Burnout Syndrome among Otorhinolaryngologists during the COVID-19 Pandemic.

Background and Objectives: To determine the prevalence of burnout syndrome among otorhinolaryngologists in Lithuania and investigate associations with sociodemographic and professional factors during the COVID-19 pandemic. Materials and Methods: Burnout was measured using the validated Lithuanian version of the Maslach Burnout Inventory. Demographic characteristics and professional characteristics were collected utilizing an anonymous questionnaire. Results: Eighty otorhinolaryngologists (ORL group) and 30 information technology professionals (the control group) were enrolled in this study. A high level of professional burnout in at least one of the subscales was observed in 82.5% of the ORL group subjects. Depersonalization and burnout syndrome were more frequently detected with increasing age in the ORL group (r = 0.2, p < 0.04). Greater satisfaction with salary and working environment resulted in a lower burnout incidence (r = 0.31, p = 0.001). Conclusions: During the COVID-19 pandemic, the incidence of burnout syndrome has been high among Lithuanian otorhinolaryngologists. Demographic and professional characteristics are significantly related to burnout syndrome among Lithuanian otorhinolaryngologists.

Cross-cultural adaptation and validation of Lithuanian-NOSE scale.

PURPOSE: To evaluate validity and reliability of Lithuanian version of Nasal Obstruction Symptom Evaluation Scale (L-NOSE), designed for the assessment of nasal obstruction. METHODS: Cross-cultural adaptation of L-NOSE was accomplished according to generally accepted methodology. L- NOSE was tested for its reliability, validity, and responsiveness in the group of 50 septoplasty patients and 100 healthy volunteers' controls. RESULTS: L- NOSE showed good internal consistency (Cronbach's alpha coefficient 0.796 for test, 0.791 for retest, 0.792 for post-operative group, and 0.817 for control group) scores and high test-retest reliability (r = 0.94, p < 0.01) scores. In patients' group, positive moderate correlations between L-NOSE scores and Sino-nasal Outcome Test-22 logically similar domain scores were found, thus indicating good convergent construct validity. L-NOSE scores for control subjects were generally lower than for patients with nasal obstruction (p < 0.001), thereby indicating good discriminant validity of questionnaire. The exploratory factor analysis confirmed one-factor structure of questionnaire. The component matrix of L-NOSE ranged from 0.667 to 0.781 (KMO = 0.754, p < 0.0001). The mean L-NOSE score improved from 58.4 ± 18.2 points to 11.1 ± 9.5 points after septoplasty (p < 0.0001), indicating good responsiveness of questionnaire. CONCLUSION: The L-NOSE questionnaire is a valid instrument with satisfactory reliability, validity, and responsiveness.

Chronic Rhinosinusitis with Nasal Polyps: Age and Disease Severity Differences in the Levels of Inflammatory Markers.

Background and objectives: The aim of our study was to analyze the concentrations of inflammatory markers in the nasal tissue of patients with chronic rhinosinusitis with nasal polyps (CRSwNPs) and controls of different age groups, as well as to find associations between age, inflammation development, and NPs. Materials and methods: Patients were divided into two groups-patients with CRSwNPs and control subjects who had nasal surgery for another reason beside CRS. Our analysis was performed across three different age groups (18-30 years, 31-50 years, and 51 years and more). Tissue biopsies from the sinus cavity for all study participants were taken and frozen at -80 °C, until use. The concentrations of IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-13, IL-21, and IL-22, were quantified using a magnetic bead-based multiplex assay. Results: In the group aged 18-30 years, the levels of inflammatory markers IL-1, IL-2, IL-5, and IL-22 were significantly higher in patients with CRSwNPs than the control subjects. Among patients aged 31-50 years, significantly higher concentrations of IL-2, IL-4, IL-5, and IL-22 were recorded in patients with CRSwNPs, as compared to the control subjects. In the oldest group (aged 51 years and more), patients with CRSwNPs had significantly higher concentrations of IL-2, IL-4, and IL-22, as compared to the control group. In the CRSwNP group, only the concentration of IL-21 was significantly higher among patients aged 31-50 years, as compared with those aged 51 years and older (p = 0.013). Conclusions: IL-2 and IL-22 levels were significantly higher in patients with CRSwNP than the control, across all age groups. Only the concentration of IL-21 was higher among patients with CRSwNP in the middle age group, as compared to the oldest group. IL-2, IL-4, and IL-22 levels correlated with the severity of CRSwNPs. Elevated concentrations of IL-2, IL-4, and IL-22 were determined in patients' groups with higher sinonasal outcome test (SNOT-22) scores, pointing to more severe clinical symptoms.

