Search

Inhaled β2 adrenergic receptor (β2-AR) agonists are the mainstay of asthma therapy. The β2-AR protein is encoded by the ADRB2 gene and variants within this gene can have significant consequences for modulating the response to asthma therapy. This cross-sectional study performed at the University Children’s Hospital in Belgrade, included 54 children with asthma. The subjects were genotyped for ADRB2 +46A>G (Arg16Gly, rs1042713) and +79C>G (Gln27Glu, rs 1042714) polymorphisms and the association with asthma severity and response to inhaled salbutamol was examined. In Serbian asthmatic children, allele +46A was detected with a frequency of 41.7% and allele +79G was detected with a frequency of 23.1%. Allele +46G was found to be associated with a better response to inhaled salbutamol (p G may be a determinant of asthma severity and response to salbutamol in children with asthma. We did not find any association of +79C>G polymorphisms with the asthma severity and bronchodilator response to inhaled salbutamol. The results of this study can be potentially useful for personalization of asthma treatment.

Introduction/objective Chronic obstructive pulmonary disease (COPD) is a pulmonary disease characterized by persistent respiratory difficulties and impaired airflow. COPD patients have a higher risk for lung infections, like the flu or pneumonia, lung cancer, heart problems, weak muscles, brittle bones, depression, and anxiety. The purpose of this study was to estimate the prevalence of ECG abnormalities in patients with COPD experiencing exacerbations. Patients and methods The research encompassed a cohort of 832 individuals diagnosed with COPD who encountered episodes of exacerbations. Five hundred seventy-five (69.11%) of the included participants were women, and 257 (30.89%) were men. The included participants ranged from 18 to 60 years old. It was ensured that none of the participants had received any treatment for their condition for more than 3 days. Results Based on the level of exacerbation severity, the patient population is categorized into three distinct groups: moderate, comprising 330 (39.66%) individuals; severe, encompassing 406 (48.79%) individuals; and extremely severe, consisting of 96 (11.53%) individuals. During episodes of exacerbation in patients with COPD, the following ECG alterations were observed: a QTc less than 0.40 s in 99.15% of cases, a transitional ECG zone in 74.33% of cases, a P more than 2.5 mm in 45.67% of cases, an axis deviation towards the second quadrant (axis II) in 28% of cases, an incomplete right bundle branch block in 26.32% of cases, and a full right bundle branch block in 25.60% of cases. Conclusion Regardless of prior cardiac pathology, ECG is a low-cost, quick, and dependable modality for detecting ischemic changes in people experiencing a flare-up of COPD.

Turbulence investigations of the flow past an unswept wing at a high angle of attack are reported. Detailed predictions were carried out using large-eddy simulations (LES) with very fine grids in the vicinity of the wall in order to resolve the near-wall structures. Since only a well-resolved LES ensures reliable results and hence allows a detailed analysis of turbulence, the Reynolds number investigated was restricted to [Re.sub.c]= [10.sup.5] based on the chord length c. Admittedly, under real flight conditions [Re.sub.c] is considerably higher (about (35-40). [10.sub.6]). However, in combination with the inclination angle of attack [alpha]=18 deg this [Re.sub.c] value guarantees a practically relevant flow behavior, i.e., the flow exhibits a trailing-edge separation including some interesting flow phenomena such as a thin separation bubble, transition, separation of the turbulent boundary layer, and large-scale vortical structures in the wake. Due to the fine grid resolution applied, the aforementioned flow features are predicted in detail. Thus, reliable results are obtained which form the basis for advanced turbulence analysis. In order to provide a deeper insight into the nature of turbulence, the flow was analyzed using the invariant theory of turbulence by Lumley and Newman (J. Fluid Mech., 82, 161-178, 1977). Therefore, the anisotropy of various portions of the flow was extracted and displayed in the invariant map. This allowed us to examine the state of turbulence in distinct regions and provided an improved illustration of what happens in the turbulent flow. Thus, turbulence itself and the way in which it develops were extensively investigated, leading to an improved understanding of the physical mechanisms involved, not restricted to a standard test case such as channel flow but for a realistic, practically relevant flow problem at a moderate Reynolds number [DOI: 10.1115/1.2175162]

Introduction. Staphylococcus (S.) aureus is one of the most omnipresent and dangerous human pathogens, whose main characteristic is the production of the enzyme coagulase. This characteristic serves to identify and assess the pathogenicity of the bacteria. In addition to skin infections, endocarditis, osteomyelitis, and infectious arthritis, it is a common cause of pneumonia both in children and adults. Case report. We described a case of a 65-year-old woman with a dry cough and malaise with patchy areas of consolidation on the chest X-ray and “ground-glass” opacity with bronchial wall thickening and unilateral mediastinal lymphadenopathy on chest computed tomography imaging. Methicillin-resistant S. aureus was isolated from the bronchoalveolar aspirate taken during bronchoscopy. The woman was empirically treated with azithromycin, and later, based on the antibiogram findings, azithromycin was replaced with meropenem, after which her health improved. Conclusion. We presented a rare case of pneumonia with unconvincing symptomatology and laboratory and radiological findings. Paying more attention to such cases in the future is crucial, especially to the use of antibiotics to which staphylococci are increasingly developing resistance.

