; it is mon in teenagers and young adults. Traditionally diagnosis is made on clinical grounds. In recent times imaging techniques have been deployed to improve diagnosis and reduce negative appendicectomy rates. The aim of the study was to describe mon clinical features of acute appendicitis among our patients, highlight the role of medical imaging, pare all these with the histological report of the excised appendix. Methods A 24-months retrospective review of all patients who underwent appendicectomy (July 1, 2019-June 30, 2021) for suspected acute appendicitis was performed. Medical records numbers of patients who had appendicectomies were retrieved from the operating room register. These numbers were used to access the hospital's electronic medical records database for the patients' records. These records were reviewed for biodata, clinical features, laboratory, medical imaging findings, and histological reports. Result In this hospital, 354 appendicectomies were performed. Only 336 plete data set suitable for further review. There were more males (N=257; 76.5%) than females (N=79, 23.5%), yielding a male to female ratio of 4:1. There were also more Saudi citizens (n=266, 79.2%), with the predominant age group being 11-30 years. Abdominal pain was the predominant symptom (100%) and was localized to the right iliac region in 331 (98.7%) of patients. Other symptoms recorded were anorexia (n=247, 73.5%), vomiting (n=190, 56.5%), and nausea (n=93, 27.7%). Atypical symptoms included diarrhoea (n=27, 8%) and constipation (n=12, 3.6%). Acute plicated appendicitis, and no appendicitis were the reported histological disposition in 174 (51.8%), 124 (36.9%), and 38 (11.3%) cases respectively. Abdominal CT scan had a higher sensitivity (98.6% vs 70.5%), higher diagnostic odd ratio (2.5 vs 1.4) and a lower miss (false negative) rate (1.4% vs pared to ultrasonography. However, the CT scan, from this study, has a rather low specificity (3.4%) and high false positive rates (96.5%). Open (n=205; 61%) and laparoscopic (n=131;39%) approaches were used for the appendicectomies. In our study, 44 patients were diagnosed with the decision to operate based on clinical grounds; and of this, 42 (95.4%; n=44) had confirmatory histology reports of appendicitis. Also, 38 patients had negative appendicectomy; giving a negative appendicectomy rate of 11.3%. This high rate may be due to the lower specificity and high false positive rate observed in this study. The plication rate was 21.4%, and this was solely due to surgical site infection, and this was mon with the open approach (p=0.001). Conclusion Suspected acute appendicitis was the sole indication for our appendicectomies. puterized tomography scan was a more reliable diagnostic tool than ultrasonography. Despite the fact that acute appendicitis is majorly a clinical diagnosis, and good clinical acumen is an excellent skill in the management of patients, we observed an overreliance on medical imaging for diagnosis. Open appendicectomies were mon, and surgical site infection was the plication of surgery. There was a relatively high negative appendicectomy rate for an image-assisted diagnosis.

36196336

Changes in Heart Rate Variability and Post-Exercise Blood Pressure from Manipulating Rest Intervals Between Sets of Resistance Training.

The purpose of this study was pare blood pressure and heart rate variability responses in physically active men after performing resistance training sessions with rest intervals of 1 min, 2 min and 3 min. Eighteen men (age, 21.6±1.1 years; body mass, 74.1±8.1 kg; body height, 175.3±7.1 cm) who performed 180min of physical activity per week participated in this study. After determining the 15RM loads for the squat, bench press, bent-over row and deadlift, participants performed a resistance training session. Participants performed three resistance training protocols in randomized counterbalanced order. Each experimental prised different rest intervals between sets of resistance training exercises (1min, 2min or 3min). During each experimental session, participants performed three sets with a 15RM load. Blood pressure and heart rate variability were measured before and for 2h after each session. The results demonstrated a greater blood pressure (p<0.05) reduction with a longer rest interval. There was no statistically significant difference in heart rate variability changes between groups. These results indicate that 2min and 3min rest intervals while using a 15RM load provide the best stimulus for a blood pressure reduction response after a resistance training session. Our findings suggest that strength and conditioning professionals should prescribe 2min or 3min rest intervals when resistance training is performed with a 15RM load if the aim is to obtain an acute reduction in blood pressure after a resistance training session.