Lithuanian version of nasolacrimal duct obstruction symptom scoring questionnaire. Cross-cultural adaptation and validation. Short- and long-term results.

OBJECTIVES: The objective of this study was to perform translation, cross-cultural adaptation and validation of the Lithuanian version of specific nasolacrimal duct obstruction symptom scoring (NLDO-SS) questionnaire and to evaluate short- and long-term results of endoscopic endonasal dacryocystorhinostomy (EN-DCRS) procedure. DESIGN, SETTING, PARTICIPANTS: Permission for questionnaire translation, cross-cultural adaptation and validation was obtained from the authors of the original questionnaire. Translation, validation and cross-cultural adaptation were carried out according to generally accepted methodology. Validation study of the Lithuanian version of NLDO-SS (L-NLDO-SS) was performed, and short- and long-term results of EN-DCRS procedure were evaluated according to symptoms. In total, 44 patients were evaluated 2 weeks before the surgical intervention, a day before the surgery and 41 patients 2 months after the surgery, and again 10 months later. MAIN OUTCOME MEASURES: We analysed the internal consistency and test-retest reliability of the L-NLDO-SS questionnaire. Cronbach's alpha was used to represent and evaluate internal consistency for ordinal responses. Validity was assessed by comparing scores between a control group of volunteers without NLDO and the NLDO group using Mann-Whitney test. To test the limiting score on which the sensitivity and specificity curves cross in identifying patients with NLDO, receiver operating characteristic (ROC) curve analysis was used. The pre- and post-operative scores were compared using the paired t-test. RESULTS: The results showed an acceptable internal consistency of L-NLDO-SS questionnaire, with Cronbach's alpha-.73 in the initial test group and .71 in the retest group. Pearson's correlation coefficient was .94 (P < .001), revealing good correlation between the initial scores and the retest scores. Our sample of healthy individuals had a mean L-NLDO-SS score of 11.42 (±12.69) points, and patients being scheduled for EN-DCRS had a mean L-NLDO-SS score of 27.45 (±9.81) points. Post-operatively mean L-NLDO-SS scores improved from 27.45 (±9.81) points to 4.45 (±6.29) points in the short term and to 5.83 (±4.17) in the long term, demonstrating the statistically significant responsiveness of the instrument over both timescales. CONCLUSIONS: Lithuanian version of NLDO-SS questionnaire is a valid instrument for assessing patients with NLDO in the Lithuanian population. It demonstrated good internal consistency, reproducibility, validity and responsiveness.

Clinical efficacy of main radiological diagnostic methods for odontogenic maxillary sinusitis.