At the beginning and during the development of civilization, natural sources were the only available source of energy. With the development of society and industry, they were replaced by intensive use of fossil fuels. Non-renewability and negative impact on the environment called into question the rationality of using such sources. Therefore, natural sources of energy are becoming more and more important, especially biomass, which is becoming an important source of energy due to its ecological advantages. There are numerous ways to convert agricultural biomass into different forms of biofuel. Thermochemical conversion includes a process of pyrolysis in which, under the influence of a high temperature of 400 to 600 °C without the presence of oxygen, very valuable products are obtained in the form of biochar. The aim of this research is to evaluate the energy properties of agricultural biomass (corn, wheat, barley, oats, triticale, rye, soybeans, rapeseed and sunflower) by thermochemical conversion by pyrolysis and analysis of biochar for the evaluation of value-added products and to suggest its application. The mentioned raw materials are characterized by significant pyrolytic conversion potential, i.e. biochar production ranged from 30.03% to 47.0%. Similarly, the heating value (HHV) of biochar after the pyrolysis process increased to 27.11 MJ/kg, which proves that agricultural biomass is a good source of energy per unit mass.

This paper presents modeling, simulations and control of the ground-to-air missile fin actuation system, where brushed DC motors are used as actuators, which are driven using voltage regulation-Pulse Width Modulation (PWM). The mathematical model of the system was determined using the differential equations of behavior of the lowest order that was experimentally confirmed. This model was taken as a starting point in the synthesis of the Lead compensator, used to regulate the position of the missile's control surfaces. The trial and error method was used for the synthesis of Lead compensator, taking care to meet the required characteristics of the System, in form of bandwidth and gain. The improved transient process and behavior of the System have also been experimentally confirmed.

Introduction. Celiac crisis is a rare and life-threatening complication of celiac disease. Although it occurs in all ages, the most common affects children within the first two years. Outline of cases. We report three infants (two female, one male, age range 9–12) with celiac crises as an initial presentation of celiac disease precipitated with rotavirus gastroenteritis. Celiac crisis was preceded by failure to thrive caused by anorexia, occasional vomiting and frequent abundant stools for 4–8 weeks, and 1–2 days before admission with fever, frequent vomiting and profuse watery diarrhea. They were admitted in a very severe general condition, severely dehydrated, markedly malnourished, with an enormously distended abdomen, edema of the lower legs and feet, and perianal erythema. After correction of dehydration and hypoalbuminemia, they were placed on a gluten- and disaccharide-free diet and within the first two weeks on additional parenteral nutrition. The applied therapeutic measures resulted in stabilization and further rapid improvement of the patient’s condition. In all three patients the latex agglutination test for rotavirus was positive, IgA anti-TTG antibodies elevated (58.6–78 U/ml) and all three were homozygous carriers of the HLA DQ2 gene. Enterobiopsy was performed two weeks after the admission and total villous atrophy (Marsh IIIc) was registered in all three patients. In the further course, the complete recovery of the patient was accomplished by a strict gluten-free diet. Conclusion. Our experience indicates that rotavirus gastroenteritis in timely unrecognized classical celiac disease in infants can lead to celiac crisis.

Introduction/Objective. Cardiovascular disease is one of the most common comorbidities among subjects with chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate electrocardiogram (ECG) parameters and mortality predictors in COPD patients. Methods. A total of 835 consecutive patients were included. The patients were classified to suffer from COPD if the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) was < 70% in three consecutive postbronchodilator measurements. The following ECG changes were observed: axis, P wave, low ORS complex, transitional zone, left bundle branch block (LBBB), right bundle branch block (RBBB), incomplete RBBB, S1S2S3 configuration, negative T in V1–V3. The patients were followed up for mortality over a five-year period. Results. Both survivors and non-survivors were of similar age, sex, and COPD status. FVC and FEV1, as well as Global Initiative for Chronic Obstructive Lung Disease stadiums were significantly higher in the survivor group (p < 0.016, p < 0.001, p < 0.001, respectively). Normal axis was in significantly higher percentage in non-survived patients (p = 0.020). RBBB and incomplete RBBB are more frequent findings in patients who died (p < 0.001, p < 0.05, respectively). LBBB, S1S2S3 configuration is in significantly higher percentage present in non-survivors (p < 0.016, p < 0.001, respectively). In the multivariable logistic model, patients with LBBB have two times higher chance of mortality compared to patients without LBBB. In contrast, patients with RBBB have 1.6 times lower chance of having death outcome. Conclusion. The main ECG predictors of COPD patients’ five-year mortality are LBBB and RBBB, but according to statistical model, ECG should be further explored and possibly obligatory involved in a routine clinical practice as an easy and low-cost screening method.

