bluuebunny/crossref_metadata_2025 huggingface dataset:
Concealed penis in pediatric age group: a comparison between three surgical techniques
Authors: Elrouby Ahmed
Published: January 2023

Background

Comparison between three different surgical techniques in the management of concealed penis.

Methods

This prospective interventional non-randomized study included 150 pediatric patients with a concealed penis. They were distributed equally into three groups; group A; patients treated by anchoring the penile skin dermis to Buck's fascia at the penile base at 3 and 9 o'clock points using PDS 5/0 (phallopexy), group B; patients treated by complete dissection and excision of dartos fascia and group C; patients treated by phallopexy as in group A after complete dissection and excision of dartos fascia. Follow-up at the end of the 1st post-operative week and then monthly for 6 months as regards penile skin congestion and/or necrosis, wound infection, edema, and/or re-retraction was carried out.

Results

Penile edema and re-retraction have a statistically significant difference among the studied groups (p < 0.001 and p = 0.002 respectively). Penile re-retraction was noticed to be lowest in patients of group C, however penile edema was observed to be highest in patients of group B.

Conclusions

Phallopexy after complete dissection and excision of dartos fascia have better results than doing either phallopexy or dartos excision alone in the treatment of concealed penis.

Clinical trial registration: The manuscript was registered in ClinicalTrials.gov Protocol Registration and Results System. ClinicalTrials.gov Identifier: NCT05565040. Our manuscript was registered on 4/10/2022.
Machine learning in 3D auto-filling alveolar cleft of CT images to assess the influence of alveolar bone grafting on the development of maxilla
Authors: Zhang Xin , Qin Niu , Zhou Zhibo , Chen Si
Published: January 2023

Background

Machine learning based auto-segmentation of 3D images has been developed rapidly in recent years. However, the application of this new method in the research of patients with unilateral cleft lip and palate (UCLP) is very limited. In this study, a machine learning algorithm utilizing 3D U-net was used to automatically segment the maxilla, fill the cleft and evaluate the alveolar bone graft in UCLP patients. Cleft related factors and the surgery impact on the development of maxilla were analyzed.

Methods

Preoperative and postoperative computed tomography images of 32 patients (64 images) were obtained. The deep-learning-based protocol was used to segment the maxilla and defect, followed by manual refinement. Paired t-tests and Mann-Whitney tests were performed to reveal the changes of the maxilla after surgery. Two-factor, two-level analysis for repeated measurement was used to examine the different trends of growth on the cleft and non-cleft sides of the maxilla. Pearson and Spearman correlations were used to explore the relationship between the defect and the changes of the maxillary cleft side.

Results

One-year after the alveolar bone grafting surgery, different growth amount was found on the cleft and non-cleft sides of maxilla. The maxillary length (from 34.64 ± 2.48 to 35.67 ± 2.45 mm) and the alveolar length (from 36.58 ± 3.21 to 37.63 ± 2.94 mm) increased significantly only on the cleft side while the maxillary anterior width (from 11.61 ± 1.61 to 12.01 ± 1.41 mm) and posterior width (from 29.63 ± 2.25 to 30.74 ± 2.63 mm) increased significantly only on the non-cleft side after surgery. Morphology of the cleft was found to be related to the pre-surgical maxillary dimension on the cleft side, while its correlation with the change of the maxilla after surgery was low or not statistically significant.

Conclusion

The auto-segmentation of the maxilla and the cleft could be performed very efficiently and accurately with the machine learning method. Asymmetric growth was found on the cleft and non-cleft sides of the maxilla after alveolar bone graft in UCLP patients. The morphology of the cleft mainly contributed to the pre-operation variance of the maxilla but had little impact on the maxilla growth after surgery.
Identification of genetic variants associated with diabetic kidney disease in multiple Korean cohorts via a genome-wide association study mega-analysis
Authors: Jin Heejin , Kim Ye An , Lee Young , Kwon Seung-hyun , Do Ah Ra , Seo Sujin , Won Sungho , Seo Je Hyun
Published: January 2023

Background

The pathogenesis of diabetic kidney disease (DKD) is complex, involving metabolic and hemodynamic factors. Although DKD has been established as a heritable disorder and several genetic studies have been conducted, the identification of unique genetic variants for DKD is limited by its multiplex classification based on the phenotypes of diabetes mellitus (DM) and chronic kidney disease (CKD). Thus, we aimed to identify the genetic variants related to DKD that differentiate it from type 2 DM and CKD.

Methods

We conducted a large-scale genome-wide association study mega-analysis, combining Korean multi-cohorts using multinomial logistic regression. A total of 33,879 patients were classified into four groups—normal, DM without CKD, CKD without DM, and DKD—and were further analyzed to identify novel single-nucleotide polymorphisms (SNPs) associated with DKD. Additionally, fine-mapping analysis was conducted to investigate whether the variants of interest contribute to a trait. Conditional analyses adjusting for the effect of type 1 DM (T1D)-associated HLA variants were also performed to remove confounding factors of genetic association with T1D. Moreover, analysis of expression quantitative trait loci (eQTL) was performed using the Genotype-Tissue Expression project. Differentially expressed genes (DEGs) were analyzed using the Gene Expression Omnibus database (GSE30529). The significant eQTL DEGs were used to explore the predicted interaction networks using search tools for the retrieval of interacting genes and proteins.

Results

We identified three novel SNPs [rs3128852 (P = 8.21×10−25), rs117744700 (P = 8.28×10−10), and rs28366355 (P = 2.04×10−8)] associated with DKD. Moreover, the fine-mapping study validated the causal relationship between rs3128852 and DKD. rs3128852 is an eQTL for TRIM27 in whole blood tissues and HLA-A in adipose-subcutaneous tissues. rs28366355 is an eQTL for HLA-group genes present in most tissues.

