bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between vitamin D and asthma from gestational to adulthood period: a meta-analysis of randomized clinical trials
Authors: Sobczak Marharyta , Pawliczak Rafal
Published: June 2023

Background

Despite numerous studies investigating vitamin D, its impact on asthma is still unknown. The aim of our meta-analysis is to analyze the vitamin D supplementation influence on asthma prevention and treatment ranging from gestational to adulthood period.

Methods

Fifteen randomized clinical trials were included after database search. Studies contained the analyzed endpoints: the number of asthma and wheezing occurrence in gestational and infantile periods, the change of childhood/adult asthma control test score and forced expiratory volume in one second (FEV1) in childhood and adulthood periods. Random effects model was used to calculate effect sizes.

Results

Supplementation by women during pregnancy period decreased the wheezing occurrence in their children by 23% (RR = 0.77; 95% CI [0.64; 0.92]; p < 0.0049, I2 = 0%); whereas had no effect on given asthma parameters during the infantile period. Moreover, vitamin D administration had negative effect on the FEV1 change in children (MD = -3.84; 95% CI [-7.68; -0.01]; p = 0.0497; I2 = 95%), but had positive effect on the change of ACT score in adults (MD = 1.80; 95% CI [0.12; 3.49]; p = 0.0359; I2 = 99%).

Conclusions

Our meta-analysis showed the varying results depending on patient's life period. It is important to further investigate the role of vitamin D supplementation in asthma management.
Applying terror management theory to patients with life-threatening illness: a systematic review
Authors: Svet Mark , Portalupi Laura B. , Pyszczynski Tom , Matlock Daniel D. , Allen Larry A.
Published: June 2023

Background

Terror management theory (TMT) posits that people manage death-related anxiety through the meaning provided by their cultural world-views and the sense of personal value provided by self-esteem. While a large body of research has supported the core propositions of TMT, little research has focused on its application to individuals with terminal illness. If TMT can help healthcare providers better understand how belief systems adapt and change in life-threatening illness, and the role they play in managing death-related anxiety, it may provide guidance on how to improve communication around treatments near the end of life. As such, we set out to review the available research articles that focus on describing the relationship between TMT and life-threatening illness.

Methods

We reviewed PubMed, PsycINFO, Google Scholar, and EMBASE through May 2022 for original research articles focused on TMT and life-threatening illness. Articles were only deemed appropriate for inclusion if direct incorporation of the principles of TMT were made in reference to a population of interest whom had life-threatening illness Results were screened by title and abstract, followed by full review of candidate articles. References were also scanned. Articles were assessed qualitatively.

Results

Six relevant and original research articles were published which provide varied levels of support for TMT’s application in critical illness, each article detailed evidence of ideological changes consistent with what TMT would predict. Building self-esteem, enhancing the experience of life as meaningful, incorporating spirituality, engaging family members, and caring for patients at home where meaning and self-esteem can be better maintained are strategies supported by the studies and serve as starting points for further research.

Conclusion

These articles suggest that applying TMT to life-threatening illness can help identify psychological changes that may effectively minimize the distress from dying. Limitations of this study include a heterogenous group of relevant studies and qualitative assessment.
Early detection and stratification of lung cancer aided by a cost-effective assay targeting circulating tumor DNA (ctDNA) methylation
Authors: Wang Zhoufeng , Xie Kehui , Zhu Guonian , Ma Chengcheng , Cheng Cheng , Li Yangqian , Xiao Xue , Li Chengpin , Tang Jun , Wang Hui , Su Zhixi , Liu Dan , Zhang Wengeng , Huang Yan , Tang Huairong , Liu Rui , Li Weimin
Published: June 2023

Background

Detection of lung cancer at earlier stage can greatly improve patient survival. We aim to develop, validate, and implement a cost-effective ctDNA-methylation-based plasma test to aid lung cancer early detection.

Methods

Case-control studies were designed to select the most relevant markers to lung cancer. Patients with lung cancer or benign lung disease and healthy individuals were recruited from different clinical centers. A multi-locus qPCR assay, LunaCAM, was developed for lung cancer alertness by ctDNA methylation. Two LunaCAM models were built for screening (-S) or diagnostic aid (-D) to favor sensitivity or specificity, respectively. The performance of the models was validated for different intended uses in clinics.

Results

Profiling DNA methylation on 429 plasma samples including 209 lung cancer, 123 benign diseases and 97 healthy participants identified the top markers that detected lung cancer from benign diseases and healthy with an AUC of 0.85 and 0.95, respectively. The most effective methylation markers were verified individually in 40 tissues and 169 plasma samples to develop LunaCAM assay. Two models corresponding to different intended uses were trained with 513 plasma samples, and validated with an independent collection of 172 plasma samples. In validation, LunaCAM-S model achieved an AUC of 0.90 (95% CI: 0.88–0.94) between lung cancer and healthy individuals, whereas LunaCAM-D model stratified lung cancer from benign pulmonary diseases with an AUC of 0.81 (95% CI: 0.78–0.86). When implemented sequentially in the validation set, LunaCAM-S enables to identify 58 patients of lung cancer (90.6% sensitivity), followed by LunaCAM-D to remove 20 patients with no evidence of cancer (83.3% specificity). LunaCAM-D significantly outperformed the blood test of carcinoembryonic antigen (CEA), and the combined model can further improve the predictive power for lung cancer to an overall AUC of 0.86.