36196337

Hand Grip Strength Vs. Locomotor Efficiency in Sitting Volleyball Players.

The objective of this paper was to determine the relationship between hand grip strength and movement time otor efficiency in a seated position using the upper and lower extremities) in sitting volleyball players. In addition, parison was made between the velocity curves for forward and backward otion. Nine male members of the sitting volleyball team participated in the study. Hydraulic and spring manual dynamometers were used to measure hand grip strength. Movement times were registered for distances of 1, 2, 3, 4, 5, 6 and 10-m with the use of the Smart Speed System photocells. Significant relationships between hand grip strength of the left (r

36196338

A Study Comparing Gait and Lower Limb Muscle Activity During Aquatic Treadmill Running with Different Water Depth and Land Treadmill Running.

Aquatic treadmill running is a partial weight-bearing exercise for rehabilitation. The purpose of this study was to investigate the surface electromyography activities of the rectus femoris, tibialis anterior, biceps femoris and medial head of gastrocnemius, and gait kinematics during aquatic treadmill running in water levels at waist, mid-thigh and mid-shin and on land. Seventeen healthy subjects (9 males and 8 females) were recruited by convenience sampling. Participants performed 2-min aquatic treadmill running at a specific speed for each water depth. The test speed was selected based upon the speed that elicited 110 steps per min. The surface electromyography data of lower limb muscles and the joint angles at three different water depths and on land were collected to evaluate the muscle activity and gait kinematics using a waterproofed surface electromyography system and inertial measurement unit for each muscle. Results showed that rectus femoris electromyography was different between depths during the swing and stance phases. Likewise, biceps femoris and tibialis anterior electromyography were different between depths for the swing phase. However, it was not the case for gastrocnemius electromyography. Peak flexion angles in both left and right hips were different between depths. A significant increase in a stance/swing ratio was observed with rising water depths. Water depth influenced muscle activity as well as kinematics. Aquatic treadmill running in the mid-thigh level should be further evaluated for its effectiveness, training value and applicability.

36196340

Neuromuscular Impact of Acute Hypertrophic Resistance Loading with And Without Blood-Flow Restriction.

Exploring acute neuromuscular fatigue induced by different modalities of resistance exercise would help understand the adaptation subsequent to specific training programs. Therefore, we investigated the acute impact of high-intensity and low-intensity blood flow-restricted resistance exercise on the development of explosive torque throughout the torque-time curve. Seventeen healthy, young participants were included in a randomized, counterbalanced within-subjects design study, in which participants underwent two experimental conditions, separated by a 1-wk period. Low-intensity blood-flow restricted exercise and high-intensity resistance exercise were performed using dynamic elbow flexion at 20 and 75% of 1 repetition maximum, respectively. Maximal voluntary contraction (MVC) and the sequential rate of torque development (absolute and relative) were measured before and after exercise. Both protocols elicited a similar decrement in MVC (~ 25%) and in the peak rate of torque development after exercise (~ 45%). The absolute rate of torque development (0-50 and 50-100 ms) was also reduced (p<0.05) similarly between conditions. After normalizing torque values to MVC, this was only sustained for the rate of torque development 0-50ms (p<0.05). We found that both exercise protocols induced similar acute attenuation of the absolute rate of torque development up to the first 100 ms of MVC. We also demonstrated that the reduction in the rate of torque development between 50-100ms (in both protocols) was largely explained by an acute deficit in muscle strength post-exercise. Conversely, the impact of each protocol on the first 50ms of muscle torque did not depend on lower levels of muscle strength after exercise.

36196339

Inter-Limb Muscle Property Differences in Junior Tennis Players.