In recent years, there has been an increase in the production of textiles and clothing, which is the result of an increase in the global population and an improvement in living standards. The consequence of this fact is the unlimited use of resources for the needs of the production process of textiles and clothing, as well as an increase in the amount of generated textile waste, which is currently not treated adequately. For the textile industry to have a chance in the future to take advantage of environmental, economic and social opportunities that it is currently unable to do, it is necessary to transform the current, linear system into a circular system. The paper presents the possibility of implementing the basic principles of the circular economy in the textile and clothing industry. According to the principles of the circular economy, the textile industry is based on the realization of four activities: elimination of unwanted substances and release (emission) of microfibers, increasing the utilization of clothing, improving the recycling sector, efficient use of resources and switching to renewable sources.

The circular economy (CE) is currently a worldwide popular concept that should ensure sustainable development and resource efficiency. It is established on the theory of consumption and use of resources in the process of production in a way that affects a limitation of adverse effects on the environment. Simultaneously, this concept creates additional value and reuse of the products. In the Republic of Serbia (RS), the idea of CE is still new and underdeveloped. Hence, this paper aims to explore the possibility of implementing a CE in companies that operate in the RS by adopting the already developed methodology in the European Union. This research was conducted by monitoring the production process in the company "MB INTERNACIONAL" that produced cardboard packaging. The obtained approximate value of Circular Indicator of this company was 0.47, which indicated that the company had excellent chances for full implementation of the CE model in the business with the application of specific measures. The low-budget and highbudget measures, which could improve the circularity level in the analyzed company, are also presented in the research.

Introduction/Objective. Pain is a disturbing experience associated with existing or potential tissue damage, with a sensory, emotional, cognitive, and social component. The aim of this study was to show the efficiency of regional anesthetic techniques in postoperative pain in children. Methods. The retrospective cohort study was conducted on a group of 564 pediatric patients during the period from 2013 to 2016. Types of regional anesthesia were classified into the following six groups: caudal, epidural, spinal block, upper limb blocks, lower limb blocks, and truncal nerve block. From statistical methods, we used descriptive statistical methods of absolute and relative numbers, measurements of variability, central tendencies for numerical features, and methods of inferential statistics. We used the χ2 test for the attributive features of observations. Results. In relation to the postoperative time when an analgesic was required, a statistically significant difference was observed in the age of children (p = 0.000), disease diagnosis (p = 0.000), type of block (p = 0.000), type of local anesthetic (p = 0.000), and type of anesthesia or sedation preoperatively (p = 0.005). Conclusion. Postoperative analgesia was most needed by older children and children who were awake during surgery. Children with injuries and tumors need postoperative analgesia the earliest. The longest postoperative analgesia was recorded in patients who received caudal block. The longest postoperative analgesia can be seen in patients who received levobupivacaine, bupivacaine or levobupivacaine combined with lidocaine to perform the block.

Background/Aim. Finger tapping test is commonly used in neurological examinations as a test of motor performance. The new system comprising inertial and force sensors and custom proprietary software was developed for quantitative estimation and assessment of finger and foot tapping tests. The aim of this system was to provide diagnosis support and objective assessment of motor function. Methods. Miniature inertial sensors were placed on fingertips and used for measuring finger movements. A force sensor was placed on the fingertip of one finger, in order to measure the force during tapping. For foot tapping assessment, an inertial sensor was mounted on the subject’s foot, which was placed above a force platform. By using this system, various parameters such as a number of taps, tapping duration, rhythm, open and close speed, the applied force and tapping angle, can be extracted for detailed analysis of a patient’s motor performance. The system was tested on 13 patients with Parkinson’s disease and 14 healthy controls. Results. The system allowed easy measurement of listed parameters, and additional graphical representation showed quantitative differences in these parameters between neurological patient and healthy subjects. Conclusion. The novel system for finger and foot tapping test is compact, simple to use and efficiently collects patient data. Parameters measured in patients can be compared to those measured in healthy subjects, or among groups of patients, or used to monitor progress of the disease, or therapy effects. Created data and scores could be used together with the scores from clinical tests, providing the possibility for better insight into the diagnosis. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175090 and Grant no. 175016]

We describe design and verification of a novel autonomous sensor system (Magnetic Cubes) for evaluating the distance between two points as well as the rotation matrix between the coordinate systems attached to the sensors. The system is based on two sensors, each comprising three orthogonal coils wound on foam cubes, and near-field coupling between the sensors, which operate the medium frequency band. Testing and verification of the designed system was done by performing various 2D and 3D movements, and comparing positions and orientations estimated by Magnetic Cubes with those measured by an optical motion capture system. In all cases, good agreement is obtained: the RMS error for the estimation of the distances between the cubes is less than 10 mm (less than 2%), while the RMS errors for the estimation of the Cartesian coordinates are less than 7%. The discrepancies between the results obtained from the two systems were also assessed by the Pearson correlation coefficient (greater than 0.9 for the Cartesian coordinates and greater than 0.99 for the distances between the cubes).