Conclusions

We successfully identified SNPs (rs3128852, rs117744700, and rs28366355) associated with DKD and verified the causal association between rs3128852 and DKD. According to the in silico analysis, TRIM27 and HLA-A can define DKD pathophysiology and are associated with immune response and autophagy. However, further research is necessary to understand the mechanism of immunity and autophagy in the pathophysiology of DKD and to prevent and treat DKD.
Molecular imaging of HER2 expression in breast cancer patients using a novel peptide-based tracer 99mTc-HP-Ark2: a pilot study
Authors: Shi Jiyun , Du Shuaifan , Wang Rongxi , Gao Hannan , Luo Qi , Hou Guozhu , Zhou Yidong , Zhu Zhaohui , Wang Fan
Published: January 2023

Background

Due to the temporal and spatial heterogeneity of human epidermal growth factor receptor 2 (HER2) expression in breast tumors, immunohistochemistry (IHC) cannot accurately reflect the HER2 status in real time, which may cause misguided treatment decisions. HER2-specific imaging can noninvasively determine HER2 status in primary and metastatic tumors. In this study, HER2 expression in breast cancer patients was determined in vivo by SPECT/CT of 99mTc-HP-Ark2, comparing with PET/CT of 18F-FDG lesion by lesion.

Methods

A novel HER2-targeted peptide probe 99mTc-HP-Ark2 was constructed. Biodistribution and nanoScan SPECT/CT imaging were performed in mice models. The correlation between the quantified tumor uptake and HER2 expression in tumor cells was analyzed. In the pilot clinical study, a total of 34 breast cancer patients (mean age ± SD: 49 ± 10 y) suspected of having breast cancer according to mammography or ultrasonography were recruited at Peking Union Medical College Hospital, and 99mTc-HP-Ark2 SPECT/CT and 18F-FDG PET/CT were carried out with IHC and fluorescence in situ hybridization as validation.

Results

Small animal SPECT/CT of 99mTc-HP-Ark2 clearly identified tumors with different HER2 expression. The quantified tumor uptake and tumor HER2 expression showed a significant linear correlation (r = 0.932, P < 0.01). Among the 36 primary lesions in the 34 patients, when IHC (2 +) or IHC (3 +) was used as the positive evaluation criterion, 99mTc-HP-Ark2 SPECT/CT imaging with a tumor-to-background ratio of 1.44 as the cutoff value reflected the HER2 status with sensitivity of 89.5% (17/19), specificity of 88.2% (15/17) and accuracy of 88.9% (32/36), while the 18F-FDG PET/CT showed sensitivity of 78.9% (15/19), specificity of 70.6% (12/17) and accuracy of 75.0% (27/36). In particular, 100% of IHC (3 +) tumors were all identified by 99mTc-HP-Ark2 SPECT/CT imaging.

Conclusion

99mTc-HP-Ark2 SPECT/CT can provide a specific, noninvasive evaluation of HER2 expression in breast cancer, showing great potential to guide HER2-targeted therapies in clinical practice.

ClinicalTrials.gov Trial registration: NCT04267900. Registered 11th February 2020. Retrospectively registered, https://www.clinicaltrials.gov/ct2/results?pg=1&load=cart&id=NCT04267900.
Delayed endovascular repair for traumatic aortic pseudoaneurysms: experience from an Asian single center
Authors: Liu Yuzhou , Sun Lin , Wang Qing , Xiang Bin , Cai Huangxing , Xie Yong , Li Muzi , Xiang Hua
Published: January 2023

Background

Traumatic aortic pseudoaneurysms (PSAs) classified as grade III aortic injuries are conventionally repaired as procedural emergencies, generally within 24 h of arrival. These patients typically require adequate resuscitation and treatment of multiple traumatic injuries, which complicate optimal management strategies of aortic PSAs. This study reviews the experience of an Asian single center to evaluate the efficacy and safety of delayed (> 24 h) endovascular repair for PSAs.

Methods

Twenty-seven patients with blunt aortic injury (BTAI) were brought to our institution between February 2014 and May 2020. Patients with other grades of aortic injuries (grade I, II, or IV) were excluded from the study, and the remaining patients with grade III aortic injuries were placed into the early (< 24 h) and delayed (> 24 h) groups according to the timing of repair. Medical records and follow-up computed tomography (CT) scans were reviewed to document the outcomes of the procedures. Primary outcomes included mortality and complications.

Results

During this period, there were 14 patients (13 males and 1 females) with aortic PSAs, and each patient received thoracic endovascular aortic repair (TEVAR). Of these 14 patients, 1 underwent emergent TEVAR, and 13 underwent delayed repair (median 7 days, range, 3–14 days). Over a period of 8 years, the overall survival of our series was 100%. No paraplegia, stroke, ischemia of limb or other serious procedural complications were observed during the duration of follow-up.

Conclusion

The experience of our center indicates that delayed repair for selected PSAs could be permissible, which enables a repair in more controlled circumstances.
Effect of wearing medical protective masks on treadmill running performance in the postpandemic era: a randomised trial
Authors: Wang I-Lin , Su Yu , Yao Shun , Jiang Yu-Hong , Li Hao-Yu , Lai Chien-Ying
Published: January 2023

Background

In the postpandemic era, wearing protective masks in public places will still be an important means of blocking popular viruses in the future. The purpose of this study was to explore whether sports performance was affected by mask wearing and exercise duration during 15-min treadmill running at a speed of 75% maximal aerobic speed.

Methods

Thirty-six males were randomly divided into mask and nonmask groups. The kinematic and kinetic data were obtained at four time points (RN0–1 min, RN5–6 min, RN9–10 min, and RN14–15 min) during running. Two-way mixed ANOVA was applied to examine the effects between groups and times with Bonferroni post hoc comparison and independent samples t-test.

Results

The results showed that there was no difference between mask and nonmask group during running (p > 0.05). As running time increased, hip joint ROM, hip joint flexion/extension max, and ankle joint plantarflexion max angles increased; knee joint flexion min and ankle joint dorsiflexion max angles decreased; average peak vertical ground reaction forces (PVGRF) increased after 9 min-running (p < 0.05).

