Littérature scientifique sur le sujet « 616.993 83 »

Background and Objectives Traditionally, transoral laser microsurgery (TLM) is commonly used to treat early glottic cancer. However, the long-term oncologic results have not been thoroughly investigated. Therefore, this study aimed to analyze long-term oncologic outcomes of TLM for early glottic cancer.Subjects and Method We retrospectively studied 132 patients who underwent TLM for early glottis cancer from January 2001 to August 2020. We assessed overall and disease-free survival according to the T classification and types of cordectomy proposed by the European Laryngological Society in 2007.Results Of the 132 patients, 125 were male and 7 female. The mean age was 61.6±9.3 years. We found 5 (3.8%), 112 (84.8%), and 15 (11.3%) patients staged as CIS, T1, and T2, respectively. For the cordectomy types, there were 6 in type I, 22 in type II, 83 in type III, 6 in type IV, 13 in type V, and 2 in type VI. Ten-year overall and disease-free survival rates were 99.2% and 87.1%, respectively. Overall and disease-free survival curves were not different according to different T classification and cordectomy types.Conclusion TLM is an excellent treatment modality for the long-term oncologic control of early glottic cancer.

613 Background: Several IO-COMBO regimens are under investigation in front-line mRCC. The clinical outcome of pts who progress on an IO-COMBO regimen and receive subsequent systemic therapy is unknown. Methods: A retrospective analysis of all pts with clear-cell mRCC enrolled in one of seven clinical trials investigating an IO-COMBO at Cleveland Clinic Taussig Cancer Institute and Barts Cancer Institute was conducted. Clinical outcome of subsequent therapy including best objective response according to RECIST v1.1, progression-free survival (PFS) and adverse events (AEs) using CTCAE v4.0, were collected. Results: From a total of 89 pts enrolled on an IO-COMBO trial, final analysis included 32 pts with PD who received ≥1 line of subsequent therapy, median age 57 (41-77), 83% male, 72% ECOG 0, 78% IMDC fav-/intm- risk. Prior IO-COMBO included atezolizumab/bevacizumab (n = 20), ipilimumab/nivolumab (n = 10) and axitinib/avelumab (n = 2). All except 1 pt received IO-COMBO in the front-line setting. All pts received 1 subsequent therapy (axitinib n = 15; pazopanib n = 9; sunitinib n = 4; cabozantinib n = 3; nivolumab n = 1) after progression on IO-COMBO, 12 pts were treated with a second subsequent therapy and 5 pts were treated with ≥3 subsequent lines of treatment. For pts with available response (n = 26), the overall best response to first subsequent therapy was 27% PR, 50% SD and 15% PD. Median PFS for the first subsequent therapy was 7.9 months (95% CI, 4.5-11.3) with 8 pts remaining on treatment. The median PFS for pts previously treated with a combination of IO plus anti-VEGF was 7.9 months (95% CI, 3.1-12.7) and was 9.3 months (95% CI, 3.5-15.0) for pts treated with a prior IO plus IO combination (p = 0.732). The most frequent G3/G4 treatment-related AEs observed with first subsequent therapy were LFT elevation (9%) and diarrhea (7%); 2 pts discontinued subsequent treatment due to toxicity. Conclusions: VEGF-TKIs have clinical activity in mRCC refractory to IO-COMBO therapy, possibly impacted by the inclusion of an anti-VEGF agent in prior IO-COMBO therapy. Subsequent therapy was in general well tolerated.

The purpose of the current study was to examine the effect of flavor on voluntary drinking and thermoregulatory responses in Chinese boys and girls exercising intermittently in a hot environment. Fourteen boys and girls (9 to 11 years old) performed four 3-hour intermittent exercise sessions (20-min walking sessions at 50% VO2peak followed by a 25-minute rest period) in a hot and humid environment (~30 °C ambient temperature and ~70% relative humidity). The participants consumed 1 of 4 beverages ad libitum in a randomized sequence by using a Latin-square principle: unflavored water (W), orange-flavored water (OF), lemon-flavored water (LF), and grape-flavored water (GF). No differences were observed in the total fluid intake (W vs. OF vs. LF vs. GF: Boys, 441 ± 114 vs. 493 ± 106 vs. 387 ± 83 vs. 568 ± 146 ml; Girls, 613 ± 131 vs. 923 ± 204 vs. 825 ± 157 vs. 790 ± 166 ml), urine and sweat output, and physiological perceptual variables among trials and between sexes. The results suggested that Chinese children can maintain body fluid balance while exercising moderately in a hot and humid environment by ad libitum drinking. The flavor of the beverages had no impact on the voluntary drinking and the state of hydration in the current study.