Background/Aim. Postural impairments and gait disorders in Parkinson's disease (PD) affect limits of stability, impaire postural adjustment, and evoke poor responses to perturbation. In the later stage of the disease, some patients can suffer from episodic features such as freezing of gait (FOG). Objective gait assessment and monitoring progress of the disease can give clinicians and therapist important information about changes in gait pattern and potential gait deviations, in order to prevent concomitant falls. The aim of this study was to propose a method for identification of freezing episodes and gait disturbances in patients with PD. A wireless inertial sensor system can be used to provide follow-up of the treatment effects or progress of the disease. Methods. The system is simple for mounting a subject, comfortable, simple for installing and recording, reliable and provides high-quality sensor data. A total of 12 patients were recorded and tested. Software calculates various gait parameters that could be estimated. User friendly visual tool provides information about changes in gait characteristics, either in a form of spectrogram or by observing spatiotemporal parameters. Based on these parameters, the algorithm performs classification of strides and identification of FOG types. Results. The described stride classification was merged with an algorithm for stride reconstruction resulting in a useful graphical tool that allows clinicians to inspect and analyze subject’s movements. Conclusion. The described gait assessment system can be used for detection and categorization of gait disturbances by applying rule-based classification based on stride length, stride time, and frequency of the shank segment movements. The method provides an valuable graphical interface which is easy to interpret and provides clinicians and therapists with valuable information regarding the temporal changes in gait. [Projekat Ministarstva nauke Republike Srbije, br. 175016 i br. 175090]

Abstract Background The control of movement in humans is hierarchical and distributed and uses feedback. An assistive system could be best integrated into the therapy of a human with a central nervous system lesion if the system is controlled in a similar manner. Here, we present a novel wireless architecture and routing protocol for a distributed functional electrical stimulation system that enables control of movement. Methods The new system comprises a set of miniature battery-powered devices with stimulating and sensing functionality mounted on the body of the subject. The devices communicate wirelessly with one coordinator device, which is connected to a host computer. The control algorithm runs on the computer in open- or closed-loop form. A prototype of the system was designed using commercial, off-the-shelf components. The propagation characteristics of electromagnetic waves and the distributed nature of the system were considered during the development of a two-hop routing protocol, which was implemented in the prototype’s software. Results The outcomes of this research include a novel system architecture and routing protocol and a functional prototype based on commercial, off-the-shelf components. A proof-of-concept study was performed on a hemiplegic subject with paresis of the right arm. The subject was tasked with generating a fully functional palmar grasp (closing of the fingers). One node was used to provide this movement, while a second node controlled the activation of extensor muscles to eliminate undesired wrist flexion. The system was tested with the open- and closed-loop control algorithms. Conclusions The system fulfilled technical and application requirements. The novel communication protocol enabled reliable real-time use of the system in both closed- and open-loop forms. The testing on a patient showed that the multi-node system could operate effectively to generate functional movement.

Background/Objectives : Prediction of a difficult airway during pre-anesthetic evaluation is of great importance because it enables an adequate anesthetic approach and airway management. As there is a scarcity of prospective studies evaluating the role of anthropometric measures of the face and neck in predicting difficult airways in infants with an apparently normal airway, we aimed to identify the aforementioned predictors of difficult facemask ventilation and intubation in infants. Methods : A prospective, observational study that included 97 infants requiring general endotracheal anesthesia was conducted. Anthropometric and specific facial measurements were obtained before ventilation and intubation. Results : The incidence of difficult facemask ventilation was 15.5% and 38.1% for difficult intubation. SMD (sternomental distance), TMA (tragus-to-mouth angle distance), NL (neck length) and mouth opening were significantly lower in the difficult facemask ventilation group. HMDn (hyomental distance in neutral head position), HMDe (hyomental distance in neck extension), TMD (thyromental distance), SMD, mandibular development and mouth opening were significantly different in the intubation difficulty group compared to the non-difficult group. HMDn and HMDe showed significantly greater specificities for difficult intubation (83.8% and 76.7%, respectively), while higher sensitivities were observed in TMD, SMD and RHSMD (ratio of height to SMD) (89.2%, 75.7%, and 70.3%, respectively). Regarding difficult facemask ventilation, TMA showed greater sensitivity (86.7%) and SMD showed greater specificity (80%) compared to other anthropometric parameters. In a multivariate model, BMI (body mass index), COPUR (Colorado Pediatric Airway Score), BOV (best oropharyngeal view) and TMA were found to be independent predictors of difficult intubation, while BMI, ASA (The American Society Physical Status Classification System), CL (Cormack-Lehane Score), TMA and SMD predicted difficult facemask ventilation. Conclusions : Preoperative airway assessment is of great importance for ventilation and intubation. Patient's overall condition and facial measurements can be used as predictors of difficult intubation and ventilation.