Conclusions

Wearing a medical protective mask does not affect the joint angle and touchdown PVGRF of lower extremities during treadmill running while affected by running time and changed after 9 min-treadmill running. Future studies will examine the effects of wearing masks during the pandemic on muscle activation and blood biochemical values during exercise.

Trial registration No. ChiCTR2000040535 (date of registration on December 1, 2020). Prospectively registered in the Chinese Clinical Trial Registry.
Androgenic-anabolic steroids use among bodybuilders in western Iran: application of ridge logistic regression model
Authors: Khalili Sanaz , Khoshravesh Sahar , Barati Majid , Mahjoub Hossein , Faradmal Javad
Published: January 2023

Introduction

Nowadays, the use of androgenic-anabolic steroids (AAS) by competitive and non-competitive bodybuilders and its side effects have become a major public health problem. Many studies have focused on determining the role and severity of various factors in AAS use, but the existence of collinearity between the factors leads to the non-significance of important factors. The study aimed to determine factors affecting the androgenic-anabolic steroids use in Iranian bodybuilders.

Method

This descriptive-analytical study was performed on 280 male bodybuilders (142 non-competitive and 138 competitive bodybuilders) in Hamadan, west of Iran, in 2016. The participations were recruited a multistage sampling method. A self-administrated questionnaire was used, which included parts such as intrapersonal, interpersonal, and behavioral factors affecting on AAS use. To solve the consequences of collinearity was used ridge logistic regression model (RLRM) in R.3.5.1 software.

Results

The mean age of bodybuilders was 25.21 years (SD = 6.31). The prevalence rate of AAS use among non-competitive and competitive bodybuilders was 27.5% and 34.1%, respectively. Factors such as age, time of starting bodybuilding, attitude, physical self-concept, behavioral intention, coach and friend use AAS, alcohol consumption, and supplement use were associated with AAS use among non-competitive and competitive bodybuilders.

Conclusion

The results of the study indicated that a combination of intrapersonal, interpersonal and behavioral factors was effective on the androgenic-anabolic steroids use among Iranian bodybuilders. Adequate education about the side effects of AAS and improvement of individual skills seem to be helpful in reducing AAS use.
Mesenchymal stem cells limit vascular and epithelial damage and restore the impermeability of the urothelium in chronic radiation cystitis
Authors: Brossard Clément , Pouliet Anne-Laure , Lefranc Anne‐Charlotte , Benadjaoud Mohamedamine , Dos Santos Morgane , Demarquay Christelle , Buard Valerie , Benderitter Marc , Simon Jean-Marc , Milliat Fabien , Chapel Alain
Published: January 2023

Background

Cellular therapy seems to be an innovative therapeutic alternative for which mesenchymal stem cells (MSCs) have been shown to be effective for interstitial and hemorrhagic cystitis. However, the action of MSCs on chronic radiation cystitis (CRC) remains to be demonstrated. The aim of this study was to set up a rat model of CRC and to evaluate the efficacy of MSCs and their mode of action.

Methods

CRC was induced by single-dose localized irradiation of the whole bladder using two beams guided by tomography in female Sprague–Dawley rat. A dose range of 20–80 Gy with follow-up 3–12 months after irradiation was used to characterize the dose effect and the kinetics of radiation cystitis in rats. For the treatment, the dose of 40 Gy was retained, and in order to potentiate the effect of the MSCs, MSCs were isolated from adipose tissue. After expansion, they were injected intravenously during the pre-chronic phase. Three injections of 5 million MSCs were administered every fortnight. Follow-up was performed for 12 months after irradiation.

Results

We observed that the intensity and frequency of hematuria are proportional to the irradiation dose, with a threshold at 40 Gy and the appearance of bleeding from 100 days post-irradiation. The MSCs reduced vascular damage as well as damage to the bladder epithelium.

Conclusions

These results are in favor of MSCs acting to limit progression of the chronic phase of radiation cystitis. MSC treatment may afford real hope for all patients suffering from chronic radiation cystitis resistant to conventional treatments.
Serum concentrations of amino acids and tryptophan metabolites are affected by consumption of a light breakfast: a clinical intervention study in adults with overweight or obesity
Authors: Hagen Ingrid V. , Helland Anita , Bratlie Marianne , Midttun Øivind , McCann Adrian , Ulvik Arve , Mellgren Gunnar , Ueland Per M. , Gudbrandsen Oddrun A.
Published: January 2023

Background

Epidemiological studies often investigate amino acids and their metabolites as biomarkers, but do not always consistently use fasting or non-fasting blood samples, or may lack information on the prandial status of the study participants. Since little information is available on the effects of the prandial status on many biomarkers, and since blood is typically sampled early in the day with participants in a fasting state or after having consumed a light meal in many trials, the main purpose of this study was to investigate the short-term effects of a light breakfast on serum concentrations of amino acids and related metabolites.

Methods

Blood was collected from sixty-three healthy adults (36 women) in the fasting state and at set times for 120 min after intake of a light breakfast with low protein content (14 g protein, 2218 kJ). Relative changes in serum biomarker concentrations from fasting to postprandial serum concentrations were tested using T test.

Results

The serum concentrations of 13 of the 20 measured amino acids were significantly changed 60 min following breakfast intake, with the most marked effects seen as increases in alanine (34%) and proline (45%) concentrations. The response did not reflect the amino acid composition of the breakfast. The concentrations of seven kynurenine metabolites were significantly decreased after breakfast.

Conclusion

Consumption of a light breakfast affected serum concentrations of several amino acids and related metabolites, underlining the importance of having information regarding the participants’ prandial state at the time of blood sampling in studies including these biomarkers.

