bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and time trends of symptoms of allergic rhinitis and rhinoconjunctivitis in Spanish children: Global Asthma Network (GAN) study
Authors: Bercedo-Sanz Alberto , Martínez-Torres Antonela , Varela Angel López-Silvarrey , Pellegrini Belinchón Francisco Javier , Aguinaga-Ontoso Ines , González Díaz Carlos , García-Marcos Luis , Grupo GAN Spain
Published: September 2023

Introduction: The time trends of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy previously described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 are unknown; or if the geographical or age differences in Spain persist.
Objective: To describe the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy in different Spanish geographical areas and compare them with those of the ISAAC.
Methods: Cross-sectional study of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy, carried out in 2016-2019 on 19943 adolescents aged 13-14 years and 17215 schoolchildren aged 6-7 years from six Spanish areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona, and Salamanca), through a questionnaire based on the Global Asthma Network (GAN) protocol.
Results: The prevalences of recent rhinitis and rhinoconjunctivitis (last 12 months), and nasal allergy/hay fever were 35.1%, 17.6%, and 14.6% in the adolescents and 20%, 8.5%, and 8.9% in the schoolchildren, respectively, with rhinoconjunctivitis in adolescents varying from 20.9% in Bilbao to 13.4% in Cartagena; and in schoolchildren, from 9.8% in La Coruña to 6.4% in Pamplona. These prevalences of rhinoconjunctivitis and nasal allergy in adolescents were higher than those described in the ISAAC (16.3% and 13%) and similar in schoolchildren to the ISAAC (9% and 9.4%).
Conclusions: There has been a stabilisation of rhinitis, rhinoconjunctivitis and nasal allergy in schoolchildren that slows the previous upward trend of ISAAC; and a slight non-significant increase in rhinoconjunctivitis and nasal allergy in adolescents. The variability found in adolescents would require local research to be better understood.
An unusual case of acquired angioedema associated with monoclonal gammopathies of uncertain significance
Authors: Liu Yun , Fan Guofeng , He Fei , Tong Hanwen , Jiang Chenxiao , Xu Peng , Wang Jun
Published: September 2023

Acquired angioedema (AAE) is a rare disease due to the C1 esterase inhibitor (C1-INH) deficiency. Clinically, its symptoms are similar to hereditary angioedema (HAE) with hereditary C1-INH deficiency. Both conditions have the potential to cause upper airway obstruction, which can be fatal in clinical practice and thus require intense attention. Here, we’d like to discuss the clinical presentation, diagnosis and follow up of a special case of AAE associated with monoclonal gammopathies of unknown significance (MGUS) with recurrent upper airway obstruction. The patient was regularly followed up after being discharged from our ward. Measurements of C3–C4 levels were carried out by a hematological test. Due to the rarity of such a disease, especially in Chinese people, relevant diagnosis methods are missing in this patient, so the patient was only diagnosed with AAE-C1-INH associated with MGUS clinically. The latest follow up showed that he still underwent recurrent upper airway obstruction; thus, he remained in a tracheostomy state due to a lack of proper medication prophylaxis and died eventually. This unusual case reminds emergency physicians to pay attention to such disease during clinical practice, and relevant diagnosis method should be improved.
VİDEO OYUNLARINDA ETKİLEŞİMİN ÖNEMİ: BİR LİTERATÜR TARAMASI
Authors: ABABAY Atif Çağlar , BİL Erkan
Published: September 2023

Video oyunları, bilgisayar yazılımı alanında etkili ve popüler bir form olarak değerlendirilmektedir. Oyuncuların oldukça fazla zaman ve çaba harcadığı oyunlar hem oyun ekosisteminin ilgisini çekmekte hem de son dönemde akademik çalışmalara sıklıkla konu olmaktadır. Video oyunları, rekabet ve iş birliği unsurlarını sorunsuz bir şekilde birleştirerek ve oyuncular arasında bağlantı kurmayı teşvik ederek bireyleri bir araya getirmektedir. Bunun yanı sıra tüm video oyunları, çeşitli insan-bilgisayar etkileşimi (İBE) yöntemlerini kullanarak oyuncuların sanal bir ortamla etkileşime geçebilmelerini sağlamaktadır. Ayrıca kullanıcılara sunduğu çeşitli etkileşim imkanlarıyla farklı bir kültürel medya türü olarak öne çıkmaktadır. Ancak bu alanın karmaşıklığı ve disiplinler arası kavramları da içermesi nedeniyle akademik çalışmalar için birtakım zorluklar oluşturmakta ve etkileşim tasarımı sürekli olarak yenilenmektedir. Bu çalışma, video oyunları etkileşimleri konusunda literatürdeki mevcut durumu ortaya koyarak gelecekte yapılacak akademik çalışmalara ve oyun tasarımlarına katkı sağlamayı amaçlamaktadır. Video oyunlarda etkileşimin etkilerine yönelik yapılan çalışmalardan derlenen sonuçlar değerlendirildiğinde sosyal etkileşimlerin ve insan-bilgisayar etkileşimlerinin, oyuncuların bağlanma düzeylerini, akış deneyimlerini, algılanan keyfi, oyun oynamaya devam etme niyetlerini ve oyun içi satın alma davranışlarını etkilediği görülmüştür.
GÖRME ENGELLİ ÂŞIKLAR VE TABİAT ALGISI
Authors: DOYKUN Samet
Published: September 2023