The goal of this study was to investigate side-to-side differences and asymmetries regarding muscle characteristics in young tennis players. Thirty-four participants performed contractile property measurements (stiffness, tone, elasticity and time to relaxation) on the dominant and non-dominant extremities including nine muscle groups involved in the kinetic chain of main tennis strokes. Significant differences (p≤0.05) and small-to-moderate effect sizes for greater stiffness and tone were found for the dominant biceps femoris (-11.1% and -5.6%; ES=0.53 and 0.54) and the non-dominant vastus medialis (5.4% and 3.2%; ES=-0.33 and -0.41), while greater tone was present in the non-dominant pectoralis major (4.0%; ES=-0.56). Time to relaxation was increased in the dominant biceps femoris (10.3%; ES=-0.58), the non-dominant pectoralis major (5.1%; ES=-0.56) and the gastrocnemius (9.1%; ES=-0.5). The non-dominant infraspinatus and dominant rectus abdominis showed greater elasticity than contralateral muscles (9.9% and -8.0%; ES=-0.58 and 0.6, respectively). These results reflect the existence of small-to-moderate differences paring side-to-side values of contractile characteristics in a small amount of the muscle groups tested. However, passive measurements of a relaxed muscle do not seem to fully reflect possible adaptation and changes derived from gameplay in young tennis players.

36196341

Addition of In-Play Cooling Breaks During Intermittent Exercise While Wearing Lacrosse Uniforms in The Heat Attenuates Increases in Rectal Temperature.

To reduce the risk of heat-related illness, appropriate body cooling strategies are needed during men's petitions in hot-humid environments. The current study investigated whether additional in-play cooling breaks would attenuate the core (rectal) body temperature rise during exercise designed to mimic the activity patterns of a men's lacrosse match while wearing uniform in hot-humid environments. In randomized and counterbalanced order, ten physically active pleted two experimental prising four quarters of 15-min intermittent cycling exercises separated by a 10-min simulated half-time break and two 2-min quarter breaks in a climate chamber (35°C, 50% relative humidity). The two trials included a regular simulated match condition (REG) and a water break time out condition (WBTO) that included additional 2-min breaks 7.5-min into each quarter. Rectal temperature was significantly lower (p=0.017) in the WBTO condition pared with the REG condition (38.50±0.46°C) at the end of the 4th quarter. In addition, ratings of perceived exertion, thermal sensation, heart rate and the physiological strain index were significantly lower (all p<0.05) in the WBTO pared with the REG condition. The current results indicated that, even when wearing lacrosse uniforms, the implementation of WBTO attenuated the core body temperature elevation only in the latter stages of an intermittent cycling exercise protocol designed to mimic the exercise pattern of a men's lacrosse match. Therefore, WBTO may provide a feasible and effective cooling strategy for lacrosse players to reduce the risk of heat-illness.

36196342

Cognitive Factors in Elite Handball: Do Players' Positions Determine Their Cognitive Processes?

For an athlete to be successful at the professional level, he or she should be characterized by extraordinary preparation in four areas: physical, technical, cognitive (related to game strategy, perception, and decision-making), and emotional (coping, emotional control). This study aimed to determine the level of selected cognitive traits in handball players while considering their sports level and assigned position on the court. Fifty handball players participated in the study. Participants consisted of 35 national team players, six first-division players, and nine second-division players. There were no significant differences between players from the elite (national team) and the sub-elite (I and II divisions) group. The results identified major differences in selective attention and short-term memory between handball players assigned to different positions pared to players in other positions, had lower attention and short-term memory). Thus, it is possible to develop a more effective psychological training program. However, it must be remembered that the results showed great variability among handball players. With this in mind, individual differences should be taken into account when planning psychological interventions.

36196343

Movement Patterns of Polish National Paralympic Team Wheelchair Fencers with Regard To Muscle Activity and Co-Activation Time.