The objective of the study was to compare the ability of dental, ENT and radiology specialists to identify the dental cause of maxillary sinusitis with conventional computed tomography, dental and panoramic radiographs. Out of 34 dental records from subjects treated at ENT and Oral and Maxillofacial Surgery Department, LUHS Kaunas Clinics, 22 females and 12 males with the diagnosis of odontogenic maxillary sinusitis, periapical (DPA), panoramic (DPR) and computed tomography (CT) images of posterior maxilla were selected for further studies. In total, 39 sinuses with an odontogenic and 37 sinuses with only rhinogenic cause (control group) were included in the study. Sinuses with mucosal thickening less than 3 mm were excluded from the research. Each image was evaluated by 5 endodontologists, 5 oral surgeons, 6 general dentists, 6 otorhinolaryngologists and an experienced oral radiologist. DPR and DPA views were not evaluated by ENT specialists. The dental cause of maxillary sinusitis was marked according to the given scale. Intraclass correlation coefficient and ROC curve statistical analysis were performed. The best accuracy was observed when CT views were evaluated by experienced oral radiologist and oral surgeons: the AUC was 0.958 and 0.859, respectively. DPR views showed the best accuracy when evaluated by oral surgeons (0.763) and DPA-by endodontologists (0.736). The highest inter-rater agreement was observed between experienced oral radiologist and oral surgeons/otorhinolaryngologists (0.87/0.78) evaluating CT. Sensitivity and specificity of CT were 89.7 and 94.6%, DPR-68.2 and 77.3%, DPA-77.9 and 67%. Identification of dental cause of maxillary sinusitis sometimes is a challenge, which depends on radiological method and, more importantly, on evaluator's experience.

Efficacy of sucralfate for the treatment of post-tonsillectomy symptoms.

Pain after tonsillectomy remains the main issue of postoperative morbidity and the search for an effective post-tonsillectomy analgesic is of increasing relevance. The aim of this study was to evaluate the effectiveness of topical sucralfate during an early post-tonsillectomy period. Fifty patients of both genders from 6 to 58 years submitted to tonsillectomy or adenotonsillectomy were randomly included into either a sucralfate treatment group (N = 25) or into a control group (N = 25). Patients of the sucralfate group received topical sucralfate four times a day for 7 days. No topical treatment was applied to patients of the control group. A systemic analgesic was standardized. Post-tonsillectomy symptoms, including throat pain, odynophagia and otalgia, were evaluated during the period of seven postoperative days. Secondary outcomes were analgesic use, well being in general, return to regular daily activities, secondary hemorrhage and side effects of sucralfate. This study revealed that during the period of the second to seventh postoperative days average throat pain scores of the sucralfate using patients were significantly lower than those of the control group patients (p < 0.05); the same could be applied to odynophagia scores during the period of all seven postoperative days (p < 0.01) and otalgia scores from the 4th postoperative day (p < 0.05). The sucralfate group patients also had a significantly smaller need for analgesics, better scores of well being in general and early return to regular daily activities with no side effects of the treatment. Topical sucralfate could be recommended for the everyday clinical practice as a safe, adjuvant medicine of treatment during the period of the first post-tonsillectomy week.

Reirradiation for patients with recurrence head and neck squamous cell carcinoma: a single-institution comparative study.

BACKGROUND AND OBJECTIVE: In the last decade, the number of publications that report on the use of external beam radiotherapy and high-dose-rate brachytherapy (HDR-BRT) in the treatment of recurrent head and neck cancer has increased, but no studies compare external beam radiotherapy and HDR-BRT. The aim of this study was to evaluate and to compare the efficacy and toxicity of the three-dimensional conformal radiotherapy (3D-CRT) and HDR-BRT in the treatment of recurrent head and neck cancer. MATERIAL AND METHODS: A total of 64 patients with head and neck cancer recurrence were randomly assigned at a 1:1 ratio to receive either 3D-CRT (50Gy/25 fractions) in the control group or HDR-BRT (30Gy/12 fraction) in the experimental group. RESULTS: The overall survival rate of patients treated with HDR-BRT at 1 and 2-years was 74% and 67%, respectively, compare to 3D-CRT group - 51% and 32%, respectively (P=0.002). Local control at 1- and 2-years in patients who received HDR-BRT was 77% and 63% compare with 47% and 25%, respectively, for the patients who received the 3D-CRT (P<0.001). Most patients developed mild to moderate acute mucositis and dermatitis. In the 3D-CRT group, severe late toxicity was determined in 11 patients (35.5%), and in the HDR-BRT group, in 1 patient (3.1%) (P=0.001). There was no grade 5 toxicity. CONCLUSIONS: Following our results, we concluded that HDR-BRT is a more effective and safer treatment approach for head and neck cancer recurrences than 3D-CRT.