Trial registration

This trial was registered at clinicaltrials.gov as NCT02350595 (registered January 2015).
Maritime infrastructure and growth: econometric measurement using panel data from Tunisia
Authors: Harizi Riadh
Published: January 2023

This study applied a Cobb–Douglas production function in an attempt to assess the effect of increased maritime sector investment on economic growth. It did this for the Tunisian economy based on panel data for the 1985–2020 period, thus making it possible to confirm the importance of spillover effects resulting from developing the Tunisian maritime infrastructure. Increases in added value for market services and non-manufacturing industries proves the benefits of investments but also the harm caused by the structuring effects of marine infrastructure. The results reveal, however, that the positive induced effects are not guaranteed, because the development of maritime infrastructure can have the opposite effect, such as by shrinking the size of the manufacturing industries in relation to services, which is a striking example of a negative effect that was suffered by the Tunisian economy.
Reversible cerebral vasoconstriction syndrome: literature review
Authors: Ribas Michelle Zonkowski , Paticcié Gabriela Ferreira , de Medeiros Sara Diógenes Peixoto , de Oliveira Veras Arthur , Noleto Felipe Micelli , dos Santos Júlio César Claudino
Published: January 2023

Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a neurovascular condition characterized by a severe sudden-onset headache that may be associated with focal neurological deficits. On imaging, the suggestive finding corresponds to multifocal vasoconstriction of the cerebral arteries, with a spontaneous resolution of approximately 12 weeks. The identification of precipitating factors and diagnosis must be carried out early, so that adequate management is established and the patient has a good prognosis, given the risk of secondary complications and residual neurological deficits. This study consists of a literature review based on the analysis of articles published between 2017 and 2022 in PubMed, SciELO, and ScienceDirect on RCVS, intending to understand the clinical and radiological characteristics, diagnosis, treatment, and prognosis of patients with RCVS. The pathophysiology, drug management, and prognosis still lack solid evidence; therefore, further studies on RCVS are needed to expand medical knowledge and avoid underdiagnosis and inadequate treatment of this important condition.
Nanoparticle carriers enhance RNA stability and uptake efficiency and prolong the protection against Rhizoctonia solani
Authors: Wang Yumeng , Yan Qin , Lan Chi , Tang Tao , Wang Kuaibing , Shen Jie , Niu Dongdong
Published: January 2023

Spray-induced gene silencing (SIGS) can inhibit plant diseases by topical application of double- (dsRNA) or single-stranded (sRNA) RNA molecules onto plants to silence virulence-related pathogen genes. However, the on-field application of SIGS is limited by the instability of naked RNA and low RNA uptake by pathogens. Nanoparticles have been used as RNA carriers to enhance RNA silencing. Rice sheath blight caused by Rhizoctonia solani (R. solani) is one of the most devastating fungal diseases in rice (Oryza sativa L.). In this study, we aimed to explore the protective effects of nanoparticle-delivered dsRNA against rice sheath blight. The key pathogenic genes, RsAGO1 and RsAGO2, of R. solani were screened as targets for dsRNA. Chitosan (CS), polyethyleneimine (PEI), protamine, carbon quantum dot (CQD), polyamidoamine (PAMAM), and chitosan/SPc complex (CSC) were selected as dsRNA carriers. All the evaluated nanoparticles could assemble with dsRNA to form nanoparticle-dsRNA complexes, and CQD and CSC showed improved dsRNA load capacity. Particularly, CSC could enhance the stability of dsRNA and cause a 7% reduction in fluorescence intensity after nuclease treatment. CSC and CS effectively enhanced the efficiency of dsRNA uptake by pathogens. Furthermore, CSC could reduce pathogen infection and prolong the protection time of dsRNA by up to 20 days. Overall, this study provides a novel and efficacious SIGS-based strategy for producing RNA-based fungicides.
A pragmatic context assessment tool (pCAT): using a Think Aloud method to develop an assessment of contextual barriers to change
Authors: Robinson Claire H. , Damschroder Laura J.
Published: January 2023

Background

The Consolidated Framework for Implementation Research (CFIR) is a determinant framework that can be used to guide context assessment prior to implementing change. Though a few quantitative measurement instruments have been developed based on the CFIR, most assessments using the CFIR have relied on qualitative methods. One challenge to measurement is to translate conceptual constructs which are often described using highly abstract, technical language into lay language that is clear, concise, and meaningful. The purpose of this paper is to document methods to develop a freely available pragmatic context assessment tool (pCAT). The pCAT is based on the CFIR and designed for frontline quality improvement teams as an abbreviated assessment of local facilitators and barriers in a clinical setting.

Methods

Twenty-seven interviews using the Think Aloud method (asking participants to verbalize thoughts as they respond to assessment questions) were conducted with frontline employees to improve a pilot version of the pCAT. Interviews were recorded and transcribed verbatim; the CFIR guided coding and analyses.

Results

Participants identified several areas where language in the pCAT needed to be modified, clarified, or allow more nuance to increase usefulness for frontline employees. Participants found it easier to respond to questions when they had a recent, specific project in mind. Potential barriers and facilitators tend to be unique to each specific improvement. Participants also identified missing concepts or that were conflated, leading to refinements that made the pCAT more understandable, accurate, and useful.