Conclusions

We developed two different models by ctDNA methylation assay to sensitively detect early-stage lung cancer or specifically classify lung benign diseases. Implemented at different clinical settings, LunaCAM models has a potential to provide a facile and inexpensive avenue for early screening and diagnostic aids for lung cancer.
A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study
Authors: de Gonzalo-Calvo David , Molinero Marta , Benítez Iván D. , Perez-Pons Manel , García-Mateo Nadia , Ortega Alicia , Postigo Tamara , García-Hidalgo María C. , Belmonte Thalia , Rodríguez-Muñoz Carlos , González Jessica , Torres Gerard , Gort-Paniello Clara , Moncusí-Moix Anna , Estella Ángel , Tamayo Lomas Luis , Martínez de la Gándara Amalia , Socias Lorenzo , Peñasco Yhivian , de la Torre Maria Del Carmen , Bustamante-Munguira Elena , Gallego Curto Elena , Martínez Varela Ignacio , Martin Delgado María Cruz , Vidal-Cortés Pablo , López Messa Juan , Pérez-García Felipe , Caballero Jesús , Añón José M. , Loza-Vázquez Ana , Carbonell Nieves , Marin-Corral Judith , Jorge García Ruth Noemí , Barberà Carmen , Ceccato Adrián , Fernández-Barat Laia , Ferrer Ricard , Garcia-Gasulla Dario , Lorente-Balanza Jose Ángel , Menéndez Rosario , Motos Ana , Peñuelas Oscar , Riera Jordi , Bermejo-Martin Jesús F. , Torres Antoni , Barbé Ferran
Published: June 2023

Background

The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU.

Methods

This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU from 19 hospitals. qPCR assays were performed in plasma samples collected within the first 48 h upon admission. A 16-miRNA panel was designed based on recently published data from our group.

Results

Nine miRNAs were validated as biomarkers of all-cause in-ICU mortality in the independent cohort of critically ill patients (FDR < 0.05). Cox regression analysis revealed that low expression levels of eight miRNAs were associated with a higher risk of death (HR from 1.56 to 2.61). LASSO regression for variable selection was used to construct a miRNA classifier. A 4-blood miRNA signature composed of miR-16-5p, miR-192-5p, miR-323a-3p and miR-451a predicts the risk of all-cause in-ICU mortality (HR 2.5). Kaplan‒Meier analysis confirmed these findings. The miRNA signature provides a significant increase in the prognostic capacity of conventional scores, APACHE-II (C-index 0.71, DeLong test p-value 0.055) and SOFA (C-index 0.67, DeLong test p-value 0.001), and a risk model based on clinical predictors (C-index 0.74, DeLong test-p-value 0.035). For 28-day and 90-day mortality, the classifier also improved the prognostic value of APACHE-II, SOFA and the clinical model. The association between the classifier and mortality persisted even after multivariable adjustment. The functional analysis reported biological pathways involved in SARS-CoV infection and inflammatory, fibrotic and transcriptional pathways.

Conclusions

A blood miRNA classifier improves the early prediction of fatal outcomes in critically ill COVID-19 patients.
Current methods for contactless optical patient diagnosis: a systematic review
Authors: Alić Belmin , Zauber Tim , Wiede Christian , Seidl Karsten
Published: June 2023

Many countries around the world face a shortage of medical personnel, leading to work overload or even burnout. This calls for political and scientific solutions to relieve the medical personnel. The measurement of vital signs in hospitals is still predominately carried out manually with traditional contact-based methods, taking over a substantial share of the medical personnel’s workload. The introduction of contactless methods for vital sign monitoring (e.g., with a camera) has great potential to relieve the medical personnel. This systematic review’s objective is to analyze the state of the art in the field of contactless optical patient diagnosis. This review distinguishes itself from already existing reviews by considering studies that do not only propose the contactless measurement of vital signs but also include an automatic diagnosis of the patient’s condition. This means that the included studies incorporate the physician’s reasoning and evaluation of vital signs into their algorithms, allowing an automated patient diagnosis. The literature screening of two independent reviewers resulted in a total of five eligible studies. The highest number of studies (three) introduce methods for the risk assessment of infectious diseases, one study introduces a method for the risk assessment of cardiovascular diseases, and one study introduces a method for the diagnosis of obstructive sleep apnea. Overall, high heterogeneity in relevant study parameters is reported among the included studies. The low number of included studies indicates a large research gap and emphasizes the demand for further research on this emerging topic.
RNA aptamers with specific binding affinity to CD40 (CD40Apt) represents a promising antagonist of the CD40-CD40L signaling for thyroid-associated ophthalmopathy (TAO) treatment in mouse
Authors: Chen Yizhi , Tang Renhong , Xiong Wei , Zhang Feng , Wang Nuo , Xie Bingyu , Cao Jiamin , Chen Zhuokun , Ma Chen
Published: June 2023