Objective: The aim of this study was to translate the Sinus and Nasal Quality of Life Surgery Survey into the Serbian language to evaluate the test-retest reliability and validity., Study Design: The study included 49 consecutive patients between 12 and 18 years old with rhinologic symptoms. Patients were given a paper survey to complete along with a link to complete the online survey within the same day., Setting: The study was conducted at the University Children's Hospital Clinic for Pulmonology and Allergology between January 2023 and March 2023., Methods: Responses between the paper and online survey were compared and regression analysis was performed to evaluate the relationship. Internal reliability and test-retest reliability were assessed using Cronbach's α coefficient and intraclass correlation coefficient. All data were collected and analyzed using SPSS 29.0., Results: Pearson correlation coefficient between the paper and online survey was very high and statistically significant ( r  = 0.999; P  < .001). Each item had a high correlation (0.993-1.000), where the lowest correlation coefficient was obtained from question 2 (0.993). Average scores in each item differed slightly for only item 2 (mean difference = -0.041), but not to the level of statistical significance. Bland-Altman plot indicated no proportional bias between the 2 versions. Linear regression analysis suggested a high level of agreement between the 2 versions (slope = 1.00, R 2  = 0.999)., Conclusion: The survey is a useful questionnaire to evaluate the quality of life in patients with rhinologic symptoms. The high correlation between the paper and online survey shows the reliability of the questionnaire regardless of administration modality., Competing Interests: The authors state that they have no conflict of interest., (© 2024 The Authors. OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

The aim of this study was to evaluate the alterations of the hippocampal function that may be related to anxiogenic response to thermal skin injury, including the morpho-functional alterations, and the effects of hyperbaric oxygen (HBO) and Filipendula ulmaria (FU) extract in the treatment of anxiety-like behavior that coincides with thermal skin injury. A rat thermal skin injury experimental model was performed on 2-month-old male Wistar albino rats. The evaluated therapeutic protocols included HBO and/or antioxidant supplementation. HBO was applied for 7 days in the hyperbaric chamber (100% O 2 , 2.5 ATA, 60 min). Oral administration of FU extract (final concentration of 100 mg/kg b.w.) to achieve antioxidant supplementation was also applied for 7 days. Anxiety level was estimated in the open field and elevated plus-maze test, which was followed by anesthesia, sacrifice, and collection of hippocampal tissue samples. HBO treatment and FU supplementation significantly abolished anxiogenic response to thermal skin injury. This beneficial effect was accompanied by the reduction in hippocampal pro-inflammatory and pro-apoptotic indicators, and enhanced BDNF and GABA-ARα2S gene expression, previously observed in untreated burns. The hippocampal relative gene expression of melatonin receptors and NPY positively responded to the applied protocols, in the same manner as µ and δ opioid receptors, while the opposite response was observed for κ receptors. The results of this study provide some confirmations that adjuvant strategies, such as HBO and antioxidant supplementation, may be simultaneously applied in the treatment of the anxiety-like behavior that coincides with thermal skin injury.

Background and Objectives : Thermal skin injuries are a prevalent cause of skin damage, potentially leading to severe morbidity and significant mortality. In this study, we intended to estimate the effects of HBO (hyperbaric oxygen treatment) and antioxidant supplementation with Filipendula ulmaria extract, individually and simultaneously, in the treatment of thermal skin injuries. Materials and Methods : As a thermal skin injury experimental model, we used two-month-old male Wistar albino rats. Thermal injuries were made with a solid aluminium bar at a constant temperature of 75 °C for 15 s. Hyperbaric oxygen treatment was performed in a specially constructed hyperbaric chamber for rats (HYB-C 300) for seven consecutive days (100% O 2 at 2.5 ATA for 60 min). Antioxidant supplementation was performed with oral administration of Filipendula ulmaria extract dissolved in tap water to reach a final concentration of 100 mg/kg b.w. for seven consecutive days. Results: Simultaneous administration of hyperbaric oxygen therapy and antioxidant supplementation with Filipendula ulmaria extract significantly ameliorated the macroscopic and histopathological characteristics of the wound area and healing. Also, this therapeutic approach decreased the local expression of genes for proinflammatory mediators and increased the expression of the μ-opioid receptor and the MT1 and MT2 receptors in the wound area and spinal cord, with a consequent increase in reaction times in behavioural testing. Conclusions: In conclusion, the presented results of our study allow evidence for the advantages of the simultaneous employment of HBO and antioxidant supplementation in the treatment of thermal skin injuries, with special reference to the attenuation of painful sensations accompanied by this type of trauma.