The aim of this study was to determine muscle co-activation and muscle activity time using EMG in Paralympic wheelchair fencers categorized into two disability-level groups: A (n= 7) and B (n= 9). The study was carried out with the use of a 16-channel EMG system. The surface EMG electrodes were placed on the fencer's body along nine channels: arm muscles - deltoideus middle head (DEL), triceps brachii (TRI) and biceps brachii (BC); forearm muscles - extensor carpi radialis longus (ECR), flexor carpi radialis (FCR); postural (abdominal and back) muscles - the right and the left external oblique abdominal (EOA RT and LT) and latissimus dorsi (LD RT and LT). To assess the relative level of co-activation (simultaneous contraction of both muscles) for the TRI-BC, ECR-FCR, LD RT-EDA RT and LD LT-EDA LT muscle pairs, the co-activation index (CI) was calculated. The collected data were processed using Jamovi. The study hypotheses were verified at the level of significance of p≤0.05 (Welch's t-test). The normal distribution of analyzed statistical features was checked with the Shapiro-Wilk test. The analysis of muscle activation time, as a percent ratio of three attempts executed in a series, confirmed the study assumptions. Fencers from Group A had a shorter activation time in all tested muscles, with the exception of the ECR (58.24), than fencers from Group B. This confirms that the activation of antagonist muscles representing a centrally programmed anticipatory mechanism stabilizing technical actions was particularly intensified in Group A fencers. The study results indicate that the standard co-activation index (CI) of key muscles involved in wheelchair fencing ranges from 48 to 51%.

36196344

The Importance of Posture and Body Composition for The Stability and Selected Motor Abilities of Professional Handball Players.

The aim of the research was to analyze position, body posture and postural stability of professional male handball players and to determine the differences between players with correct and incorrect body posture, considering power of the lower limbs and agility, speed, and change of direction deficit. The prised 16 professional handball players. position analysis was performed using the method of electrical bioimpedance. Body posture was examined using the Diers formetric III 4D optoelectronic method. Postural stability was tested via the Biodex Balance System. Players performed the following fitness tests assessing lower limb muscle power (LP, HS, CMJ), linear speed (SLS 20 m), and COD speed (Zig-Zag test, COD deficit). Only 31.25% of players demonstrated body posture with correct physiological curvatures, while 68.75% showed changes in body asymmetry. The group with correct body posture performed better in SLS 20m than the group with incorrect posture, yet in the Zig-Zag agility test, the difference in the results was not significant and this affected the COD deficit, which was higher. The vast majority of participants demonstrated postural defects and incorrect physiological curvatures of the spine. The occurrence of scoliotic posture was also observed. The body deflection angles indicated that athletes' postural stability was good. However, it is worth noting that the majority demonstrated a tendency towards asymmetrical body deflections to the right or to the left, backwards direction. One-sided sports specialization leads to disturbances in the statics of the body, therefore, it es necessary to include postural re-education exercises in training.

36196345

On-Court Change of Direction Test: an Effective Approach To Assess COD Performance in Badminton Players.

The aim of this research was to assess the reliability of a specific change of direction test (i.e., "On-Court COD test") in youth badminton players, evaluate the effect of age on On-Court COD performance, and examine its correlations with linear speed, change of direction speed, and vertical jump tests. Forty-two young badminton players (27 males and 15 females; age: 17.3±1.6 years, body height: 170.3±7.5 cm, body mass: 59.0±9.7 kg) were divided into two age groups (Under 17 years and under 19 years). Tests included: linear sprints (5, 10, and 20-m), bilateral/unilateral countermovement jumps, a hexagon test, traditional and modified 505 change of direction tests; and On-court COD. Results showed an excellent intraclass correlation coefficient score (0.90) and a very low coefficient of variation values (1.6%) for the On-Court COD test. Comparing age groups, under 19 players were significantly faster in linear sprints (i.e., 5, 15 and 20-m; small to moderate effect sizes) and in all change of direction tests (moderate to large effect sizes). Moreover, the On-Court COD test showed moderate to large (r=.513-.779) relationships with both acceleration and COD abilities in under 17 players, and with linear sprints, COD, and jump performances in under 19 players. These data indicate that the On-Court COD test is a useful and reliable means to assess COD performance in youth badminton players and it is associated with acceleration, sprint and jump performance.

36196346

Accuracy of Predicting One-Repetition Maximum from Submaximal Velocity in The Barbell Back Squat and Bench Press.

This study examined the accuracy of predicting a free-weight back squat and a bench press one-repetition maximum (1RM) using both 2- and 4-point submaximal average concentric velocity (ACV) methods. Seventeen resistance trained men performed a warm-up and a 1RM test on the squat and bench press with ACV assessed on all repetitions. The ACVs during the warm-up closest to 1.0 and 0.5m

36196347

The Repeated Curve Sprint Test Appears To Be an Appropriate Tool for Estimating Anaerobic Fitness in Young Trained Male Futsal Players.