IntroductionScreening programs for perinatal depression are systematicly implemented in developed countries. To circumvent the most commonly pointed limitation by the primary healthcare professionals (the questionnaires length), we have developed shorter forms of the Beck and Gable Postpartum Depression Screening Scale-35. The shortest version consists of seven items, each one representing a dimension evaluated by the PDSS. This PDSS-7 demonstrated equal levels of reliability and validity as the 35-item PDSS with the advantage of being completed in as little as 1-2 minutes(Pereira et al. 2013).ObjectivesTo analyze the construct validity of the PDSS-7 using Confirmatory Factor Analysis, to use both in Portugal and in Brazil.MethodsThe Portuguese sample was composed of 616 women (Mean age: 32.29±4.466; Mean gestation weeks=17.13±4.929). These participants were not the same who participated in the psychometric study that led to the selection of the seven items. The Brazilian sample was composed of 350 women (Mean age: 30.01±5.452; Mean gestation weeks=25.17±6.55). They all had uncomplicated pregnancies and completed the European/Brazilian Portuguese versions of PDSS-24 (Pereira et al. 2013/ Barros et al. 2021), which was composed of the same items and included the seven items that compose the PDSS-7.ResultsThe unidimensional model of PDSS-7 presented a good fit in both samples (Portuguese/Brazilian: χ2/d.f.=3.439/2.653; RMSEA=.066/.069, CFI=.974/.981, TLI=.947/.957, GFI=.939/.957; p<.001). The PDSS-7 Cronbach’s alphas were .82/.83 and all the items contribute to the internal consistency.ConclusionsThe PDSS-7 is a valid and precise, economic, fast and easy screening instrument for perinatal depression, a major public health problem, both in Portugal and in Brazil.

Background: Bronchoscopy can play a major role in both diagnosis and treatment. Diagnostic bronchoscopy is a useful tool for the diagnosis of pulmonary lesions particularly bronchogenic carcinoma and pulmonary tuberculosisAim: To find out the role of fibre-optic bronchoscopy in the diagnosis of pulmonary diseases.Methods: This observational study was conducted in the Indoor patient, Department of Medicine in Rangpur Medical College Hospital. Of all patients aged 18 years and above Undiagnosed pulmonary lesion in the medical wards between October 2012 to October 2014.Results: Out of 256 cases, mean age ±SD was 61.01(±11.51), minimum age was 23 and maximum age was 86 years. Majority 84% were male and 16% were female. Most of the respondent were smoker whereas (82%). Most common presenting complains were cough, dyspnoea, haemoptysis and fever 83%, 59.3%,53% and 36% respectively. General Physical examination findings, 97% were anamia and clubbing were 41% and cyanosis 02%. Respiratory system examination findings, 54% were features suggestive of complete collapse, 15% features suggestive of consolidation and 31% normal chest findings. Chest x-ray findings of the study population, 25.8% were dense homogenous opacity involving right or left lung field, 17.9% were complete collapse of affected lungs , 5.5% were right middle lobe collapse, 4.3% Unilateral hilar lymphadenopathy, 7.03% were elevation of hemidiaphragm of affected site and 7.03% were pleural effusion. 6.6% patient had normal CxR. In present study shows bronchoscopic findings in patients studied, Vocal cord paralysis were 9.3%, Right main bronchus were 15.6% , Right upper lobe bronchus were 7.03% , Right middle lobe bronchus were 7.8%, Right lower lobe bronchus were 9.8%, Left main bronchus were 14% , Left upper lobe 4.3%, Left lingular were 1.9% and Left lower lobe bronchus were 9.3%.In this study shows histologhical findings majority 18% were squamaus cell carcinoma,8.2% were small cell carcinoma,2.3% were adeno carcinoma,6.6% infiltration of Inflammatory cell and granuloma 1.2%.Conclusion: In this study male are predominant. Most of the respondent was smoker. Most common presenting complains were cough, haemoptysis, fever and chest pain. Most of general physical examination findings were anamia and clubbing. Respiratory system examination findings were features suggestive of complete collapse, features suggestive of consolidation and normal chest findings. chest x-ray findings of the study population were complete collapse of affected lungs, rtight middle lobe collapse, Dense homogenous opacity involving right or left lung field, Unilateral hilar lymphadenopathy. Bronchoscopic findings were vocal cord paralysis, right main bronchus, right upper lobe bronchus, right middle lobe bronchus, right lower lobe bronchus, left main bronchus, left lingual and left lower lobe bronchus. Histologhical findings majority were squamaus cell carcinoma. Most of the patient poorly differentiated carcinoma among the study subjectsBangladesh J Medicine Jan 2016; 27(1) : 16-21