The Diagnostic Value of CEUS in Assessing Non-Ossified Thyroid Cartilage Invasion in Patients with Laryngeal Squamous Cell Carcinoma.

Background: Accurate assessment of thyroid cartilage invasion in squamous cell carcinoma (SCC) of the larynx remains a challenge in clinical practice. The aim of this study was to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT), and magnetic resonance imaging (MRI) in the detection of non-ossified thyroid cartilage invasion in patients with SCC. Methods: CEUS, CECT, and MRI scans of 27 male patients with histologically proven SCC were evaluated and compared. A total of 31 cases were assessed via CEUS and CECT. The MR images of five patients and six cases were excluded (one patient had two suspected sites), leaving twenty-five cases for analysis via MRI. Results: CEUS showed the highest accuracy and specificity compared with CECT and MRI (87.1% vs. 64.5% and 76.0% as well as 84.0% vs. 64.0% and 72.7%, respectively). The sensitivity and negative predictive value of CEUS and MRI were the same (100%). CEUS yielded four false-positive findings. However, there were no statistically significant differences among the imaging modalities (p > 0.05). Conclusions: CEUS showed better diagnostic performance than CECT and MRI. Therefore, CEUS has the potential to accurately assess non-ossified thyroid cartilage invasion and guide appropriate treatment decisions, hopefully leading to improved patient outcomes.

Research on Thermal Stability and Flammability of Wood Scob-Based Loose-Fill Thermal Insulation Impregnated with Multicomponent Suspensions.

Loose-fill thermal composite insulation produced from surface-modified wood scobs has been explored as a potential fire-resistant material for building envelopes. This work involves fire resistance behavior comparisons between four coating systems consisting of liquid glass, liquid glass-tung oil, liquid glass-expandable graphite, and liquid glass-tung oil-expandable graphite. The techniques of thermogravimetric and differential thermogravimetric analyses, gross heat combustion via a calorimetric bomb, cone calorimetry, SEM imaging of char residues, and energy dispersive spectrometry for elemental analysis, as well as propensity to undergo continuous smoldering, were implemented. The coating technique resulted in greater thermal stability at a higher temperature range (500-650 °C) of the resulting loose-fill thermal composite insulation, reduced flame-damaged area heights after the exposure of samples at 45° for 15 s and 30 s, with a maximum of 49% decreased gross heat combustion, reduced heat release and total smoke release rates, improved char residue layer formation during combustion and changed smoldering behavior due to the formation of homogeneous and dense carbon layers. The results showed that the highest positive impact was obtained using the liquid glass and liquid glass-expandable graphite system because of the ability of the liquid glass to cover the wood scob particle surface and form a stable and strong expanding carbon layer.

Effect of Liquid Glass-Modified Lignin Waste on the Flammability Properties of Biopolyurethane Foam Composites.

Water-blown biopolyurethane (bioPUR) foams are flammable and emit toxic gases during combustion. Herein, a novel approach suggested by the current study is to use different amounts of lignin waste (LigW), which increases the thermal stability and delays the flame spread and sodium silicate (LG), which has foaming ability at high temperatures and acts as a protective layer during a fire. However, there have been no studies carried out to investigate the synergy between these two materials. Therefore, two different ratios, namely 1/1 and 1/2 of LigW/LG, were used to prepare bioPUR foam composites. The obtained bioPUR foam composites with a 1/2 ratio of LigW/LG exhibited inhibition of flame propagation during the ignitability test by 7 s, increased thermal stability at higher temperatures by 40 °C, reduced total smoke production by 17%, reduced carbon monoxide release by 22%, and increased compressive strength by a maximum of 123% and 36% and tensile strength by a maximum of 49% and 30% at 100 °C and 200 °C, respectively, compared to bioPUR foam composites with unmodified LigW. Additionally, thanks to the sufficient compatibility between the polymeric matrix and LigW/LG particles, bioPUR foam composites were characterised by unchanged or even improved physical and mechanical properties, as well as increased glass transition temperature by 16% compared to bioPUR foam composites with unmodified LigW particles, making them suitable for application as a thermal insulating layer in building envelopes.