This study aimed to determine the magnitude of correlation between the repeated curve sprint test (RCST), the running-based anaerobic sprint test (RAST) and the Wingate anaerobic test (WAnT) in elite male futsal players to determine whether the field test can be a futsal-specific alternative assessment pared to the other tests. Fifteen trained futsal players (20±3 yrs) performed the RCST, RAST and WAnT in a crossover design over three weeks. Peak power (PP), average power (AP) and the fatigue index (FI) were obtained from the tests. Finger-prick blood-lactate measurements were performed before and after the tests, and heart rate loading was recorded. To assess the magnitude and direction of the relationship between variables the Pearson's correlation coefficient (r) was calculated. In respect of AP, there was a significant correlation between the RCST and both the WAnT (r=0.63, p=0.012) and the RAST (r=0.67, p=0.006). In respect of PP, the RCST only correlated with the RAST (r=0.71, p=0.003). In respect of the FI, the RCST did not correlate with either the RAST or the WAnT (p>0.05). Post-test heart rate values in the RCST correlated with those in both the WAnT (r=0.88, p=0.001) and the RAST (r=0.77, p=0.001). Also, post-test blood-lactate levels in the RCST correlated with those in both the RAST (r=0.58, p=0.025) and the WAnT (r=0.54, p=0.039). In conclusion, the RCST can be a valid and practical field test for measuring anaerobic fitness petitive futsal players.

36196348

Anaerobic Variables As Specific Determinants of Functional Classification in Wheelchair Basketball.

Every parasport is currently encouraged to consider evidence-based classification to develop their respective classification system. Therefore, the aims of this study were to: (1) assess the relationship between trunk function and anaerobic power determining proficiency in wheelchair basketball, and (2) define "natural classes" in wheelchair basketball based on anaerobic power. Fifty-nine elite players (representing five national teams) were divided into four main functional classes: Group 1 (n=17), Group 2 (n=14), Group 3 (n=16), Group 4 (n=12). They performed the 6x10s Anaerobic Power Test using an arm crank ergometer. Average values of mean power, peak power, relative mean power, relative peak power, and power decrement were calculated for the 6x10s and 3x10s tests. The Spearman's correlation matrix revealed significant correlations between classes and values recorded in the 6x10s test. This confirmation between anaerobic power and players' classification endorses the division of players into different classes. Furthermore, cluster analysis (with fair quality) divided players into two "natural classes". The first resulting class was mainly formed of participants from Group 1 (71%). An plement to this research could be to consider wheelchair acceleration and the volume of trunk action in wheelchair basketball classification.

36196349

The Creation of Goal-Scoring Opportunities at The 2019 FIFA Women's World Cup.

The aim of this study was to analyse how goal-scoring opportunities (GSOs) were created at the 2019 FIFA Women's World Cup. The sample consisted of 868 GSOs that led to a shot at the goal throughout all 52 games during the tournament. All games were downloaded from the InStat platform. Descriptive statistics, chi-square of association and binary logistic regression analysis were used to analyse the data. Of the 868 GSOs, 81 (9.1%) resulted in goals. A significant association was observed between GSOs and the type of attack (χ

36196350

Training with a Heavy Puck Elicits a Higher Increase of Shooting Speed Than Unloaded Training in Midget Ice Hockey Players.