Conclusions

The pCAT is designed to be practical, using everyday language familiar to frontline employees. The pCAT is short (14 items), freely available, does not require research expertise or experience. It is designed to draw on the knowledge of individuals most familiar with their own clinical context. The pCAT has been available online for approximately two years and has generated a relatively high level of interest indicating potential usefulness of the tool.
Approach to the Patient: Preventing Adrenal Crisis Through Patient and Clinician Education
Authors: Ahmet Alexandra , Gupta Anshu , Malcolm Janine , Constantacos Cathrine
Published: January 2023

Adrenal crisis continues to be an important cause of death despite being a preventable condition. Significant deficits in patient education in the prevention of adrenal crisis have been identified as a contributor to adrenal crisis risk, despite the importance of patient education being highlighted in international guidelines. Deficits in clinician education have also been identified as risk factors for adrenal crisis although they have not been addressed. We use 3 clinical cases to highlight the role of both patient and clinician education in the prevention of adrenal crisis, review what is known about education related to adrenal insufficiency and provide a possible approach to addressing education deficits with the aim of reducing the risk of adrenal crisis through both patient and clinician education.
Effects of Hypocaloric Low-Fat, Ketogenic, and Ketogenic and Ketone Supplement Diets on Aldosterone and Renin
Authors: Belany Paul , Kackley Madison L , Zhao Songzhu , Kluwe Bjorn , Buga Alex , Crabtree Christopher D , Nedungadi Divya , Kline David , Brock Guy , Simonetti Orlando P , Volek Jeff S , Joseph Joshua J
Published: January 2023

Context

Ketogenic diets (KDs) and low-fat diets (LFD) result in similar weight loss, but have differential cardiometabolic effects on lipids and insulin. Generally, weight loss decreases renin–angiotensin–aldosterone system (RAAS) activity.

Objective

Investigate the effects of KDs with varying sodium content vs LFD on RAAS in overweight and obese adults.

Methods

Twenty-eight participants were randomized 1:1 to a KD + ketone salt supplement (KD + KS) or a KD + placebo (KD + PL) arm with prepared hypocaloric meals. Twelve participants were enrolled in a post hoc LFD arm. Serum renin, aldosterone, and anthropometric and metabolic biomarkers were assessed at 0, 2, 4, and 6 weeks. Linear mixed models with random intercepts were used to compare between group differences controlling for sex and body mass index.

Results

Participants had a median age of 33 years, 51% female, weighed 91.3 kg, with body mass index 30.6 kg/m2. At 6 weeks, weight decreased by 6, 8, and 7 kg on average in the KD + KS, KD + PL, and LFD groups, respectively (P < .05). Aldosterone increased by 88% and 144% in the KD + PL and KD + KS groups, respectively, but did not change in the LFD after 6 weeks while renin decreased across groups. Systolic and diastolic blood pressure did not change in the KD + PL and KD + KS groups. Log ketones were positively associated with aldosterone (P < .001). Aldosterone was not associated with cardiovascular measures including blood pressure and ejection fraction (P > .05).

Conclusion

KD reduced weight and increased aldosterone without worsening cardiometabolic risk factors. Future KD studies are needed to elucidate mechanistic connections between ketones and aldosterone.
Prinos i kvalitet paradajza iz organske i konvecionalne plasteničke proizvodnje u severoistočnoj Grčkoj
Authors: Καπούλας Νικόλαος
Published: January 2023

Τρεις ποικιλίες τομάτας (Robin-F1, Amati-F1 και Elpida-F1) καλλιεργήθηκαν στο θερμοκήπιο (τοξωτό ύψους 3,5 m, καλυμμένη με termolux 180 μm) κατά την περίοδο 2008-2010 που βρίσκεται στις Σάπες της Βορειοανατολικής Ελλάδας, με τη χρήση βιολογικό και συμβατικό σύστημα καλλιέργειας. Η φύτευση έγινε στις 18 Απριλίου (με πυκνότητα φυτού 2,64 φυτό/μ2). Τα συστήματα παραγωγής διέφεραν ως προς το χρησιμοποιούμενη λίπανση (οργανικό: κοπριά κατσίκας, συμβατικό: ορυκτό λίπασμα NPK 12-12-17, Nitrophos blue special+2MgO+8S+Ιχνοστοιχεία - ποσότητα 400 kg/ha), τον αριθμό φυτοϋγειονομικών επεξεργασιών ( μεγαλύτερο σε οργανικό σύστημα), και τους τύπους φυτοφαρμάκων που εφαρμόζονται (προληπτικά στο οργανικό σύστημα και προληπτικά ή επουλωτικά με μεταβλητή περίοδο αποτελεσματικότητας στο συμβατικό). Η περίοδος συγκομιδής διήρκεσε από τα μέσα Ιουνίου έως τα τέλη Αυγούστου. Η μέση εμπορική παραγωγή των τριών ποικιλιών που δοκιμάστηκαν στο βιολογικό σύστημα (71,4 t•ha-1) ήταν σημαντικά υψηλότερη από τον μέσο όρο των τριών ποικιλιών στο συμβατικό σύστημα (54,95 t•ha-1). Το καλύτερο αποτέλεσμα πέτυχε η ποικιλία Ελπίδα F1 σε βιολογική παραγωγή με μέση απόδοση 89,87 t•ha-1. Επίσης, στόχος αυτής της μελέτης ήταν η σύγκριση των ποιοτικών παραμέτρων των καρπών των ποικιλιών τομάτας που καλλιεργούνται σε βιολογικό και συμβατικό σύστημα καλλιέργειας. Υψηλότερα επίπεδα TSS, σακχάρων και βιταμίνης C προσδιορίστηκαν στις συμβατικές ντομάτες. Οι ντομάτες που καλλιεργήθηκαν βιολογικά περιείχαν σημαντικές ποσότητες λυκοπενίου και καροτενοειδών. Τα αποτελέσματα έδειξαν διαφορές μεταξύ των ποικιλιών και της καλλιεργητικής περιόδου. Το Elpida F1 πέτυχε την υψηλότερη περιεκτικότητα σε TSS (5,08 °Brix), λυκοπένιο (3,75 mg•100-1 g f.w.), βιταμίνη C (14,3 mg•100g-1) και συνολική οξύτητα (0,48%) μεταξύ των ελεγχόμενων ποικιλιών. Η μέση περιεκτικότητα Brix βαθμός και οξύτητας ήταν 4,8 και 0,46 g/100 g (%) κιτρικού οξέος, αντίστοιχα. Οι μέσες τιμές του γευστικού δείκτη σε όλες τις ντομάτες που ανήκουν σε όλες τις υπό εξέταση ποικιλίες ήταν υψηλότερες από 0,85, πράγμα που δείχνει ότι οι ποικιλίες ντομάτας που αναλύθηκαν είναι γευστικές Αυτή η μελέτη επιβεβαιώνει ότι η πιο σημαντική μεταβλητή στην περιεκτικότητα σε μικροθρεπτικά συστατικά της ντομάτας είναι η ποικιλία. Γενικά, οι σημαντικές διαφορές μεταξύ των ντοματών που καλλιεργούνται σε βιολογικό ή συμβατικό σύστημα παραγωγής είναι:1/ Η βιολογική ντομάτα περιέχει περισσότερα μέταλλα (P, K, Mg, Ca)2/ Η βιολογική ντομάτα περιέχει πολύ λιγότερα βαρέα μέταλλα (Pb, Zn, Cu, Ni)3/ Η βιολογική ντομάτα περιέχει περισσότερα καροτενοειδή4/ Η βιολογική ντομάτα περιέχει πολύ λιγότερα νιτρικά, περίπου 30-40% λιγότερα5/ Η βιολογική ντομάτα δεν περιέχει υπολείμματα φυτοφαρμάκων
Η σκοτεινή πλευρά της ηγεσίας στην πρωτοβάθμια και δευτεροβάθμια ελληνική εκπαίδευση
Authors: Μπαχαράκης Θωμάς
Published: January 2023