e22020 Background: The pediatric cancers is in the global agenda to improve the survival rates which is still low in LMICs although it is more than 80% in HICs. More than 300.000 pediatric cancer cases annually are expected in children and adolescents aged 0-14 globally. Registry is the first step of an efficient cancer control. Here, we present the most updated results of the pediatric cancer registry fromTurkey. Methods: Turkish Pediatric Oncology Group and Turkish Pediatric Hematology Association has established the pediatric cancer registry in 2002. The childhood cancer cases registered between 2009-2021 was included in this analysis. International Childhood Cancer Classification System was used for the classification. Essential demographic findings, ICD-O-3 morphology and topography codes were recorded for each case. Results: During the 13 years from 2009 to 2021, 24080 cases were registered. For all cases, median age was 6.7 year (0-19; M/F 13461/10609, 4 hermaphrodite, 6 unknown). Age distribution was 0-4 yrs, 40.8%; 5-9 yrs, 23.8%; 10-14 yrs, 23.3%; 15-19 yrs, 12.1%) The distribution of the tumor types were [number of cases, percentage of total, median age yrs, M/F]: Leukemia (5819, 24.2%, 5.5, 3366/2453); Lymphoma & other RES tumors (4446, 18.5%, 9.8, 2956/1487, 1 hermaphrodite & 2 unknown); CNS [brain & spinal] (3730, 15.5%, 6.8, 2061/1668, 1 unkown); Symphatetic system (1965, 8.2%, 2.3, 1010/955); Retinoblastoma (675, 2.8%, 1.4, 375/300); Renal (1160, 4.8%, 3.1, 557/601, 1 hermaphrodite & 1 unknown); Liver (409, 1.7%, 2.2, 234/175); Malignant bone (1584, 6.6%, 12.6, 864/720); Soft tissue sarcomas (1726, 7.2%, 7.7, 983/743); Germ cell (1593, 6.6%, 9.6, 588/1001, 2 hermaphrodite, 2 unknown); Carcinoma & other malignant epithelial (804, 3.3%, 13.5, 381/423); Other/non-specific malignant (169, 0.7%, 7.9, 86/83). Five year survival rate was found as 72.3%. Conclusions: The registry shows that the survival rates for children and adolescents have been improved to 72% which reflects the status of the pediatric cancer care in Turkey. The data from this work became a valuable source for all stakeholders in national and international level working on improvement the pediatric cancer control.