A method of load variability is mon way of developing specific skills in various sports, however, not explored considering the use of different ice-hockey pucks. Therefore, the purpose of this study was pare shooting speed, shooting accuracy, and handgrip strength changes after training with variable training loads (lighter 60g pucks and heavier 260g pucks) in the wrist shot and snapshot. Sixteen male ice hockey players (13.62±0.35y; 167.67±7.71cm; 53.87±7.55kg) were subjected to a 12 week experiment during which they trained six weeks with a light puck and six weeks with a heavy puck and were tested for shooting speed, shooting accuracy and handgrip strength. The variable load training increased shooting speed (the long hand snapshot by 7.4%, the shorthand snapshot by 8.5%, and the wrist shot by 13%), shooting accuracy (by 14%), and handgrip strength (by 8.7%) of the bottom hand; all at p<0.001. Training with heavy pucks was more effective (d=0.50-0.86) than training with lighter pucks (d=23-25) for increasing puck speed. Shooting accuracy was increased by variable load training with a similar effect of heavy and light puck training. The variable training load had a positive effect on shooting speed and accuracy and the use of a heavier load was more effective than using the unloaded puck. Variable load shooting training in youth ice-hockey players is more effective with heavier pucks than lighter ones, and the improvements are greater in players with better shooting skills.

36196351

Evidence-Based Recovery in Soccer - Low-Effort Approaches for Practitioners.

Strategies to improve recovery are widely used among soccer players at both amateur and professional levels. Sometimes, however, recovery strategies are ineffective, improperly timed or even harmful to players. This highlights the need to educate practitioners and athletes about the scientific evidence of recovery strategies as well as to provide practical approaches to address this issue. Therefore, recent surveys among soccer athletes and practitioners were reviewed to identify the recovery modalities currently in use. Each strategy was then outlined with its rationale, its physiological mechanisms and the scientific evidence followed by practical approaches to implement the modality. For each intervention, practical and particularly low-effort strategies are provided to ensure that practitioners at all levels are able to implement them. We identified numerous interventions regularly used in soccer, i.e., sleep, rehydration, nutrition, psychological recovery, active recovery, foam-rolling/massage, stretching, cold-water immersion, pression garments. Nutrition and rehydration were classified with the best evidence, while cold-water pression garments, foam-rolling/massage and sleep were rated with moderate evidence to enhance recovery. The remaining strategies (active recovery, psychological recovery, stretching) should be applied on an individual basis due to weak evidence observed. Finally, a guide is provided, helping practitioners to decide which intervention to implement. Here, practitioners should rely on the evidence, but also on their own experience and preference of the players.

36196352

The Effects of Preferred Music and Its Timing on Performance, Pacing, and Psychophysiological Responses During the 6-min Test.

The aim of this study was to investigate the effects of listening to preferred music during a warm up or exercise, on performance during a 6-min all-out exercise test (6-MT) in young adult males. Twenty-five healthy males volunteered to participate in this study. Following a within subject design, participants performed three test conditions (MDT: music during the test; MDW: music during the warm-up; WM: without music) in random order. es included mean running speed over the 6-min test (MRS6), total distance covered (TDC), heart rate responses (HR

36196353

Validity and Reliability of The Smart Groin Trainer for Measuring Hip Adduction Strength.

We analyzed the Smart Groin Trainer device's validity and reliability to measure the isometric hip adduction strength during the adductor squeeze strength test. Fifteen professional soccer players (25.33±4.06 years) and fifteen university students (21.60±1.76 years) participated in this study. All participants performed the squeeze strength test using two portable dynamometers: Smart Groin Trainer and Globus Ergometer. Three maximal isometric hip adduction contractions lasting 5s, interspersed by 3min rest intervals, were performed. Reliability was analyzed with intraclass correlation coefficients, standard error of measurements, and minimal detectable change. The absolute percent error and inter-device accuracy were also analyzed. Correlation analysis assessed the inter-device concurrent validity. The results found no significant differences (p>0.05) between devices in the squeeze strength test values in soccer players and university students. parisons revealed excellent levels of reliability and accuracy in soccer players. Concurrent validity measures revealed strong inter-device relationships in soccer players (r=0.89) and very strong relationships in university students (r=0.99). Intra-device analysis using the Smart Groin Trainer showed excellent relative and absolute reliability in tested soccer players. Our data demonstrated excellent levels of agreement between both dynamometers during the squeeze strength test, suggesting the Smart Groin Trainer as a valid, reliable, and accurate device to measure isometric hip adduction strength.

36196354

Influence of Tactical Behaviour on Running Performance in The Three Most Successful Soccer Teams During the Competitive Season of The Spanish First Division.