Thyroid-associated ophthalmopathy (TAO) is the most common autoimmune inflammatory diseases of the orbit. The CD40-CD40L pathway has been regarded as a potential molecular mechanism contributing to the development and progression of TAO, and RNA aptamers with specific binding affinity to CD40 (CD40Apt) represents a promising inhibitor of the CD40-CD40L signaling in TAO treatment. In this study, CD40Apt was confirmed to specifically recognize mouse CD40-positive ortibtal fibroblast. Mouse orbital fibroblasts were isolated from TAO mice model orbital tissues and validated. In TGF-β-induced orbital fibroblast activation model in vitro, CD40Apt administration inhibited TGF-β-induced cell viability, decreased TGF-β-induced α-SMA, Collagen I, Timp-1, and vimentin levels, and suppressed TGF-β-induced phosphorylation of Erk, p38, JNK, and NF-κB. In TAO mice model in vivo, CD40Apt caused no significant differences to the body weight of mice; furthermore, CD40Apt improved the eyelid broadening, ameliorated inflammatory infiltration and the hyperplasia in orbital muscle and adipose tissues in model mice. Concerning orbital fibroblast activation, CD40Apt reduced the levels of CD40, collagen I, TGF-β, and α-SMA in orbital muscle and adipose tissues of model mice. Finally, CD40Apt administration significantly suppressed Erk, p38, JNK, and NF-κB phosphorylation. In conclusion, CD40Apt, specifically binds to CD40 proteins in their natural state on the cell surface with high affinity, could suppress mouse orbital fibroblast activation, therefore improving TAO in mice model through the CD40 and downstream signaling pathways. CD40Apt represents a promising antagonist of the CD40-CD40L signaling for TAO treatment.
Oral microbiota may affect osteoradionecrosis following radiotherapy for head and neck cancer
Authors: Li Zhengrui , Fu Rao , Huang Xufeng , Wen Xutao , Zhang Ling
Published: June 2023

Background

Osteoradionecrosis (ORN) is a serious complication of radiotherapy for head and neck cancer (HNC). However, its etiology and pathogenesis have not been completely elucidated. Recent studies suggest the involvement of the oral microbiota in the development of ORN. The aim of this study was to assess the correlation between oral microbiota and the extent of bone resorption in ORN patients.

Materials and methods

Thirty patients who received high-dose radiotherapy for HNC were enrolled. Tissue specimens were collected from the unaffected and affected sides. The diversity, species differences and marker species of the oral microbial community were determined by 16 S rRNA sequencing and bioinformatics analysis.

Results

The ORN group had greater microbial abundance and species diversity. The relative abundance of f_Prevotellaceaeand, f_Fusobacteriaceae, f_Porphyromonadaceae, f_Actinomycetaceae, f_Staphylococcaceae, g_Prevotella, g_Staphylococcus, s_Endodontalis and s_Intermedia were particular;y increased in ORN, suggesting a potential association between the oral microbiota and ORN. Furthermore, g_Prevotella, g_Streptococcus, s_parvula and s_mucilaginosa were identified as potential diagnostic and prognostic biomarkers of ORN. Association network analysis also suggested an overall imbalance in species diversity and ecological diversity in the oral microbiota of ORN patients. In addition, pathway analysis indicated that the dominant microbiota in ORN may disrupt bone regeneration by regulating specific metabolic pathways that increase osteoclastic activity.

Conclusion

Radiation-induced ORN is associated with significant changes in the oral microbiota, and the latter may play a potential role in the etiopathology of post-radiation ORN. The exact mechanisms through which the oral microbiota influence osteogenesis and osteoclastogenesis remain to be elucidated.
Exploring the potential of microRNA as a diagnostic tool for gestational diabetes
Authors: Elhag Duaa Ahmed , Al Khodor Souhaila
Published: June 2023

MicroRNAs (miRNAs) are small non-coding RNAs that play critical roles in regulating host gene expression. Recent studies have indicated a role of miRNAs in the pathogenesis of gestational diabetes mellitus (GDM), a common pregnancy-related disorder characterized by impaired glucose metabolism. Aberrant expression of miRNAs has been observed in the placenta and/or maternal blood of GDM patients, suggesting their potential use as biomarkers for early diagnosis and prognosis. Additionally, several miRNAs have been shown to modulate key signaling pathways involved in glucose homeostasis, insulin sensitivity, and inflammation, providing insights into the pathophysiology of GDM. This review summarizes the current knowledge on the dynamics of miRNA in pregnancy, their role in GDM as well as their potential as diagnostic and therapeutic targets.
Soybean leaf estimation based on RGB images and machine learning methods
Authors: Li Xiuni , Xu Xiangyao , Xiang Shuai , Chen Menggen , He Shuyuan , Wang Wenyan , Xu Mei , Liu Chunyan , Yu Liang , Liu Weiguo , Yang Wenyu
Published: June 2023

Background

RGB photographs are a powerful tool for dynamically estimating crop growth. Leaves are related to crop photosynthesis, transpiration, and nutrient uptake. Traditional blade parameter measurements were labor-intensive and time-consuming. Therefore, based on the phenotypic features extracted from RGB images, it is essential to choose the best model for soybean leaf parameter estimation. This research was carried out to speed up the breeding procedure and provide a novel technique for precisely estimating soybean leaf parameters.

Results

The findings demonstrate that using an Unet neural network, the IOU, PA, and Recall values for soybean image segmentation can achieve 0.98, 0.99, and 0.98, respectively. Overall, the average testing prediction accuracy (ATPA) of the three regression models is Random forest > Cat Boost > Simple nonlinear regression. The Random forest ATPAs for leaf number (LN), leaf fresh weight (LFW), and leaf area index (LAI) reached 73.45%, 74.96%, and 85.09%, respectively, which were 6.93%, 3.98%, and 8.01%, respectively, higher than those of the optimal Cat Boost model and 18.78%, 19.08%, and 10.88%, respectively, higher than those of the optimal SNR model.