Introducción: el parasitismo es uno de los principales problemas de salud y producción animal en Colombia, como lo es en otros países de la región; por lo tanto, es importante identificar aquellos más frecuentes con el propósito de considerar estrategias de prevención y control. Este trabajo se realizó con el objetivo de aportar al conocimiento sobre los endoparásitos y ectoparásitos presentes en los équidos sacrificados entre octubre y diciembre de 2015 en la Planta de Beneficio Villa Rosa, Piedecuesta, Santander, Colombia. Metodología: para la identificación de los ectoparásitos y hemoparásitos se utilizaron 83 équidos, y 75, para los parásitos gastrointestinales. Los ectoparásitos se colectaron directamente de la piel y para los hemoparásitos se utilizaron las técnicas de hemocultivo, Woo, preparaciones en fresco, extendidos coloreados y Knott. Los parásitos gastrointestinales se estudiaron mediante las técnicas de McMaster, sedimentación-flotación, cultivo de heces y necropsia helmintológica. Resultados: el 31,32 % de los équidos examinados estaban parasitados con Anocentor nitens y el 8,43 % presentó infestación mixta con Amblyomma cajennense s.l. El piojo Haematopinus asini fue colectado en un animal. Salvo la presencia de microfilarias de Setaria equina en 7,2 % de las muestras, no se detectaron hemoparásitos con los procedimientos parasitológicos empleados. Se observaron huevos tipo Strongylida en 88 % de las muestras; Dictyocaulus sp. en 6,6 %; Parascaris sp. en 5,33 %; Oxyuris sp. en 5,33 %; Strongyloides sp. en 1,33 % y Anoplocephala sp. en 9,3 %. En el cultivo de heces se observaron 12 larvas L3 de la subfamilia Cyathostominae o “pequeños Strongylus” y una del nematodo Trichostrongylus axei. En las necropsias se hallaron adultos de: Habronema megastoma, Setaria equina, Oxyuris equi, Strongylus sp., Triodontophorus, Cyathostominae y Anoplocephala perfoliata. Conclusiones: los parasitismos por garrapatas, grandes y pequeños estróngilos y tenias, son frecuentes en los equinos sacrificados. Se recomiendan técnicas serológicas y moleculares para detectar hemoparásitos en estudios posteriores.

Background: Four million newborn babies die in the neonatal period, India 1.2 million neonatal deaths every year. India contributes for a quarter of global neonatal deaths and thus faces the biggest newborn health challenge of any country in the world. The aims of the study were done with the objective to conclude the morbidity and mortality pattern of neonates admitted to a neonatal intensive care unit (NICU).Methods: Hospital based prospective study was conducted at NICU Government Medical Collage, Srikakulam, Andhra Pradesh, India. Neonates from admission to discharge flowed, LAMA or death collecting the data by using a predesigned standardized preform.Results: Neonates were admitted in the NICU during period April 2014 to March 2019. The data analysis for the morbidity showed that the neonatal jaundice (NNJ) were 765(10.57%) , septicemia were 1110 (15.34%), prematurity were 593 (8.19%), birth asphyxia were 963 (13.30%), respiratory distress syndrome (RDS) were 184 (2.54%),hypoxic ischemic encephalopathy (HIE) were 984 (8.46%), meconium aspiration syndrome (MAS)were 612 (8.46%),transient tachypnea of neonate (TTN) were 634 (8.76%), low birth weight (LBW) were 418 (5.77%), intra uterine growth retardation (IUGR) were 179 (2.47%), congenital anomalies were 131 (1.81%), meningitis were 83 (1.15%), seizure disorder were 49 (0.68%) and others. The disease wise mortality among the neonates admitted to NICU was studied and were found that prematurity 212 (35.75%), septicemia were 74 (6.67%), birth asphyxia were 91 (21.70%), meconium aspiration syndrome were 70 (11.44%) and respiratory distress syndrome were 66 (35.87%), low birth weight were 102 (24.40%) congenital anomalies were 31 (23.66%) the top major contributors to the neonatal mortality.Conclusions: The commonest causes of admission were neonatal jaundice (NNJ), sepsis, prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies. The most common cause of case fatality was prematurity, meconium aspiration syndrome, birth asphyxia, low birth weight, congenital anomalies in NICU in a tertiary care teaching hospital, government medical college, Srikakulam, Andhra Pradesh, India.