Η ηγεσία συνδέεται κυρίως με θετικές επιπτώσεις σε οργανισμούς και εργαζομένους. Ωστόσο η ηγεσία έχει και τη σκοτεινή πλευρά της, που προκαλεί σοβαρά προβλήματα στους εργαζόμενους και στους οργανισμούς. Πολλές μελέτες, που αμφισβητούν το αλάθητο των ηγετών και προσδιορίζουν τους τρόπους διερεύνησης της αρνητικής ηγεσίας, έχουν δημοσιευτεί τις τελευταίες δεκαετίες. Στην παρούσα εργασία διερευνάται ο τρόπος με τον οποίο οι εκπαιδευτικοί αντιλαμβάνονται την ηγεσία είτε ως θετική, είτε ως αρνητική, μέσα από τις εργασιακές συμπεριφορές του διευθυντή του σχολείου τους. Σύμφωνα με τη βιβλιογραφία, ο διευθυντής σχολείου είναι ηγέτης, καθοδηγητής και συνεργάτης, δραστηριοποιούμενος συνεχώς στην κατεύθυνση της αναβάθμισης της ποιότητας της παρεχόμενης εκπαίδευσης. Οι διευθυντές των Ελληνικών σχολείων έχουν ένα δύσκολο και περίπλοκο ρόλο. Βρίσκονται στην κορυφή της σχολικής κοινότητας και είναι διοικητικά αλλά και επιστημονικά-παιδαγωγικά υπεύθυνοι για τη σχολική μονάδα. Στην έρευνα πήραν μέρος 1329 εκπαιδευτικοί Ελληνικών σχολείων πρωτοβάθμιας και δευτεροβάθμιας εκπαίδευσης, όπου εξετάστηκε ποιες ατομικές γνωστικές – αντιληπτικές – συναισθηματικές διαστάσεις επηρεάζουν την αντίληψη των εκπαιδευτικών αναφορικά με την αξιολόγηση των συμπεριφορών των διευθυντών των σχολικών τους μονάδων, συμπεριφορές που μπορούν να κυμαίνονται μεταξύ των δύο ακραίων πόλων: τις πλήρως αρμόζουσες συμπεριφορές και τις πλήρως ανάρμοστες συμπεριφορές. Οι ατομικές γνωστικές – αντιληπτικές – συναισθηματικές διαστάσεις κατηγοριοποιήθηκαν σε τρία συστήματα (είδη). Το πρώτο σύστημα περιλαμβάνει τις προσωπικές εργασιακές πτυχές (γνωρίσματα) των εκπαιδευτικών, το δεύτερο σύστημα προσδιορίζεται από το ψυχολογικό συμβόλαιο και το τρίτο από τις εργασιακές στάσεις των εκπαιδευτικών Τρία διαφορετικά στοιχεία τοποθετήθηκαν σε καθένα από τα δύο πρώτα συστήματα ενώ στο τρίτο σύστημα ελέγχθηκαν πέντε διαφορετικά στοιχεία. Τα αποτελέσματα έδειξαν ότι δύο στοιχεία του πρώτου συστήματος (η «έδρα ελέγχου» και η διάσταση της προσωπικότητας «ευσυνειδησία») δεν επηρεάζουν τις αντιλήψεις των εκπαιδευτικών για τις εργασιακές συμπεριφορές των διευθυντών τους. Διαπιστώθηκε ότι όλα τα άλλα στοιχεία επηρεάζουν τις αντιλήψεις των εκπαιδευτικών για τις εργασιακές συμπεριφορές των διευθυντών τους. Σημαντικό ενδιαφέρον παρουσιάζουν τα ευρήματα της αξιολόγησης των εκπαιδευτικών σχετικά με το εύρος των συμπεριφορών των διευθυντών τους και το υψηλό ποσοστό (23%) αρνητικής ηγεσίας στα Ελληνικά σχολεία πρωτοβάθμιας και δευτεροβάθμιας εκπαίδευσης.
Discrepancies between two long-term dietary datasets in the United Kingdom (UK)
Authors: Smith Kerry G. , Scheelbeek Pauline , Balmford Andrew , Alexander Peter , Garnett Emma E.
Published: January 2023

Background: Studying dietary trends can help monitor progress towards healthier and more sustainable diets but longitudinal data are often confounded by lack of standardized methods. Two main data sources are used for longitudinal analysis of diets: food balance sheets on food supply (FBS) and household budget surveys on food purchased (HBS).

Methods: We used UK longitudinal dietary data on food supply, provided by the Food and Agriculture Organisation (FAO) (FAO-FBS, 1961-2018), and food purchases, provided by the Department for Environment, Food and Rural Affairs (Defra) (Defra-HBS, 1942-2018). We assessed how trends in dietary change per capita compared between FAO-FBS and Defra-HBS for calories, meat and fish, nuts and pulses, and dairy, and how disparities have changed over time.