Conclusion

The results show that the Unet neural network can separate soybeans accurately from an RGB image. The Random forest model has a strong ability for generalization and high accuracy for the estimation of leaf parameters. Combining cutting-edge machine learning methods with digital images improves the estimation of soybean leaf characteristics.
Swimming prevents cell death of chondrocytes via PI3K/AKT pathway in an experimental model
Authors: Qian Jiajia , Zhao Peiru , Xu Qi , Yang Weiwei , Cai Ren
Published: June 2023

Background

Knee Osteoarthritis (KOA) is one of the main causes of disability in the elderly and with limited treatment options. Swimming was considered as an ideal form of non-surgical management of KOA. Nevertheless, the mechanism of swimming intervene OA remains unclear. ACLT induced OA model was often used to study the pathogenesis and treatment of OA. Thus, we evaluated the protective effect of swimming on KOA mouse and tried to explore the underlying mechanism.

Methods

Forty C57BL/6 mice were randomly divided into five groups: Blank group, ACLT group, ACLT + Swim group, Sham group and Sham + Swim group (n = 8). OA model was established by Anterior Cruciate Ligament Transection surgery (ACLT). After modeling, mice in ACLT + Swim and Sham + Swim groups were trained with a moderate swimming program, 5 d/week, for 6 weeks. HE and Safranin-O/fast staining, Immunohistochemistry, TUNEL assay and Western blot were used to detect the effect of swimming on pathological changes, cell death and the mechanism in KOA mouse.

Results

Swimming significantly enhanced CoII expression and suppressed ADAMTS5 expression in cartilage of KOA mouse, thus ameliorated KOA development. Apoptotic and autophagic processes were enhanced in OA cartilage, which might be caused by down-regulation of PI3K/AKT pathway; swimming could activate PI3K/AKT pathway and thus regulate apoptosis and autophagy processes of chondrocytes.

Conclusion

Swimming could prevent cell death of chondrocytes via PI3K/AKT pathways, thus delayed the progression of KOA in an experimental model.
Severe osteoporosis in a young man with bilateral Cushing’s syndrome: a case report
Authors: Reis Bárbara Oliveira , Leal Christianne Toledo Sousa , Ezequiel Danielle Guedes Andrade , dos Santos Ribeiro Simões Juliano Ana Carmen , de Macedo Veloso Flávia Lopes , da Silva Leila Marcia , Ferreira Lize Vargas , Ferreira Mariana , De Oliveira Souza Gabriel Zeferino
Published: June 2023

Background

The diagnosis of Cushing’s syndrome is challenging; however, through the clinical picture and the search for secondary causes of osteoporosis, it was possible to reach the diagnosis of the case reported. There was an independent, symptomatic ACTH hypercortisolism manifested by typical phenotypic changes, severe secondary osteoporosis and arterial hypertension in a young patient.

Case presentation

A 20-year-old Brazilian man with low back pain for 8 months. Radiographs showed fragility fractures in the thoracolumbar spine, and bone densitometry showed osteoporosis, especially when evaluating the Z Score (− 5.6 in the lumbar spine). On physical examination, there were wide violaceous streaks on the upper limbs and abdomen, plethora and fat increase in the temporal facial region, hump, ecchymosis on limbs, hypotrophy of arms and thighs, central obesity and kyphoscoliosis. His blood pressure was 150 × 90 mmHg. Cortisol after 1 mg of dexamethasone (24.1 µg/dL) and after Liddle 1 (28 µg/dL) were not suppressed, despite normal cortisoluria. Tomography showed bilateral adrenal nodules with more severe characteristics. Unfortunately, through the catheterization of adrenal veins, it was not possible to differentiate the nodules due to the achievement of cortisol levels that exceeded the upper limit of the dilution method. Among the hypotheses for the differential diagnosis of bilateral adrenal hyperplasia are primary bilateral macronodular adrenal hyperplasia, McCune–Albright syndrome and isolated bilateral primary pigmented nodular hyperplasia or associated with Carney’s complex. In this case, primary pigmented nodular hyperplasia or carcinoma became important etiological hypotheses when comparing the epidemiology in a young man and the clinical-laboratory-imaging findings of the differential diagnoses. After 6 months of drug inhibition of steroidogenesis, blood pressure control and anti-osteoporotic therapy, the levels and deleterious metabolic effects of hypercortisolism, which could also impair adrenalectomy in the short and long term, were reduced. Left adrenalectomy was chosen, given the possibility of malignancy in a young patient and to avoid unnecessary definitive surgical adrenal insufficiency if the adrenalectomy was bilateral. Anatomopathology of the left gland revealed expansion of the zona fasciculate with multiple nonencapsulated nodules.

Conclusion

The early identification of Cushing’s syndrome, with measures based on the assessment of risks and benefits, remains the best way to prevent its progression and reduce the morbidity of the condition. Despite the unavailability of genetic analysis for a precise etiological definition, it is possible to take efficient measures to avoid future damage.
Spontaneous calcific cerebral embolization revealing a calcified rheumatic mitral stenosis: a case report
Authors: Haboub M. , Abouradi S. , Mechal H. , Minko G. , Moukhliss A. , Arous S. , Benouna M. E. G. , Drighil A. , Azzouzi L. , Habbal R.
Published: June 2023

Background

Cerebral cardiac embolism accounts for an increasing proportion of ischemic strokes and transient ischemic attacks. Calcified cerebral emboli are rare and mostly iatrogenic secondary to heart or aorta catheterization. However, spontaneous cerebral calcified embolism in the case of calcified aortic valve is very rare and there are less than 10 case reports in the literature. And a more interesting fact is that such an event, in the context of calcified mitral valve disease, has never been reported, at least to our knowledge. We are reporting a case of spontaneous calcified cerebral embolism revealing a calcified rheumatic mitral valve stenosis.