Controlled trial of combined radiofrequency-assisted uvulopalatoplasty in the treatment of snoring and mild to moderate OSAS (pilot study).

PURPOSE: The aim of this study was to assess the efficacy of radiofrequency treatment (RFT) of the soft palate and combined radiofrequency-assisted uvulopalatoplasty (RF-UPP) in the treatment of snoring and mild to moderate obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: In the study group consisting of 32 snoring and mild to moderate OSAHS patients with excessive soft tissue of the soft palate or uvula, 13 patients underwent RFT of the soft palate and 19 patients underwent combined RF-UPP. The baseline and posttreatment polysomnography and clinical test battery consisting of Visual Analogue Scales (VAS), Lithuanian version of Sleep Apnea Quality of Life Index (SAQLI-LT), Spielberg's Trait-State Anxiety Inventory, Beck Depression Inventory-second edition (BDI-II), and Epworth Sleepiness Scale were applied to assess the treatment outcomes. RESULTS: After a short-term follow-up of 2 to 3 months, the group of the RFT patients showed improvement in mean VAS snoring and SAQLI-LT scores, while the group of RF-UPP patients showed statistically significantly improvement in mean apnea-hypopnea index (AHI) (12.51 ± 7.66 vs. 7.88 ± 6.05, p < 0.05, ß = 0.107), SAQLI-LT, and BDI-II scores. The group of RF-UPP patients had superior and statistically significant improvement compared to the RFT alone patients with regard to mean AHI (effect size 4.63 ± 4.65 vs. 0.95 ± 4.83, p < 0.05) and SAQLI-LT (effect size 0.75 ± 0.59 vs. 0.33 ± 0.40, p < 0.05) scores. CONCLUSIONS: Combined RF-UPP showed to be effective in the treatment of snoring and mild to moderate OSAS overcoming the RFT alone.

Helicobacter pylori infection in laryngeal diseases.

Clinical studies have shown that Helicobacter pylori can be found not only in the mucosa of the stomach, but in the pharyngeal and laryngeal regions as well. The aim of this prospective case-control study was to identify H. pylori infection in the biopsy material from the larynx of the patients suffering from benign laryngeal diseases (vocal fold polyps, laryngitis) and laryngeal cancer and to investigate the possible relationships between the laryngeal H. pylori and patients' socio-demographic data and laryngopharyngeal reflux. The results of the biopsy material from 67 adult patients treated for benign laryngeal diseases and laryngeal cancer and 11 individuals of the control group revealed that H. pylori infection could be identified in more than one-third of the patients. In the majority of cases H. pylori was found in the patients with chronic laryngitis (45.5%) and laryngeal cancer (46.2%). The findings of these sub-groups significantly differed from those of the control group (9.1%) (p < 0.05). No significant relationships between H. pylori infection found in the laryngeal region and patients' demographic data, their unhealthy habits and reflux-related symptoms or signs were obtained. It could be concluded that H. pylori can colonize in the larynx of patients with benign laryngeal diseases and laryngeal cancer. To clarify the role of H. pylori as a risk factor for laryngeal diseases further research is needed.

Translation, cross-cultural adaptation, and validation of the sino-nasal outcome test (SNOT)-22 for Lithuanian patients.