Results: Estimates made by FAO-FBS were significantly higher (p<0.001) than Defra-HBS for calorie intake and all food types, except nuts and pulses which were significantly lower (p<0.001). These differences are partly due to inclusion of retail waste in FAO-FBS data and under-reporting in Defra- HBS data. The disparities between the two datasets increased over time for calories, meat and dairy; did not change for fish; and decreased for nuts and pulses. Between 1961 and 2018, both FAO-FBS and Defra-FBS showed an increase in meat intake (+23.4% and +1.4%, respectively) and a decrease in fish (-7.1% and -3.2%, respectively). Temporal trends did not agree between the two datasets for dairy, calories, and nuts and pulses.

Conclusions: Our finding raises questions over the robustness of both data sources for monitoring UK dietary change, especially when used for evidence-based decision making around health, climate change and sustainability.
Necesidad de aumentar el nivel de la educación financiera en Estudios reglados no especializados
Authors: Villacorta Hernández Miguel Ángel
Published: January 2023

La motivación del artículo se basa en que hay estudios e informes realizados por organismos nacionales e internacionales que han detectado un nivel bajo de la educación financiera en España. El objetivo de este trabajo es analizar el nivel de la educación financiera en los estudios reglados no especializados en España, y emitir propuestas para mejorarla. Para su consecución se realizan tres análisis: en el primero se muestra diversos estudios realizados por instituciones nacionales e internacionales que dejan claro el escaso conocimiento de los conceptos económicos y financieros entre la población española, en el segundo se analizan las asignaturas impartidas en los estudios reglados no especializados con estos contenidos, y en el tercero se realiza un estudio empírico que muestra la transversalidad de los conceptos en el resto de las asignaturas que no son específicas de economía y finanzas. De estos estudios se infiere que la situación de la educación financiera no es la deseable. El artículo culmina con una propuesta para incorporar de forma más adecuada los conceptos en economía y finanzas en los planes de estudio. Ésta consiste en aumentar la formación de los contenidos económicos y financieros en dos sentidos: en un mayor número de asignaturas que lleguen a un mayor número de alumnos y un aumento de conocimientos transversales a lo largo del resto de asignaturas.
Turning back time: los relojes epigenéticos desde la perspectiva de la bioética y de los derechos humanos.
Authors: Fanni Simona
Published: January 2023

Los relojes epigenéticos son análisis moleculares que cuantifican, con bastante precisión, el envejecimiento y la posibilidad de desarrollas las enfermedades relacionadas con este proceso. Por un lado, representan herramientas diagnósticas prometedoras, que tienen el potencial de innovar las respuestas terapéuticas a patologías graves y difundidas tales como las enfermedades neurodegenerativas y cardiovasculares, y hasta el cáncer. Por otro lado, los relojes epigenéticos plantean cuestiones de gran relevancia para el jurista, inherentes a la protección de la dignidad humana, de la identidad y de la integridad a nivel genético, y susceptibles de afectar la esfera del derecho a la salud y del derecho a la ciencia. El presente estudio pretende analizar estas cuestiones desde el punto de vista de la bioética y de los derechos humanos, con el propósito de sugerir algunas respuestas a los desafíos que los relojes epigenéticos plantean, haciendo particular hincapié en el principio de la dignidad humana.
Eutanasia, inteligencia artificial y robótica.
Authors: Valdivia Jiménez Ramón Darío
Published: January 2023

La Ley Orgánica 3/2021 de 24 de marzo (LORE) que regula la eutanasia ha suscitado una polémica de difícil gestión porque hace uso de la monopolización de la profesión médica para un fin, la eutanasia, que no es estrictamente sanitario, en el sentido de cuidar (care) cuando la persona ya no se puede curar (cure). Esta regulación de la eutanasia está generando un “malestar” entre los profesionales médicos, que pueden ver cómo la IA y la robótica pueden sustituirle con facilidad. En efecto, el momento más complejo para el “médico responsable” será calibrar las condiciones de admisión o rechazo de esta prestación de ayuda a morir (PAM), según las condiciones, imprecisas, que establece la Ley en el llamado “contexto eutanásico”. Preveo que la Inteligencia Artificial puede registrar, ordenar y establecer algoritmos en los que no sólo estén presentes las constantes biométricas, sino también otros datos del paciente registrados en el historial médico para conceder, o no, esta prestación con una objetividad más exacta que la mera perspectiva ideológica, o la exclusiva sensibilidad del médico responsable de incoar el expediente administrativo de la eutanasia. Otra parte del proceso que regula la LORE y que rechaza la profesión médica es la misma ejecución de la Prestación de la Ayuda a Morir (PAM). Así, en lugares donde el suicidio asistido es una realidad más presente que en nuestra sociedad, y donde la tecnología robótica es mucho más avanzada, pronto se podrán encontrar robots que puedan realizar todo el proceso de la aplicación de la eutanasia sin control médico alguno. El presente trabajo supone un acercamiento ético a esta realidad, comprender el encaje normativo que supondría en nuestro ordenamiento jurídico y valora las condiciones éticas que implicaría.
Erosión en los derechos de los pacientes, por parte de los centros de salud de atención primaria a raíz de la pandemia.
Authors: Craviotto Valle Patricia
Published: January 2023

La pandemia mundial del coronavirus SARS-CoV-2, ha evidenciado un problema que, a pesar de tener naturaleza administrativa o de gestión, provocó durante y tras la misma, una grave erosión al derecho a la protección de la salud de los pacientes. Las confusas situaciones en las que estos se vieron inmersos durante el confinamiento, han dado paso a una situación post-Covid-19, que, de manera mucho más transparente, ha repercutido en una disminución de derechos sanitarios de las personas que, necesitando atención primaria, han acudido a sus Centros de Salud. Una merma de derechos, que están aún, por resolverse.
El controvertido principio de voluntariedad de la vigilancia de la salud en el ámbito laboral.
Authors: Sánchez Torrado José Manuel
Published: January 2023