Case presentation

We report a case of a 59 year-old Moroccan patient, with a history of rheumatic fever at the age of 14 and no history of recent cardiac intervention or aortic/carotid manipulation, who was admitted to the emergency department after a transient ischemic attack. Physical examination at admission found normal blood pressure of 124/79 mmHg and heart rate of 90 bpm. A 12-lead electrocardiogram showed an atrial fibrillation, no other anomalies. Unenhanced cerebral computed tomography imaging was performed, revealing calcified material inside both middle cerebral arteries. Transthoracic echocardiography was performed, showing severe mitral leaflets calcification with a severe mitral stenosis, probably due to rheumatic heart disease. Cervical arteries Duplex was normal. A vitamin K antagonist (acenocoumarol) was prescribed, targeting an international normalized ratio of 2–3 and mitral valve replacement surgery was performed using mechanical prosthesis. Short- and long-term health, with a 1-year follow-up, were good and the patient did not experience any stroke.

Conclusion

Spontaneous calcified cerebral emboli secondary to mitral valve leaflet calcifications is an extremely rare condition. Replacement of the valve is the only option to prevent recurrent emboli and outcomes are still to be determined.
A scheduling algorithm to maximize storm throughput in heterogeneous cluster
Authors: Nasiri Hamid , Nasehi Saeed , Divband Arman , Goudarzi Maziar
Published: June 2023

In the most popular distributed stream processing frameworks (DSPFs), programs are modeled as a directed acyclic graph. Using this model, a DSPF can benefit from the parallelism capabilities of distributed clusters. Choosing a reasonable number of vertices for each operator and mapping the vertices to the appropriate processing resources significantly affect the overall system performance. Due to the simplicity of the current DSPF schedulers, these frameworks perform poorly on large-scale clusters. In this paper, we present a heterogeneity-aware scheduling algorithm that finds the proper number of the vertices of an application graph and maps them to the most suitable cluster node. We begin with a pre-processing step which allocates the vertices to the given cluster nodes using profiling data. Then, we gradually increase the topology input rate in order to scale up the application graph. Finally, using a CPU utilization model which predicts the CPU workload based on the input rate to vertices and the processing node’s CPU characteristics, we identify the bottlenecked vertices and allocate new instances derived from them to the least utilized processing resource. Our experimental results on Storm Micro-Benchmark show that (1) the prediction model estimate CPU utilization with 92% accuracy. (2) Compared to the default scheduler of Storm, our scheduler provides 7 to 44% throughput enhancement. (3) The proposed method can find the solution within 4% (worst case) of the optimal scheduler, which obtains the best scheduling scenario using an exhaustive search over problem design space.
Cannabis for morning sickness: areas for intervention to decrease cannabis consumption during pregnancy
Authors: Swenson Karli
Published: June 2023

Background

Cannabis use during pregnancy is increasing, with 19–22% of patients testing positive at delivery in Colorado and California. Patients report using cannabis to alleviate their nausea and vomiting, anxiety, and pain. However, preclinical and clinical data highlight harmful effects to offspring physiology and behavior following fetal cannabis exposure. This narrative review identifies potential areas for intervention to decrease cannabis consumption during pregnancy.

Methods

A combination of keywords, including “cannabis”, “cannabis”, “weed”, “pregnancy”, “morning sickness”, “child protective services”, and “budtender” were searched in databases such as PubMed and Google Scholar, as well as in social media forums, governmental webpages, and other publicly available sources.

Results

The literature search identified several areas for intervention to reduce cannabis use during pregnancy, including physician and pharmacist training, engagement with pregnant patients, regulation of dispensary workers, and the role of child protective services.

Discussion

This comprehensive review identifies multiple areas for improvement to benefit pregnant patients. Recommendations are independent and can be implemented simultaneously by the identified groups. Limitations of this research includes the relatively limited availability of data focused specifically on cannabis consumption during pregnancy and the complexity of the sociopolitical field of substance use during pregnancy.

Conclusions

Cannabis consumption during pregnancy is increasing and causes harm to the developing fetus. To educate pregnant patients about these risks, we must address the gaps in education from multiple contact points.
Fathers’ involvement in the healthcare of their children: a descriptive study in southwest Nigeria
Authors: Bodunde Olubunmi Temitope , Sholeye Oluwafolahan Oluwagbemiga , Jeminusi Olubukunonla Ayodele , Ajibode Haroun Adetunji , Otulana Taibat Olusola , Adebayo Emmanuel Olusegun
Published: June 2023

Objective

This study aims at determining why fathers do not follow their children to the clinic or hospital and exploring the factors that will promote father’s participation in healthcare of their children.

Design

Descriptive cross-sectional study.

Setting

Community (Sagamu township of Sagamu Local Government Area of Ogun State {LGA}, Nigeria).

Participants

All fathers ≥ 18 years that have ever had children, selected from 3 wards in Sagamu township of Sagamu LGA.