Self-medication is an important issue, especially in developing countries. Self-medication is the concept in which individuals use medicine to ease and manage their minor illnesses. The current survey was designed to conduct interviews at different universities based on the availability of the students from August 2021 to October 2021 in Hazara region of Khyber Pakhtunkhwa (KPK), Pakistan. Overall, 1250 questionnaires were distributed to students from various departments. Students of microbiology (n = 305, 24.4%) and agriculture 236 (n = 18.8%) were the most elevated members in this study, while other participants were from medical lab technology (n = 118, 9.4%), chemistry (n = 103, 8.2%), food science (n = 92, 7.3%), business administration (n = 83, 6.6%), sociology (n = 78, 6.2%), math/physics (n = 6, 14.8%), Pak study (n = 58, 4.6%), English (n = 47, 3.7%), and psychology (n = 19, 1.5%). Students working towards their Bachelor numbered (n = 913, 73.0%), Master (minor) numbered (n = 80, 6.4%), Master (major) numbered (n = 221, 17.6%), and Doctorate numbered (n = 36, 2.8%). The age group of participants was majorly 20–25 years (61.0%), while others belonged to the age groups 25–30 years (20.6%), 30–35 years (9.8%), and 35–40 years (8.4%). The mean and standard deviation of daily practices of self-medication were observed (M = 416.667, SD = 1,026,108.667) and p = 0.002. The mean and standard deviation of daily practices of antibiotic knowledge was (M = 431.5, SD = 1,615,917) and p = 0.002. Antimicrobial agents were leading over others with 631 (50.4%), followed by anti-inflammatory with 331 (26.4%), multivitamins with 142 (11.3%), gynecological purpose with 59 (4.7%), and analgesic with 72 (5.7%), while the lowest frequency rate was observed against herbal remedies with 15 (1.2%). The results of the current study concluded that students practiced self-medication for reasons such as convenience to obtain these medications from cheap sources and to avoid the fee of a physician. They searched for the medicine on social media platforms and purchased it blindly from the pharmacy without any prescription from a physician.

Background—Increased concentrations of 5-hydroxytryptamine (5-HT) can be detected in the systemic circulation after a meal and may be involved in the physiological control of gastrointestinal motility. Abnormalities of 5-HT release after a meal might explain some of the postprandial symptoms associated with the irritable bowel syndrome (IBS).Aim—To investigate the effect of a standard meal on plasma 5-HT and urinary 5-hydroxyindole acetic acid (5-HIAA) concentrations in patients with diarrhoea predominant IBS and in healthy volunteers.Methods—After an overnight fast, six volunteers and five patients with IBS were given a carbohydrate-rich meal. Blood and urine samples were taken before and for four hours after the meal. Platelet-poor plasma 5-HT and urinary 5-HIAA were analysed by reversed phase high performance liquid chromatography with fluorometric detection. 5-HIAA was expressed as a ratio with urinary creatinine concentration, which was measured by spectrophotometry.Results—During the four hour postprandial period, 5-HT concentrations were significantly higher in patients with IBS than in healthy volunteers at 0.5 hours (p<0.05), 2 hours (p<0.05) and 2.5 hours (p<0.05). 5-HT was not detected in the plasma in the fasting state in patients or volunteers. Median peak 5-HT in patients with IBS (359 (198–796) nmol/l) was significantly greater than volunteers (83 (7–190)) (p<0.05). “Area under the curve” for 5-HT detection was greater for patients with IBS (317 (138–771)) than for healthy volunteers (51 (4–129); p<0.05).The duration of the 5-HT peak was significantly longer in patients with IBS (3 (1–3) hours) than in the healthy volunteers (1 (1–1) hours; p<0.01). Postprandial urinary median 5-HIAA values in controls (5.6 (5.5–5.8) μmol/mmol creatinine) and patients with IBS (3.0 (2.5–6.8) μmol/mmol creatinine) were not significantly different from preprandial values (controls: 5.9 (5.5–6.6) μmol/mmol creatinine; patients with IBS: (6.2 (2.4–9.3) μmol/mmol creatinine).Conclusion—These findings indicate that there may be a difference in the way that 5-HT is released in patients with diarrhoea predominant IBS, and could suggest a possible role for 5-HT in the postprandial symptoms of these patients.