The objective of this study was to perform translation, cross-cultural adaptation, and validation of the SNOT-22 in the Lithuanian language. This is a prospective case-control study. The study was conducted at the University clinic. The sino-nasal outcome test 22 (SNOT-22) was translated into the Lithuanian language; the pilot study involved 34 patients, the test-retest group consisted of 34 patients with chronic rhinosinusitis (CRS), and the control group of 115 patients with no CRS complaints; 36 patients were evaluated before surgery and 3 months after surgery. The results showed a good internal correlation with Cronbach's alpha-0.89 in the initial test, and 0.93 in the retest; both values suggesting good internal consistency within the SNOT-22. Pearson's correlation coefficient was 0.72 (p < 0.001), revealing good correlation between the initial scores and the retests scores. Our sample of healthy individuals had a median score of 12 points, and the instrument was capable of differentiating between the healthy and the patient group, demonstrating its validity (p < 0.0001). The statistically significant reduction in the post-operative scores, vis-à-vis pre-operative values, demonstrates the responsiveness of the instrument. The minimally important difference was 13 points in the SNOT-22 score. The Lithuanian version of the SNOT-22 is a valid instrument for assessing patients with CRS. It demonstrated good internal consistency, reproducibility, validity, and responsiveness.

Impact of Different Ratios of Lignin Waste and Liquid Glass on the Performance Characteristics of Biopolyurethane Foams.

In the current study, biopolyurethane foam was modified with 2.5-10 wt.% lignin waste (LigW) and liquid glass (LG)-modified LigW particles at different LigW/LG ratios-1:1 and 1:2-and their impact on performance characteristics-i.e., rheology, foaming times, apparent density, thermal conductivity before and after aging, dimensional stability at ambient and elevated conditions, compressive and tensile strengths, short-term water absorption by partial immersion, and water vapor permeability-was determined and evaluated. Structural analysis was implemented and structural parameters were taken into consideration as well. During the study, it was determined that 2.5-10 wt.% particles at the LigW/LG ratio of 1:2 showed a superior impact on the physical and mechanical properties of bioPUR foams. The apparent density only insignificantly increased and was in a density range suitable for commercially available polyurethanes. For particles at 10 wt.% and LigW/LG ratio of 1:1, the thermal conductivity value improved by 3.2%, the compressive strength increased by 153%, while the tensile strength improved by 23.5%, indicating sufficient interfacial adhesion between the filler and polymer matrix. Moreover, the short-term water absorption by partial immersion remained almost unchanged, while the water vapour diffusion resistance factor improved from 43 to 48. Additionally, the incorporation of LigW/LG 1:1 and LigW/LG 1:2 particles made it possible to obtain dimensionally and structurally stable closed-cell bioPUR foams for possible application as thermal insulation in building envelopes.

Development of High Strength Particleboards from Hemp Shives and Corn Starch.

In the current study, high-strength boards for the construction industry were developed from renewable natural resources, fibrous hemp shives, and corn starch. During the research, the influence of the composition of the mixture, the processing of raw materials, and technological parameters on the operational properties of the board were evaluated. The influence of the binding material and the water content on the properties of the molded boards was evaluated. It was established that the rational amount of starch is 15% of the mass of the shives, and the amount of water is 10%. It has been established that with the proper selection of the forming parameters of the board, it is possible to avoid internal disintegration of the structure due to the water vapor pressure, increase the bending strength, and ensure uniform sintering of the board throughout the entire volume. It was found that additional processing of hemp shives can increase bending strength by more than 40%. Furthermore, during the processing of shives by chemical means, soluble substances are washed out, which reduces the density and thermal conductivity of the shives. Selection of a rational level of compression allowed us to increase the bending strength of the boards by 40%. The assessment of all factors made it possible to obtain boards with a bending strength of 40 MPa. The additives used made it possible to reduce the water absorption of the boards up to 16 times and obtain non-flammable boards. The thermal conductivity of the resulting boards varied from 0.07 to 0.095 W/(m·K). The analysis of macrostructure and microstructure allowed us to evaluate the process of the formation of bonds between hemp shives.

Reuse of Textile Waste in the Production of Sound Absorption Boards.