Results

A total of 416 fathers participated in the study. The mean age of participants was 42.0 ± 12.7 years. Forty-four-point five percent (44.5%) had secondary education, while 36.6% were unskilled workers. Forty-two-point three percent (42.3%) said it is a woman’s job to take children to the hospital, while about half of the respondents said following a child to the hospital is time-consuming. About 2/3rd of the participants said waiting time in the hospital is too long, while 53.6% will rather go in search of money than go with a child to the hospital. Thirty-nine-point nine percent will need paternity leave to be more involved.

Conclusion

The major individual factors influencing father’s involvement in the healthcare of their children in this study are semi-skilled occupation, marital status, and work schedule. Majority do not think paternity leave is required before fathers can be involved in the healthcare of their children. Intensive health education by healthcare practitioners will improve male participation in children’s health.
Expression of Secretin and its Receptor Along the Intestinal Tract in Type 2 Diabetes Patients and Healthy Controls
Authors: Gilliam-Vigh Hannah , Jorsal Tina , Nielsen Sophie W , Forman Julie L , Pedersen Jens , Poulsen Steen S , Vilsbøll Tina , Knop Filip K
Published: June 2023

Context

The hormone secretin (SCT) is released from intestinal S cells and acts via the SCT receptor (SCTR). Circulating SCT levels increase after Roux-en-Y gastric bypass surgery and have been associated with massive weight loss and high remission rates of type 2 diabetes (T2D) linked to these operations. Exogenous SCT was recently shown to reduce ad libitum food intake in healthy volunteers.

Objective

To understand SCT biology and its potential role in T2D pathophysiology, we examined the intestinal mucosal expression profile of SCT and SCTR and evaluated the density of S cells along the intestinal tract of individuals with T2D and healthy controls.

Methods

Using immunohistochemistry and messenger RNA (mRNA) sequencing, we analyzed intestinal mucosa biopsies sampled along the small intestine at 30-cm intervals and from 7 well-defined anatomical sites along the large intestine (during 2 sessions of double-balloon enteroscopy) in 12 individuals with T2D and 12 healthy controls.

Results

Both groups exhibited a progressive and similar decrease in SCT and SCTR mRNA expression and S-cell density along the small intestine, with reductions of 14, 100, and 50 times, respectively, in the ileum compared to the duodenum (used as reference). Negligible amounts of SCTR and SCT mRNA, as well as low S-cell density, were found in the large intestine. No significant differences were observed between the groups.

Conclusion

SCT and SCTR mRNA expression and S-cell density were abundant in the duodenum and decreased along the small intestine. Very low SCT and SCTR mRNA levels and S-cell numbers were observed in the large intestine, without aberrations in individuals with T2D compared to healthy controls.
A Rare Case of Exostosis of the Medial Sesamoid Bone
Authors: Akram Nimra , Asif Aqua , Mangwani Jitendra
Published: June 2023

Introduction: Exostoses in the foot and ankle are extremely rare with no current literature of exostosis of the sesamoid bone. Case Report: A middle-aged woman was referred to orthopedic foot surgeons following a long-standing issue of a painful non-fluctuant swelling beneath her left hallux with normal imaging. Repeat X-rays, with sesamoid views of the foot, were conducted due to the patient’s ongoing symptoms. The patient underwent a surgical excision and made a complete recovery. The patient is now able to comfortably walk for longer distances with no restrictions to her mobility. Conclusion: Conservative management should be initially trialed to preserve the foot’s functions and limit the risk of surgical complications. As in this case, when surgical options are explored, it is critical to preserve as much of the sesamoid bone as possible to restore and sustain function. Keywords: Orthopedics, trauma, foot, surgery, osteochondroma, exostosis.
Red Herring in Orthopedics: A Case Report on Painful Os Vesalianum Pedis Masquerading as an Avulsion Fracture of 5th Metatarsal and Review of Literature
Authors: Mathew Ashish Jacob , Hugh Clint , Nath Sanjay , Pillai Manju G
Published: June 2023

Introduction: Os vesalianum pedis (OVP) is a rare accessory ossicle of the foot located proximal to the base of 5th metatarsal. It is usually asymptomatic but can mimic an avulsion fracture of proximal 5th metatarsal and is an infrequent cause of lateral foot pain. There have only been 11 cases of symptomatic OVP reported in the current literature. Case Report: Our patient, a 62-year-old male presented with lateral foot pain following an inversion injury of his right foot, with no history of any previous trauma. What was initially mistaken as an avulsion fracture of the 5th metacarpal base was later revealed to be an OVP on contralateral X-ray. Conclusion: Treatment is mostly conservative, but surgical excision can be done in cases following failed non-operative treatment. In the context of trauma, OVP must be differentiated from other causes of lateral foot pain such as Iselin’s disease and avulsion fractures of base of 5th metatarsal. Understanding the various etiologies of the condition and what those etiologies are usually related to can help prevent unnecessary treatment. Keywords: Os vesalianum pedis, lateral foot pain, foot ossicles, 5th metatarsal avulsion fracture.
The Subacute Necrotizing Fasciitis: The Forgotten form of this Life-threatening Infection. A Case Report
Authors: Tramallino Jorge , Wojda Adelaide , Farhat Houssein , Muhadri Atdhe
Published: June 2023