This essay analyses how Euripides reused the epic pattern of the so-called τις-Rede or tis-speech, used by Homer sometimes to make a character speculate about what someone might say, other times to give a single and anonymous example of a crowd’s opinion. Euripides uses both the traditional epic models in his tragedies: potential τις-Reden (Alc. 954-61, 995-1005; Her. 26-30, 515-9; Pho. 578-83; fr. 708 K.) and actual τις-Reden (Andr. 1104-6; Hel. 1589-91; HF 950-2). The quoted passages are all studied, together with some other passages mentioned for comparison purposes (Ba. 204-5; Hec. 313-6; HF 1286-90; IT 1358-61; Or. 1416-24; Suppl. 314-6, 343-6).

Este trabalho teve como objetivo avaliar a toxicidade do fármaco paracetamol por meio de bioensaio em sementes de alface. O experimento, realizado em placas de petri, foi instalado em laboratório, com delineamento inteiramente ao acaso, com 5 tratamentos (água destilada = 0 mg L-1; 2,7 mg L-1; 5,0 mg L-1; 9,3 mg L-1 e 15 mg L-1) e 4 repetições. As parcelas experimentais, placas de petri, foram compostas por 10 sementes de alface, cujas variáveis analisadas foram o número de sementes germinadas, crescimento da radícula e do hipocótilo (mm) de cada semente, e peso (mg) das 10 sementes. Estas foram submetidas à Análise de Variância (α = 0,05) e ao Teste de Tukey (α = 0,05) para comparações das médias quando necessário. As concentrações de paracetamol de 2,7 mg L-1 e 15 mg L-1 causaram redução no crescimento da radícula em 30% e 82%, respectivamente. No crescimento do hipocótilo, tais concentrações afetaram em 53% e 83%, respectivamente. Já no peso tais concentrações afetaram em 45% e 66%, respectivamente. Nas condições em que esse experimento foi realizado, o fármaco paracetamol foi tóxico para o desenvolvimento das plântulas de alface.

The problem of lower and upper limb defects concerns about 45-55% of all posture defects in children and adolescents, therefore it is necessary to conduct research assessing the arch of the feet in this age group. The aim of the study is to determine the relationship between non-weight bearing and weight-bearing feet and condition of their arching in children living in the rural areas. Material and methods: 99 pupils joined the study (38 boys and 61 girls), aged from 13 to 16. The method used in the study has been podoscopic evaluation using Podoscan 2D. Results: In the study it was observed that the level of longitudinal arch of the feet was different in the non-weight bearing and weight bearing state. During the non-weight bearing test, no one was characterized by a flat foot, lowered arch for the right foot was noted in 34.34% of people for the left in 42.42%. In the weight-bearing test, the foot with lowered arching was most often observed, 63.63% right foot and 70.70% left foot. Conclusion: The Clarke's angle significantly decreased under the load of the body weight. The Wejsflog index did not change significantly depending on the method of conducting the research. Gender had no influence on the arches of the feet.

Blood transfusion is a vital part of present health care system. If used precisely, blood transfusion can improve patient health status and can reduce death rate. Like other drug, blood transfusion may cause short-term and long-term complications like transfusion reactions and transmit infections such as HIV, hepatitis virus, syphilis etc. The main aim was to study the pattern of utilization of blood and its components in a teaching hospital. Hence, a retrospective study was carried out at the blood bank of a teaching hospital of Telangana District. The total number of blood and its components issued from our blood bank in a year were 7638 units. Out of all transfusions, 3594 units were of whole blood, 1978 units packed cells, 985 Fresh Frozen Plasma, 998 platelet rich plasma, 83 Single Donor Platelet. Supply of blood was found to be more in General Medicine department followed by Gynaecology and Obstetrics and General Surgery and least number of units were supplied to Operation Theatre. Furthermore, we examined the reasons of discarding the blood components; we found that 656 units of blood products were discarded in one year due to reasons like expiry of shelf life, HbsAg, HIV and HCV. Periodic review of utilization of blood and its components is important to avoid inappropriate use of blood and its components which may cause deficit amount of blood supply to patients suffering from serious ailments.