The purpose of this study was to analyze the influence of tactical behavior on physical performance of the three best Spanish soccer teams. Team 1 employed a 1-4-4-2 formation pact defence and direct attacks, Team 2 employed an indirect style of play with a 1-4-3-3 formation and Team 3 used a 1-4-3-3 formation with elaborate attacks and strong counter-attacks. 816 individual situations of 54 professional soccer players categorized as fullbacks (FB), central defenders (CD), central midfielders (MF), wide midfielders (WM), and strikers (S) were included in the analysis. Their performance was examined with a player-tracking system. The analyzed variables included total distance covered, distance covered above 14, 21 and 24 km·h

36196355

Post-Activation Performance Enhancement in Sprinters: Effects of Hard Versus Sand Surfaces.

This study aimed pare the post-activation performance enhancement induced by successive drop-jumps performed on hard and sand surfaces in sprint and jump performance of top-level sprinters. Athletes were tested on two occasions. On each visit they were allocated to one of the experimental protocols, which consisted of performing 2x5 drop-jumps from a box with the height of 60-cm on hard or sand surfaces in randomized order, seven days apart. Prior to and 7 and 15-min after executing drop-jumps, sprinters performed countermovement jumps and 60-m sprint tests. Differences between sprinting splits and surfaces were assessed using a two-way analysis of variance with repeated measures. No significant differences in jump height or sprint time were observed (p>0.05), regardless of the surface used (i.e., hard or sand) during the conditioning activity (effect sizes [95% confidence intervals] ranging from 0.01 [-0.84;0.84] to 0.44 [-0.42;1.27]). Performing drop-jumps on sand or hard surfaces immediately before maximum sprinting bouts does not provide any advantage or disadvantage to top-level sprinters. Sprint coaches may prescribe short-plyometric training activities on sand surfaces even close petitions, bearing in mind that this strategy will promise sprint-specific performance.

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Assessing the Sprint Force-Velocity Profile in International Football Players with Cerebral Palsy: Validity, Reliability and Sport Class' Profiles.

This study assessed and described the Sprint Force-velocity (SFv) profile, and its validity and reliability in international cerebral palsy (CP) football players. Twenty international male CP football players (age: 26.9±7.4) performed a 30-m sprint, a vertical jump (CMJ), a change of direction (MAT), a dribbling and an intermittent endurance (Yo-YoIR1) test. The SFv profile and physical performance variables were shown according to the players' sport class with the estimation of the effect sizes between classes. The SFv showed high reliability (ICC=0.77 to 0.99; SEM=0.89 to 8.66%). Validity for the SFv was provided by its positive correlation with the players' sport class (r=0.53 to 0.75; p=.02 to <.01) and the rest of the physical performance tests (r=0.45 to 0.99; p=.04 to <.01). The RFmax was the main SFv profile variable that explained players' performance in the rest of the tests (β=0.77 to 1.0; p<.05; R2=0.59 to 0.99). The SFv profile seems to be an efficient test to assess international CP football players' physical performance. This provides information about the players' individual sprint mechanical characteristics and their sprint strengths and weaknesses, allowing coaches and conditioning trainers to individualize their training interventions to optimize sprint performance.

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Handcycling Training in Men with Spinal Cord Injury Increases Tolerance To High Intensity Exercise.

Individuals with spinal cord injury are characterised by reduced physical capacity pared to able-bodied persons, and are at risk of developing cardiovascular disease. The study aimed to evaluate the differences in physiological responses to an exercise test in handcycling-trained vs. able-bodied-trained and non-trained men. Eight males with spinal cord injury who were trained in handcycling, eighteen able-bodied males who were trained in powerlifting, and fourteen physically active non-athletes performed a graded arm crank ergometer test. The following physiological indices were measured before and during the test: heart rate, oxygen uptake, and blood lactate concentrations. Aerobic capacity was significantly higher in athletes with spinal cord pared to able-bodied athletes (p<0.01) and the control group (p<0.01). The heart rate achieved by handcycling-trained athletes was significantly lower pared to powerlifters (p<0.01), however, the oxygen pulse was significantly higher (p<0.05). Handcycling-trained athletes reached significantly higher peak power (P

36196359

Genetic Polymorphism of NQO1 Gene is Associated with Susceptibility of Ischemic Stroke in Chinese Han Nationality.