Introduction: Necrotizing fasciitis (NF) is a life-threatening soft-tissue infection. While the fulminate form is well documented, the subacute NF is rarely reported. Failure to consider NF as a diagnosis during this indolent presentation can be detrimental to patients because the surgical aggressive debridement remains the key of the treatment. Case Report: We report a case of a 54-year-old man who developed a subacute NF. After an initial diagnosis of cellulitis, the patient failed to show improvement with antibiotic treatment; he was referred to our institution in view to benefit of a surgical management. The patient developed progressive systemic toxic symptoms and an emergency debridement was made 10 h after his admission. Our patient achieves to show improvement with antibiotic treatment, vacuum-assisted closure therapy, hyperbaric oxygen therapy, and reconstructive surgery. Complete recovery was observed after 2 months. Conclusion: NF is a surgical emergency. Early diagnosis is essential, it is often ambiguous and commonly misdiagnosed including the subacute form. There needs to be a high suspicion for NF even in patients presenting with cellulitis without systemic symptoms. Keywords: Necrotizing fasciitis, subacute necrotizing fasciitis, necrotizing soft-tissue infection, clinical spectrum.
Bilateral Femoral Shaft Fractures in a Young Child due to Nonaccidental Trauma: A Case Report and Literature Review
Authors: Padgett Anthony M , Kothari Ezan A , Williams Kevin A
Published: June 2023

Introduction: Bilateral femoral diaphyseal fractures in children due to nonaccidental trauma (NAT) are a rare occurrence, with no reported cases currently published in the literature. The authors present a case of an 8-month-old male who presented with bilateral femoral shaft fractures. History, physical examination, and radiographic findings support NAT as the cause of his injuries. Due to the patient’s size and associated comorbidities, he was initially treated with Pavlik harness placement, rather than spica casting. The patient demonstrated appropriate radiographic evidence of fracture healing on follow-up. Case Report: An 8-month-old male with a complex past medical history presents to the emergency department. Per the patient’s mother, he has been demonstrating a progressive loss of movement and refusal to bear weight in his bilateral lower extremities over the preceding 1–2 weeks. Other injuries include facial bruising and lesions indicative of subconjunctival hemorrhages. After orthopedics was consulted, the decision was made to treat the patient’s bilateral femoral shaft fractures with a Pavlik harness, rather than spica casting, due to his small size and associated past medical history. The patient was subsequently discharged under foster care. Follow-up visit demonstrates appropriate fracture healing in the bilateral femoral diaphyses. Conclusion: Many cases of NAT in the pediatric population are initially missed. Orthopedic providers must maintain a high index of suspicion for NAT as many of these patients will present with musculoskeletal injuries. The authors report a rare case of NAT in a male child resulting in bilateral femoral diaphyseal fractures. The patient was successfully treated through Pavlik harness placement. Orthopedic providers should consider Pavlik harness placement as a viable option even for young children >6 months of age presenting with femoral shaft fractures if spica casting or open reduction internal fixation is not appropriate. Keywords: Femoral fracture, nonaccidental trauma, pediatric.
Triple Disruption of the Superior Shoulder Suspensory Complex: review and Surgical Technique
Authors: Jaën Matthieu , Sayer Lydie , Fornaciari Paolo
Published: June 2023

Introduction: The shoulder girdle is composed of two arches, and these two arches are held together by the superior shoulder suspensory complex (SSSC), a ligamentous complex. Goss’s 1993 description of the SSSC as a ring includes the glenoid, coracoid process, coracoclavicular ligaments, distal clavicle, acromioclavicular joint, and acromion. Goss also noted in a 1996 study that a rupture of the SSSC in two places can result in an unstable lesion. This case report presents an unusual association of fractures involving the coracoid process, acromion, and distal clavicle, which has rarely been reported in the literature. Indeed, a triple lesion of the SSSC is very uncommon and the treatment is still debated. Therefore, we propose a surgical technique which we believe to have provide good results. Case Report: A 54-year-old Caucasian male patient presented with Neer I distal third fracture of the clavicle, a displaced fracture of the acromion, and a fracture of the coracoid process following a left shoulder trauma after an epileptic crisis. The patient underwent surgery and has been followed for 1 year with good clinical and functional outcomes. Conclusion: This case report highlights the complexity of lesions of the SSSC and the importance of determining proper surgical technique based on the type of lesion. It demonstrates that surgery combined with active rehabilitation can lead to good functional outcomes for patients with this type of injury. This report will be of interest to clinicians involved in the treatment of this type of lesion and should add a valuable treatment option for the treatment of triple disruption of the SSSC. Keywords: Shoulder fractures, superior shoulder suspensory complex, surgical technique.
Non-classical Celiac Disease as an Unrecognized Cause for Post-operative Knee Swelling following Patellofemoral Arthroplasty: A Case Report
Authors: Mirle Vikranth , Gamsarian Vahram , Krishnan Aditya , Brusalis Christopher , Forsythe Brian
Published: June 2023