Introduction: The Asthma Control Questionnaire (ACQ) is a seven-item questionnaire assessing symptoms that asthma clinicians consider to be most important for evaluating the adequacy of asthma control. An online version of the ACQ may be able to indicate whether a visit to the physician is warranted to modify therapy to achieve better control of their asthma, ultimately reducing the number of unnecessary visits, particularly during the pandemic. The aim of our study is to compare the paper and online ACQ to validate the online version for use in real-life settings. Methods: Our study included 28 patients who completed both paper and the online ACQ on the same day when they came home. The online version of the questionnaire was prepared to look similar to the paper form, with the same sentences and answers. Results: The correlation between paper and online ACQ questionnaires was very high ( r  = 0.935; p  < 0.001). When comparing each individual item, correlation coefficients ranged from 0.672 to 0.935. The lowest correlation is obtained in activity limitations, while the next one is 0.767, others higher than 0.8. The online form gave small and insignificantly higher scores compared to paper form with mean difference between -0.07 and 0.21. Mean difference of 0.01 ( p  = 0.986) between paper ACQ and online ACQ is obtained. Conclusion: The online version of the ACQ can be used for asthma control monitoring in pediatric patients in order to minimize unnecessary social contacts as well as hospital patient load, but retain adequate surveillance of disease symptoms by their physician.

Although scientific evidence has shown that natural mineral waters have potential beneficial metabolic effects, there is still very scarce data on their influence on type 2 diabetes mellitus (T2DM). The study was designed to investigate the effects of low mineral water from the "Sneznik-1/79″ source in Serbia on microbiota, metabolic, and oxidative stress parameters in patients with T2DM. In total, 60 patients with confirmed T2DM were included in the study, and they consumed "Sneznik-1/79″ water for 28 days. To examine the positive effects of "Sneznik-1/79″ water, we compared the results before and after the four weeks of "Sneznik-1/79″ water intake. Standard biochemical analyses were carried out, such as glucose level, lipid profile, and stool tests. The blood samples were collected to evaluate the effects of "Sneznik-1/79″ water on the redox status. At the end of the monitoring period, the total cholesterol concentration significantly dropped compared to the initial value. A significant improvement in intestinal peristalsis was observed, which was reflected in the fact that after four weeks, all patients established regular, daily bowel movements. Moreover, consumption of "Sneznik-1/79″ water eliminated the appearance of dysbiosis in 50% of patients. Additionally, the antioxidant capacity was improved by increasing the concentration of superoxide dismutase and reduced glutathione. The result of our study pointed out that the intake of "Sneznik-1/79″ water could be a promising adjuvant therapy for improving intestinal peristalsis as well as reducing the appearance of dysbiosis in T2DM patients., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

Human mesenchymal stem cells (hMSCs) are multipotent cells and an attractive therapeutic agent in regenerative medicine and intensive clinical research. Despite the great potential, the limitation that needs to be overcome is the necessity of ex vivo expansion because of insufficient number of hMSCs presented within adult organs and the high doses required for a transplantation. As a result, numerous research studies aim to provide novel expansion methods in order to achieve appropriate numbers of cells with preserved therapeutic quality. Bioreactor-based cell expansion provide high-level production of hMSCs in accordance with good manufacturing practice (GMP) and quality standards. This review summarizes current knowledge about the hMSCs manufacturing platforms with a main focus to the application of bioreactors for large-scale production of GMP-grade hMSCs., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background and Objectives : Oral disorders, frequently observed in patients with primary Sjögren's syndrome, can profoundly affect patients' daily lives and well-being, as oral health represents a fundamental part of general health. Saliva plays an essential part in maintaining and protecting oral health, so the decrease in its quantity and quality leads to chronic oral discomfort alongside a broad spectrum of problems. The objective of the present study was to evaluate the oral health of patients with primary Sjögren's syndrome and establish its effect on the different domains of their oral health-related quality of life (OHRQoL). Materials and Methods : The research was designed as an observational case-control study with prospective data collection. Eighty patients, divided into two groups based on their oral status, participated in the study. All subjects underwent a complete oral examination. The OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Results : The most prevalent oral manifestation was exfoliative cheilitis, while 30% of subjects complained of chewing and swallowing difficulties. The OHIP-14 summary score was significantly higher in the patients with oral lesions (26.0 (5.0) vs. 17.0 (4.0), respectively; p < 0.001). Oral manifestations, systemic involvement, medication, and periodontal indexes were significantly associated with OHIP-14 scores. Conclusions : Patients with oral alterations had a substantially decreased OHRQoL. These findings emphasize the importance of oral diseases for patients' well-being. Therefore, it is essential for dentists to be included in the multidisciplinary teams managing primary Sjögren's syndrome, as improving patients' oral status would lead to better oral health and enhanced OHRQoL.