Bones from the inhumation graves in Świbie were very poorly preserved. The skeletal fragments analysed were significantly eroded. The poor state of preservation of the skeletons is most likely due to the environmental changes taking place in the area occupied by the necropolis and the unfavourable post-depositional conditions prevailing there. Osteological materials have been preserved in only about 33% of the graves. Anthropological analyses were carried out on bones identified in 220 graves: 100 skeletal, 93 cremations, and 27 bi-ritual graves. A total of 242 individuals have been identified, of which 114 were inhumed and 128 cremated. The presence of more than one individual was observed in 21 burials (excluding burials where bones were lost: 1+?), with three graves: 33, 211, and 427 containing remains of three individuals. Estimating the sex was possible in 62 cases (25.6%), and due to the very poor condition of bones of inhumed individuals, this was more often possible for individuals from cremation graves (26.6%) than from inhumation graves (24.6%). For 33 individuals, tomographic examinations were also undertaken to determine sex based on the LA method. Age at death assigned to a single age category was determined for 98 individuals (40.5%): 32 (28.1%) from inhumation graves and 66 (51.6%) from cremation graves. In addition, 83 individuals (34.3%) were classified into the general age categories of “infans” – 8 individuals (3.3%): four each from cremation and inhumation graves; and “adult” – 75 specimens (30.9%): 50 (43.9%) from inhumation graves and 25 (19.5%) from cremation graves. For 34 individuals out of the 35 examined, a precise age determination was obtained using the TCA method. Based on the data obtained from the constructed mortality tables, the life expectancy of a newborn (e0) was approximately 21 years, or within a range of 13.05–14.27 years after estimating the missing number of deceased children (d0-14.9). According to the data thus compiled, inhumed individuals had slightly higher life expectancy parameters (e0=22.03 years, after d0-14.9 estimation: 13.89–15.06 years) compared to individuals from cremation graves (e0=19.79 years, after d0-14.9 estimation: 12.60–13.84 years). Individuals of reproductive age (e20) lived to 28 years on average. The average age of death for adult individuals was 28.27 years (28.52 years for inhumed individuals and 28.16 years for cremated individuals). Almost 70% of the population survived to this age, but only 2.3% reached an age above 40 years. The structure of the living population calculated based on the Cx parameter suggests a relatively stable nature of the community using the cemetery, with the structure of inhumed individuals corresponding to a developing population and the structure of cremated individuals to a stabilised one. Children were more than twice as likely to be cremated, particularly those in the Infans I age category (chi2=4.7635, df.=1, p=0.021809). No such trend was observed among adults, although the data collected suggest that individuals from the Adultus category were inhumed less frequently. For individuals from cremation graves, the total bone mass was determined along with the weight of the distinguished bone fractions. The weight distribution of individual specimens ranged from 0.22 g to 2123.82 g (X=294.35 g; Me=81.46 g; SD=419.739 g) with the most numerous range from 0 to 100 g. Paleopathology was found in a total of 33 individuals (13.6%). Most of the conditions identified were related to nutritional deficiencies and manifested as linear enamel hypoplasia (LEH), interglobular dentin (IGD), cribra orbitalia and hyperostosis porotica. Degenerative lesions (osteophytes, eburnation of the radius head, metatarsal bones fusion), probable changes from respiratory diseases (SES), non-specific diseases (periostitis), diseases of unknown aetiology (HFI), and congenital diseases (Klippel-Feil syndrome) were also found. In addition, the presence of epigenetic traits were observed in three individuals.