Introduction: Non-classical Celiac disease is a previously undescribed cause of debilitating post-operative cutaneous complications following an orthopedic procedure. Non-specific symptoms and rarity of the disease pose a diagnostic challenge; however, given underdiagnosis and significant morbidity, after ruling out of acute pathology, Celiac disease should be included in differential diagnosis for refractory cutaneous complications following an operative procedure. Case Report: A 34-year-old woman who underwent patellofemoral arthroplasty and medial patellofemoral ligament reconstruction experienced over 5 months of post-operative knee swelling, erythema, and pain unresponsive to antihistamines and negative infectious, vascular, and implant allergy testing workups. After careful dietary monitoring by an allergy specialist, she was tested and confirmed to have Celiac disease. Following cessation of her oral contraceptive pill and dietary gluten, her knee swelling, erythema, and debilitating pain resolved. Conclusion: Skin erythema, swelling, and pain are known complications after any operative treatment, but after ruling out of acute infectious and thromboembolic processes, diagnosis and management of refractory complications pose a challenging scenario. In this rare phenomenon, previously undescribed, a patient presented with months of post-operative knee erythema, swelling, stiffness, and extreme pain on activity along with non-specific symptoms of headache and fatigue before diagnosis with Celiac disease. On cessation of her birth control and dietary gluten, her symptoms and knee function improved dramatically. Keywords: Knee arthroplasty complication, celiac disease, medial patellofemoral reconstruction, patellofemoral arthroplasty, autoimmune disease.
Antimicrobial activity of phytofabricated silver nanoparticles using Carica papaya L. against Gram-negative bacteria
Authors: Arsene Mbarga Manga Joseph , Viktorovna Podoprigora Irina , Alla Marukhlenko , Mariya Morozova , Davares Anyutoulou Kitio Linda , Carime Bassa Zacharie , Anatolievna Gizinger Oksana , Vyacheslavovna Yashina Natalya , Vladimirovna Zhigunova Anna , Andreevna Smolyakova Larissa , Aleksandrovna Vasilieva Elena , Alekseevich Butusov Leonid , Nikolaïevna Borekhova Marina , Parfait Kezimana , Andrey Vodyashkin
Published: June 2023

Background and Aim: Antibiotic resistance, especially in Gram-negative bacteria, is a major public health risk affecting all industries requiring the use of antibiotics, including agriculture and animal breeding. This study aimed to use papaya extracts to synthesize silver nanoparticles (AgNPs) and evaluate their antimicrobial activity against various Gram-negative bacteria.

Materials and Methods: Silver nanoparticles were synthesized from the aqueous extracts of papaya seed, root, and bark, with AgNO3 used as a reducing agent. The phytofabricated AgNPs were analyzed by ultraviolet–visible absorbance, X-ray diffraction (XRD), Fourier-transform infrared spectroscopy, and photon cross-correlation spectroscopy (PCCS). The disc-diffusion method was used to perform antibacterial analysis, and the minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations were determined. We also investigated the antibiofilm activity of AgNPs and attempted to elucidate the potential mechanism of action on Escherichia coli ATCC 25922.

Results: Phytofabrication of AgNPs was successful with papaya root (PR-AgNPs) and papaya seed (PS-AgNPs), but not with papaya bark. Silver nanoparticles using papaya root and PS-AgNPs were both cubic and showed maximum absorbances of 2.6 and 0.3 AUs at 411.6 and 416.8 nm wavelengths and average hydrodynamic diameters X50 of 59.46 ± 7.03 and 66.57 ± 8.89 nm, respectively. The Ag in both AgNPs was confirmed by X-ray fluorescence by a distinctive peak in the spectrum at the silver Ka line of 22.105 keV. Both AgNPs exhibited broad-spectrum antimicrobial and antibiofilm activity against all Gram-negative bacteria, and PR-AgNPs were slightly better than AgNPs-PS. The MIC ranged from 16 µg/mL–28 µg/mL and 16 µg/mL–64 µg/mL, respectively, for PS-AgNPs and PR-AgNPs. The elucidation of the mechanism of action revealed interference with E. coli ATCC 25922 growth kinetics and inhibition of HM+-ATPase proton pumps.

Conclusion: Papaya seed and root extracts were efficient reducing agents for the biogenic synthesis of AgNPs, with noteworthy antibacterial and antibiofilm activities. Future studies should be conducted to identify the phytochemicals and the mechanism involved in AgNPs synthesis.

Keywords: antibiotic resistance, biogenic synthesis, Carica papaya, Gram-negative, silver nanoparticles.
English by Digital Printing as a Form of Visual Language and an Alternative Way of Communication (in the Inscriptions and Prints on Clothing and Footwear)
Authors: Efremova Alla Eduardovna
Published: June 2023

The article considers the inalienable attributes of a person in modern society - clothes and shoes with inscriptions in English – as a phenomenon of "talking clothes". This phenomenon is studied from the point of view of the interaction of language and culture in postmodernism as one of the new ways of global communication, as a way of transmitting messages, ideas, verbal and non-verbal, as a visual language using digital printing technologies. The author analyses the existence of common elements of Jacobson and Lotman’s communicative model and the model of indirect communication through the perception of prints\inscriptions on clothing; two directions of the communication channel described by Jacobson and Lotman are justified and confirmed by the illustrative examples.
Comparative Classification of Homonyms in Russian and Uzbek Languages
Authors: Усманова Svetlana Nematovna , Khamraeva Dilorom Azamovna
Published: June 2023

T

The article deals with the comparative classification of homonyms in the Russian and Uzbek languages. The authors examine the relationship of homonymy with polysemy. Homonymy is studied in the aspect of the systemic organization of vocabulary and connections with word building. The classification of non-derivative and derivative homonyms of the Russian and Uzbek languages is presented, taking into account the ways of their formation, derivativeness and non-derivativeness of lexemes, depending on their interaction in the word-building nest. The article also deals with the features and distinctive properties of lexical, word-forming homonyms, examples of reflected homonymy in the system of word-building nests, as well as the difference between homonyms in the Uzbek language in their internal structure and appearance, the division of homonyms depending on their material, content and graphic forms into groups. The results of the analysis indicate that the phenomenon of homonymy in the Russian and Uzbek languages has a regular and systemic character.