NAD(P)H: Quinone Oxidoreductase 1 gene (NQO1) polymorphism is associated with the risk of cardiovascular disease. This study was designed to investigate the relationship between NQO1 gene polymorphism and ischemic stroke susceptibility in Chinese Han nationality.

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Anomalous and heterogeneous characteristics of the BOLD hemodynamic response function in white matter.

Detailed knowledge of the BOLD hemodynamic response function (HRF) is crucial for accurate analyses and interpretation of functional MRI data. Considerable efforts have been made to characterize the HRF in gray matter (GM), but much less attention has been paid to BOLD effects in white matter (WM). However, several recent reports have demonstrated reliable detection and analyses of WM BOLD signals both after stimulation and in a resting state. WM and GM differ position, energy requirements, and blood flow, so their neurovascular couplings also may well be different. We aimed to derive prehensive characterization of the HRF in WM across a population, including accurate measurements of its shape and its variation along and between WM pathways, using resting-state fMRI acquisitions. Our results show that the HRF is significantly different between WM and GM. Features of the HRF, such as a prominent initial dip, show strong relationships with features of the tissue microstructure derived from diffusion imaging, and these relationships differ between WM and GM, consistent with BOLD signal fluctuations reflecting different energy demands and neurovascular couplings in tissues of position and function. We also show that the HRF varies in shape significantly along WM pathways and is different between different WM pathways, suggesting the temporal evolution of BOLD signals after an event vary in different parts of the WM. These features of the HRF in WM are especially relevant for interpretation of the biophysical basis of BOLD effects in WM.

36196358

Predictors of Positive Subxiphoid Pericardial Window in Stable Patients with Penetrating Injuries to the Precordial Region.

Subxiphoid pericardial window (SPW) remains a valuable diagnostic tool for patients at risk of occult cardiac injuries. However, how to select patients that could benefit from this procedure remains unclear. We aimed to identify clinical predictors of positive SPW in patients with penetrating precordial injuries.

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Telepathology in Nigeria for Global Health Collaboration.

Inadequate pathology personnel and high cost of running a Pathology facility are factors affecting access to timely and quality pathology services in resource-constrained settings. Telepathology is a novel technology that allows Pathologists to remotely assess collected samples. Though the initial cost of setting up a telepathology facility is high, its overall benefits far outweigh the cost. Its usefulness as a quality assurance measure, as a permanent image data storage system, in reducing costs associated with repeated slide preparations, reducing turn-around time of pathology reports, in collaborative research and in teaching has been well documented. This paper highlights the experiences, gains and challenges encountered in the deployment of telepathology in two resource-constrained settings in Nigeria. ing the challenges associated with setting up a telepathology service in sub-Saharan Africa is important as it has the potential to improve overall health es in a medically underserved region while ensuring technology and knowledge transfer are achieved.

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The Use of Drones in the Area of Minimizing Health Risk during the COVID-19 Epidemic.

Despite their general availability, drones are not currently widely used in emergency medicine, distribution of medication and other medical products, as well as in epidemiological emergencies, in which limiting interpersonal contact is crucial for minimizing the public health risk. Given the current epidemiological situation, it is pertinent to consider, whether implementing activities with the use of drones can significantly contribute to minimizing health risks, and whether such initiatives are acceptable in the light of applicable legal regulations. The main objective is supported by an analysis of the usefulness of applicable provisions, indicating the direction of possible changes in existing legal regulations. Additionally, the article aims to demonstrate the feasibility of drone use in activities related bating epidemics, as well as to emphasize their practical importance. Reports on mercial use of drones in the distribution of goods and services have also been used as material prehensive analysis. Simultaneously, the article also includes data on quantities of equipment available to healthcare units in Poland for saving life and health. The present work uses the method of analysis of applicable legal regulations, as a criterion for the usefulness of existing solutions in the area of improving the quality of medical services, including preventive measures bating the effects of an epidemic.