Возрастная группа до 45 лет наиболее сложна для определения типа сахарного диабета (СД), так как в ней может встречаться диабет 1 типа (СД1), 2 типа (СД2), MODY и LADA. Целью исследования: определить клинические маркеры для проведения дифференциальной диагностики типов СД у молодых пациентов. МАТЕРИАЛЫ И МЕТОДЫ: включено 202 пациента, которые наблюдаются в НИИТПМ-филиал ИЦиГ СО РАН, с началом диабета в возрасте от 18 до 45 лет: 1 группа – 77 пациентов с MODY, 2 – 83 с СД 2, 3 – 14 с СД 1, 4 – 28 с LADA. Группы сопоставимы по полу, возрасту. Пациенты сравнивались по отягощенной наследственности по СД, особенностям дебюта заболевания, коморбидным патологиям, исходным ан- тропометрическим показателям. РЕЗУЛЬТАТЫ: при MODY чаще, чем при СД2, при СД1 и LADA определялась отягощенная наследствен- ность по СД2 (95 и 79 %, р=0,005, 95 и 29 %, р<0,001, 95 и 64 % р=0,035), чаще родственники заболевали СД до 45 лет (70 и 29 %, р<0,001, 70 и 14 %, р<0,001) и более, чем в 3 поколениях (65 и 28 %, р<0,001, 65 и 7 %, р<0,001, 65 и 8 %, р<0,001, 65 и 15 %, р<0,001). При СД 2 чаще определялось ожирение, чем при MODY (34 и 4 %, р<0,001), заболевания желудочно-кишечного тракта (25 и 6 %, р=0,001) и артериальная гиперто- ния (14 и 5 %, р=0,044). При СД1 чаще, чем при MODY и при СД2, были симптомы при диагностировании СД (93 и 23%, р<0,001, 93 и 26 %, р<0,001), снижение веса (50 и 3 %, р<0,001, 50 и 0 %, р<0,001), кетоацидоз (64 и 1 %, р<0,001, 64 и 1 %, р<0,001). При СД1 чаще чем при LADA был кетоацидоз (64 и 15 %, р=0,013). При LADA, чаще при СД2 были симптомы СД (61 и 26%, р=0,016) и снижение веса (15 и 0%, р=0,017) и реже за- болевания желудочно-кишечного тракта (0 и 25 %, р=0,031). При LADA чаще, чем при MODY были симптомы СД (61 и 23 %, р=0,009), ожирение (31 и 4 %, р=0,008) и патология щитовидной железы (31 и 9%, р = 0,040). ВЫВОДЫ: 1. Основные клинические характеристики для проведения дифференциальной диагностики типа СД: отягощенная наследственность по СД, вес пациентов; наличие клинических симптомов гипергликемии, кетоацидоза в дебюте. 2. При диагностировании СД 2 у лиц молодого возраста необходимо проводить скрининг на наличие артериальной гипертонии, заболеваний желудочно-кишечного тракта, ожирения, при LADA - на за- болевания щитовидной железы. Тезисы написаны в рамках гранта Президента РФ для государственной поддержки молодых российских ученых - докторов наук МД-3017.2022.3.

Abstract The paper presents research on the online performance-based diagnostics by implementing a novel methodology, which is based on the combination of Kalman Filter, Artificial Neural Network, Neuro-Fuzzy Logic and Fuzzy Logic. These methods are proposed to improve the success rate, increase the flexibility, and allow the detection of single and multiple failures. The methodology is applied to a 2-shaft industrial gas turbine engine for the automated early detection of single and multiple failures with the presence of measurement noise. The methodology offers performance prediction and the possibility of utilizing multiple schemes for the online diagnostics. The architecture leads to three possible schemes. The first scheme includes the base methodology and enables Kalman Filter for data filtering, Artificial Neural Network for the component efficiency prediction, the Neuro-Fuzzy logic for the failure quantification and the Fuzzy Logic for the failure classification. For this scheme, a performance simulation tool (Turbomatch) is used to calculate the thermodynamic baseline. The second scheme replaces Turbomatch with the Artificial Neural Network, that is used to calculate the deteriorated efficiencies and the reference efficiencies. The third scheme is identical to the first one but excludes the shaft power measurements, which are not available in aero engines or might not be usable for some power plant configurations. The paper compares the performance of the three methodologies, with the presence of measurement noise (0.4% reference noise and 2.0% reference noise), and 24 types of random single and multiple failures, with variable magnitude. The first methodology has been already presented by Togni et al. [10], whereas the other two methodologies and results are part of the PhD thesis presented by Togni [18] and they extend the applicability of the method. The success rate, targeting the correct detection of the of the failure magnitude ranges between 92% and 100% without measurement noise and ranges between 66% and 83% with measurement noise. Instead, the success rate of the classification, targeting the correct detection of the type of failure ranges between 93% and 100% without measurement noise and between 85% and 100% with measurement noise.

Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.