Commercially manufactured or generated through environmental degradation, microplastics (MPs) and nanoplastics (NPs) considerably contribute to environmental pollution. There is a knowledge gap in how exposure to MPs/NPs changes cellular function and affects animal and human health. Here, we demonstrate that after oral uptake, fluorescent polystyrene (PS) nanoparticles pass through the mouse digestive system, accumulate and aggregate in different organs, and induce functional changes in cells and organs. Using cochlear explant as a novel in vitro system, we confirmed the consequences of PS-MP/NP interaction with inner ear cells by detecting aggregates and hetero-aggregates of PS particles in hair cells. The testes of treated males accumulated MPs/NPs in the interstitial compartment surrounding the seminiferous tubules, which was associated with a statistically significant decrease in testosterone levels. Male mice showed increased secretion of interleukins (IL-12p35 and IL-23) by splenocytes while cyto- and genotoxicity tests indicated impaired cell viability and increased DNA damage in spleen tissue. Males also showed a broad range of anxiogenic responses to PS nanoparticles while hippocampal samples from treated females showed an increased expression of Bax and Nlrp3 genes, indicating a pro-apoptotic/proinflammatory effect of PS treatment. Taken together, induced PS effects are also gender-dependent, and therefore, strongly motivate future research to mitigate the deleterious effects of nanosized plastic particles., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The beneficial effects of HBO in inflammatory processes make it an attractive type of treatment for chronic arthritis. In addition, the effects of combination therapy based on adipose stem cells and HBO on OA progression have not been fully investigated. The current study explored the efficacy of intra-articular injection of allogeneic adipose-derived mesenchymal stem cells (ADMSCs) combined with hyperbaric oxygenation treatment (HBO) in a rat osteoarthritis (OA) model. The rat OA model was induced by intra-articular injection of monoiodoacetate (MIA) and 7 days after application of MIA rats were divided into five groups: healthy control (CTRL), osteoarthritis (OA), ADMSCs (ADS), the HBO+ADS 21day and HBO+ADS 28day groups. A single dose of 1 × 10 6 allogeneic ADMSCs suspended in sterile saline was injected into the knee joint alone or in combination with HBO treatment. Rats were sacrificed at 3 or 4 weeks after MIA injection. Treatment outcomes were evaluated by radiographic, morphological and histological analysis and by specific staining of articular cartilage. We also measured the level of inflammatory and pro/antioxidative markers. We confirmed that combined treatment of ADMSCs and HBO significantly improved the regeneration of cartilage in the knee joint. Rtg score of knee joint damage was significantly decreased in the HBO+ADS 21day and HBO+ADS 28day groups compared to the OA. However, the positive effect in the HBO+ADS 28day group was greater than the HBO+ADS 21day group. The articular cartilage was relatively normal in the HBO+ADS 28day group, but moderate degeneration was observed in the HBO+ADS 21day compared to the OA group. These findings are in line with the histopathological results. A significantly lower level of O 2 - . was observed in the HBO+ADS 28day group but a higher NO level compared to the HBO+ADS 21day group. Moreover, in the HBO+ADS 28day group significantly higher concentrations of IL-10 were observed but there was no significant difference in proinflammatory cytokine in serum samples. These results indicate that a single intra-articular injection of allogeneic ADMSCs combined with HBO efficiently attenuated OA progression after 28 days with greater therapeutic effect compared to alone ADMSCs or after 3 weeks of combined treatment. Combined treatment might be an effective treatment for OA in humans.

The aim of this study was to use cone-beam computed tomography (CBCT) to evaluate the morphometric properties of the interradicular septum (IRS) in the maxillary molar region that may be indicative for prosthetic-driven implant placement. Following the repetitive algorithm based on the visual identification of IRS shapes, we described the following IRS shapes: arrow, boat, drop, and palatal and buccal convergence. The incidence of IRS shapes showed significant differences for the first and second maxillary molars (the highest frequency for the arrow shape, and the lowest for the drop shape) with no significant difference between the molars. The most prominent width indicative for implant placement was observed in the palatal convergence shape, whereas the height criteria were the most satisfying in the buccal convergence-shaped IRS for both molars. Apart from the parameters in the coronal view, the image analysis in the axial view revealed that IRS surface area, required for the implant placement, was the most prominent in the palatal convergence shape for the first, and boat shape for the second molars. Our results showed the benefits of CBCT diagnostics in posterior maxilla morphometric analysis. IRS shape classification may be helpful in achieving more rapid and accurate planning for interventions in this region.

The aim of this study was to evaluate the interradicular septum bone morphometric characteristics using cone beam computed tomography (CBCT) images, as well as to establish quantitative shortcuts to allow clinicians to make a faster and more reliable plan for immediate implant placement in the maxillary molars area. This retrospective quantitative study was conducted on CBCT images obtained from 100 patients. The morphometric analysis of the maxillary molars region was based on the parameters obtained on the sagittal and axial slices. The analysis performed on sagittal slices showed that the first maxillary molars had a wider interradicular septum when compared to the second molars, but the septum height in the first molars was significantly below the height in the second maxillary molars. The axial CBCT slices analysis showed that both interradicular septum perimeter and surface area were significantly more pronounced in the first than in the second maxillary molars. The interradicular furcation angle significantly correlated with the surface area (positively) and septum height (negatively) for both molars. The results of this study may recommend CBCT image analysis as a useful tool in predefining the circumstances that can allow for substantially better planning of immediate implant placement procedures in the region of maxillary molars.