Textile waste is formed in various stages, from the preparation of raw materials to the utilisation of textile products. One of the sources of textile waste is the production of woollen yarns. During the production of woollen yarns, waste is generated during the mixing, carding, roving, and spinning processes. This waste is disposed of in landfills or cogeneration plants. However, there are many examples of textile waste being recycled and new products being produced. This work deals with acoustic boards made from waste from the production of woollen yarns. This waste was generated in various yarn production processes up to the spinning stage. Due to the parameters, this waste was not suitable for further use in the production of yarns. During the work, the composition of waste from the production of woollen yarns was examined-namely, the amount of fibrous and nonfibrous materials, the composition of impurities, and the parameters of the fibres themselves. It was determined that about 74% of the waste is suitable for the production of acoustic boards. Four series of boards with different densities and different thicknesses were made with waste from the production of woollen yarns. The boards were made in a nonwoven line using carding technology to obtain semi-finished products from the individual layers of combed fibres and thermal treatment of the prepared semi-finished product. The sound absorption coefficients in the sound frequency range between 125 and 2000 Hz were determined for the manufactured boards, and the sound reduction coefficients were calculated. It was found that the acoustic characteristics of soft boards made from woollen yarn waste are very similar to those of classic boards or sound insulation products made from renewable resources. At a board density of 40 kg/m3, the value of the sound absorption coefficient varied from 0.4 to 0.9, and the noise reduction coefficient reached 0.65.

Recurring desmoid tumor of the neck: A case report.

The infiltrative growth pattern of desmoid tumors and their proximity to important anatomical structures make them difficult to manage. Mutilating surgery should be avoided, while surveillance or radiotherapy remain valid options.

Performance Analysis of Loose-Fill Thermal Insulation from Wood Scobs Coated with Liquid Glass, Tung Oil, and Expandable Graphite Mixture.

The current study presents the results of monitoring the behavior of loose-fill thermal insulating material for buildings made of wood scobs (WS), which were coated with one, two, and three component-based coatings from liquid glass (LG), tung oil (TO), and expandable graphite (EG). The thermal conductivity of samples in the dry state and under normal laboratory conditions, short-term water absorption by partial immersion, surface wettability, and water vapor permeability were evaluated, and regression equations describing the variations in numerical values of specified properties under different amounts of each coating component were presented. It was shown that LG and TO act as hydrophobic layers that, in conjunction, reduce water absorption by a maximum of 274%, have a contact angle equal to 86°, and lower thermal conductivity by 55% in the dry state due to the specifics of the layer formed on the surface of WS. The addition of EG to LG coating resulted in insignificantly changed water absorption and thermal conductivity values, indicating the potential of this material to be used to improve the fire resistance of wood-based composites in the future. The results showed that the three-component layer of LG/TO/EG reduces water absorption by a maximum of 72%, increases thermal conductivity in the dry state by a minimum of 0.4%, and increases the contact angle to 81° at 100 wt.% LG. The changes in water vapor permeability of all compositions were determined to be insignificant.

An unusual case of a sore throat and otalgia in a 4-year-old boy.

A sore throat, otalgia, and snoring are the common symptoms seen in children presenting to an otorhinolaryngological clinic. Sometimes, however, these symptoms may be suggestive of an aggressive malignancy. We present a rare case of Burkitt's lymphoma of the tonsil in a young child, which initially manifested as a sore throat and otalgia.

Analysis of Active and Passive Deformation of Expanded Polystyrene Foam under Short-Term Compression.

In this paper, we undertake a detailed analysis of the active and passive deformation of expanded polystyrene (EPS), which is used as a thermal insulating layer in building partitions, under short-term compressive loading. The values of residual strain in 10-40 kg/m3 density EPS after monotonically increasing loading under active deformations of 20%, 30%, 40%, 50%, and 60% with the following complete removal are determined. These values are a physical sign of the elastic-plastic state of EPS. It has been shown that the final destruction of cells takes place in EPS when the active strain reaches 50%. Empirical equations are proposed to estimate the residual strain of EPS based on density with determination coefficients varying from 0.744 to 0.986 at a confidence level of 90%. Moreover, graphical interpretations with regression equations for residual strain dependence on density and compressive strength, as well as density and active strain, were proposed with determination coefficients equal to 0.779 and 0.717, respectively.