La vigilancia de la salud, a través de los reconocimientos médicos, se considera uno de los instrumentos más relevantes para velar por la seguridad y salud de las personas trabajadoras. Si bien, la conexión entre vigilancia de la salud y los derechos fundamentales de las personas trabajadoras, unido al interés empresarial por cumplir la obligación de garantizar la vigilancia de la salud, provoca una alta conflictividad, que se ha visto incrementada por el surgimiento de nuevos riesgos emergentes en el ámbito laboral. En este sentido, los riesgos relacionados con la pandemia, la implantación de la digitalización e inteligencia artificial en las organizaciones productivas dota de mayor protagonismo la vigilancia de la salud y nos obliga a analizar la efectividad del marco normativo ante los nuevos riesgos y desafíos para la seguridad y salud de las personas trabajadoras.
El régimen jurídico de los bienes de las concesiones de la contratación pública. Una aproximación comparada Francia-Colombia
Authors: Fajardo Restrepo Daniel Hernán
Published: January 2023

A pesar de la gran incidencia práctica en materia económica y frente a la actividad concesional del Estado en sí misma, el estudio del régimen de los bienes de las concesiones en Colombia ha sido muy poco estudiado. Este libro pretende suplir la carencia por parte del Derecho local, adoptando una perspectiva comparativa con el Derecho francés, régimen jurídico de referencia para Colombia en materia de Derecho Administrativo y de contratación pública. Así, el autor aborda el régimen de los bienes de las concesiones de la contratación pública, a partir de la constatación y el estudio, en el seno de los órdenes jurídicos francés y colombiano, de nociones o categorías jurídicas que permiten identificar un régimen particular sobre estos bienes y las consecuencias de dicho régimen. En la primera parte de libro el autor presenta la identificación de la existencia de un régimen particular frente a los mencionados bienes, planteando la existencia de un estatus particular sobre algunos bienes de determinadas concesiones y el carácter de orden público y la autonomía de la voluntad sobre el régimen en cuestión. Y, en la segunda parte, expone los efectos prácticos de dicho régimen; en donde analiza la propiedad de los bienes durante y al finalizar el contrato de concesión y examina el principio común del retorno o reversión gratuito de los bienes, al igual que sus excepciones.
Astımlı Çocuklarda İnfluenza Aşısı İle Hastalık Kontrolü Arasındaki İlişkinin Belirlenmesi
Authors: ÇAPANOĞLU Murat , CİVELEK Ersoy
Published: January 2023

Amaç: İnfluenza aşısının astım kontrolü üzerindeki etkisi tartışmalıdır. Bu çalışmanın amacı astımlı çocuklarda influenza aşısının hastalık kontrolüne etkisini araştırmaktır.

Gereç ve Yöntemler: Astım tanısı alan çocuklar prospektif olarak çalışmaya dahil edildi. Hastaların sosyo-demografik özellikleri, bir önceki yılda influenza aşısı olma durumu, bronkodilatatör kullanımı ve sistemik steroid tedavisi, hastaneye yatış sıklığı, aşılam durumunu ve hastalığın kontrol durumunu etkileyecek risk faktörleri araştırıldı.

Bulgular: Çalışmaya ortanca yaşı 11 olan toplam 187 astımlı çocuk dahil edildi. Hastaların yaklaşık yarısında (%47,6) astım kontrol altında değildi. Son bir yılda %14,4'ü, %14,4'ü iki, %19,3'ü ≥3 atağı geçirirken, %51,9'u astım atağı geçirmedi. Bir önceki yılda hastaların %52,4'ü grip aşısı olmuştu. İnfluenza aşılaması, kontrollü ve kontrolsüz astımı olan hastalarda eşit oranda yaygındı (%54.1'e karşı %50.6) ve aşılamanın hastalık kontrolü üzerinde etkisi yoktu (p=0.662). Alerjik riniti ve atopisi olan hastalarda, alerjik riniti olmayan hastalara göre anlamlı olarak daha yüksek kontrolsüz astım durumu vardı (sırasıyla p=0.027 ve p=0.041). Kontrolsüz astımı olan çocuklar kontrol grubuna göre daha az profilaktik ilaç kullanmışlardı (p<0.001).

Sonuç: İnfluenza aşısının astımlı çocuklarda hastalık kontrolüne etkisi yoktur. Alerjik rinit ve atopiye sahip olmak hastalığın kontrolünü azaltır.
Iatrogenic Lesion of the Lateral Plantar Artery following Plantar Fasciotomy for Cavus Foot Correction – A Case Report
Authors: Mazzotti Antonio , Zielli Simone Ottavio , Artioli Elena , Facchini Giancarlo , Miceli Marco , Faldini Cesare
Published: January 2023

Introduction: The aim of this study was to report a patient with a iatrogenic lesion of the lateral plantar artery following plantar fasciotomy (PF) for cavus foot correction, an extremely rare complication. Case Report: A 13-year-old male patient with bilateral cavus foot was surgically treated at the right foot. At 36 days follow-up, after plaster cast removal, a massive soft plantar bulge was located on the medial aspect of the foot. Once suture stiches removal was performed, a huge blood collection was evacuated, and active bleeding observed. Contrast-enhanced angio-CT revealed a lesion of the lateral plantar artery. A vascular suture was performed. At 5 months follow-up, the patient was pain-free in his foot. Conclusion: Despite a iatrogenic lesion of the plantar vascular structures following PF is extremely rare, it is a potential complication to consider. Meticulous attention to surgical technique and careful inspection of the foot the day after surgery, before patient discharge, are recommended. Keywords: Plantar fasciotomy, cavus foot, complication, vascular lesion, lateral plantar artery