Reconstruction of jaw bone defects present a significant problem because of specific aesthetic and functional requirements. Although widely used, the transplantation of standard autograft and allograft materials is still associated with significant constraints. Composite scaffolds, combining advantages of biodegradable polymers with bioceramics, have potential to overcome limitations of standard grafts. Polyethyleneimine could be an interesting novel biocompatible polymer for scaffold construction due to its biocompatibility and chemical structure. To date, there have been no in vivo studies assessing biological properties of hydroxyapatite bioceramics scaffold modified with polyethyleneimine. The aim of this study was to evaluate in vivo effects of composite scaffolds of hydroxyapatite ceramics and poly(lactide-co-glycolide) and novel polyethyleneimine on bone repair in swine's mandibular defects, and to compare them to conventional bone allograft (BioOss). Scaffolds were prepared using the method of polymer foam template in three steps. Pigs, 3 months old, were used and defects were made in the canine, premolar, and molar area of their mandibles. Four months following the surgical procedure, the bone was analyzed using radiological, histological, and gene expression techniques. Hydroxyapatite ceramics/polyethyleneimine composite scaffold demonstrated improved biological behavior compared to conventional allograft in treatment of swine's mandibular defects, in terms of bone density and bone tissue histological characteristics.

Aim: To investigate the influence of strain differences in immune responses on the pathogenesis of experimental periapical lesions in Dark Agouti (DA) and Albino Oxford (AO) inbred strains of rats., Methodology: Periapical lesions were induced in male DA and AO rats by pulp exposure of the first mandibular right molars to the oral environment. Animals were killed 21 days after pulp exposure. The mandibular jaws were retrieved and prepared for radiographic, pathohistological, immunohistochemical analysis, real-time PCR and flow cytometry. Blood samples and the supernatant of periapical lesions were collected for measurement of cytokines and oxidative stress marker levels. Statistical analysis was performed using the Kruskal-Wallis H and Mann-Whitney U non-parametric tests or parametric One-Way anova and Independent Samples T-test to determine the differences between groups depending on the normality of the data. A significant difference was considered when p values were <.05., Results: DA rats developed significantly larger (p < .05) periapical lesions compared to AO rats as confirmed by radiographic and pathohistological analysis. The immunohistochemical staining intensity for CD3 was significantly greater in periapical lesions of DA rats compared to AO rats (p < .05). In DA rats, periapical lesions had a significantly higher (p < .05) percentage of CD3+ cells compared to AO rats. Also, the percentage of INF-γ, IL-17 and IL-10 CD3+CD4+ cells was significantly higher in DA rats (p < .05). DA rats had a significantly higher Th17/Th10 ratio. RT-PCR expression of IL-1β, INF-γ and IL-17 genes was significantly higher in periapical lesions of DA compared to AO rats (p < .05). The receptor activator of nuclear factor kappa-Β ligand/osteoprotegerin ratio was higher in DA compared to AO rats with periapical lesions (p < .05). Systemic levels of TNF-α and IL-6 were significantly higher in DA compared to AO rats (p < .05). Levels of lipid peroxidation measured as thiobarbituric acid reactive substances and reduced glutathione were significantly higher (p < .05) in the supernatant in the periapical lesions of DA rats., Conclusion: After pulp exposure, DA rats developed much larger periapical lesions compared to AO rats. Genetically determined differences in immunopathology have been demonstrated to be a significant element defining the severity of periapical lesions., (© 2021 International Endodontic Journal. Published by John Wiley & Sons Ltd.)

We evaluated the influence of an antioxidant-rich extract of Filipendula ulmaria L. on anxiety levels induced by nano-sized particles of different calcium phosphates. Rats in experimental groups were administered with either nano-sized hydroxyapatite, tricalcium phosphate, or amorphous calcium phosphate in the presence of Filipendula ulmaria extract. Appropriate behavioral tests were performed to assess anxiety levels, while oxidative status and apoptosis parameters were determined in the hippocampus samples. The applied calcium phosphates increased oxidative stress markers in hippocampal tissue, accompanied by an enhanced pro-apoptotic mechanism. Moreover, the hippocampal immunoreactivity for brain-derived neurotrophic factor and GABAergic-A receptors was significantly lower following calcium phosphate nanoparticles intake. The observed functional and morphological alterations in the rat hippocampus occurred simultaneously with the anxiogenic response estimated in behavioral testing. The neuroprotective effect of Filipendula ulmaria was markedly manifested by the attenuation of oxidative damage induced by amorphous calcium phosphate and enhanced anti-apoptotic action in the rat hippocampus. The increased hippocampal immunoreactivity for brain-derived neurotrophic factor, GABAergic-A receptors and significant anxiolytic-like effects of Filipendula ulmaria may suggest a beneficial role of antioxidant supplementation in preventing anxiogenic response to nano-sized calcium phosphates., Competing Interests: The authors declare no conflict of interest., (© 2021 The Author(s). Published by IMR Press.)