Âşıklık geleneği içerisinde 16. yüzyıldan beri birçok âşık yetişmiştir. Âşıklar, eserlerinde başta aşk olmak üzere hemen her konuyu ele alıp eserlerinde işlemişlerdir. Bu konulardan biri de dış dünyanın işlendiği tabiat olmuştur. Tabiat, özellikle 19. yüzyıla kadar sanat ve edebiyat eserlerine dâhil edilmemiş ve “çirkin” sayılmıştır. 19. yüzyıldan sonra ise başta İngiltere’de olmak üzere pek çok ülkenin sanat ve edebiyat eserlerine girmeye başlamıştır. Türk edebiyatına gelindiğinde ise başta klasik edebiyat ürünlerinde ele alınan tabiat unsurları, soyut ifadelerle ve genellikle sevgili tasvirleri için kullanılmıştır. Akabinde âşık şiirinde de kullanılmaya başlanan tabiat unsurları söz konusu kullanımdan ziyade somut olarak ele alınmıştır. Âşıklar eserlerinde sevgiliyi anlatırken tabiat unsurlarından yararlanmış ve daha sonra tabiatı doğrudan şiirin konusu yaparak aktarmaya, anlatmaya başlamıştır. Âşıklık geleneği içerisinde geleneğin başladığı yüzyıldan itibaren var olan görme engelli âşıklar da tabiatı eserlerinde işlemişlerdir. Görme engelli âşıklar görme yetilerini hayatlarının bir döneminde kaybetmelerine veya doğuştan görme engelli olmalarına rağmen tabiatla ilgili eser vermeleri oldukça dikkat çekicidir. Bu çalışmada görme engelli âşıkların tabiatı nasıl algıladıkları ve görmeden nasıl anlattıkları konusu âşıklardan derlenen şiirler ve yayınlanan eserler üzerinden tespit edilip değerlendirilmeye çalışılmıştır. Bu çalışma sonucunda doğuştan görme yetisi olmayan ve gözlerini sonradan kaybeden âşıkların, tabiatı kendi iç dünyalarında kurdukları tabiat algısıyla ya da gelenekten beslenerek eserlerine yansıttıkları tespit edilmiştir.
TÜRK DIŞ POLİTİKASINDA TİCARİ İLİŞKİLERİN ETKİSİ, TİCARİ DİPLOMASİNİN, İÇERİDEKİ ONTOLOJİK GÜVENLİK KAYGILARINI GİDERMEDEKİ ROLÜ: KUZEY IRAK VAKASI
Authors: TAŞÇI Ufuk Necat
Published: September 2023

Bu çalışmada son dönemde alanda üzerine yapılan çalışmaların giderek arttığı ontolojik güvenlik-dış politika ilişkisi ve ontolojik güvenlik merkezli kaygıların ortadan kaldırılmasında ticari diplomasinin rolü sorgulanmaktadır. Türkiye gibi, son yıllarda ticareti dış politika önceliklerinin başına yerleştiren bölgesel bir gücün, Kuzey Irak Bölgesel Yönetimi ile olan ilişkileri PKK terör örgütünün oluşturduğu güvenlik tehdidi çerçevesinde ele alınmaya çalışılmıştır. Dış politikada kısa, orta ve uzun vadeli pek çok ikili krizi ticari diplomasiyi de kullanarak ortadan kaldıran Türkiye, ontolojik güvenlik kaygısının yoğun hissedildiği Kuzey Irak bölgesinde PKK terör örgütünün varlığı doğrultusunda belirli güvenlik hassasiyetlerinden taviz vermekten geri durmuştur. İkili ilişkilerindeki sorunların çözümünde ticari ilişkileri de önemli bir yere koyan Türk dış politikasında yaşananların ele alındığı bu çalışma, ticari diplomasinin dahi bazen ontolojik güvenlik kaygılarını gidermede yetersiz olduğu gerçeğini ortaya koymayı amaçlamaktadır. Özellikle 2000’li yılların başından itibaren reformist, proaktif bir dönüşüm geçiren Türk dış politikasında dahi, beka söz konusu olduğunda realizmin hem Türkiye hem de diğer ülkeler adına son sözü söylediği gözlemlenmiştir. Fiziksel güvenliğin devletin temel aktör olduğu durumlarda ontolojik güvenlik kaygıları tetiklenmiş, ticari çıkarlar dahi ‘kaygı’ söz konusu olduğunda ikinci planda kalmıştır. Bu kaygının giderilmesi adına, karşılıklı bağımlılık ilişkilerini kullanarak fiziksel güvenlik endişelerini ortadan kaldırmaya çalışma stratejisi, fiziksel güvenliğe realist anlamda tehdit olarak telakki edilen terörizm gibi hususlarda geçersiz kalmıştır.
SEÇİLMİŞ AB ÜLKELERİ VE TÜRKİYE’DE DOĞRUDAN YABANCI YATIRIM VE ENDÜSTRİ-İÇİ TİCARET: DUMİTRESCU-HURLİN PANEL NEDENSELLİK ANALİZİ
Authors: ŞENTÜRK Canan
Published: September 2023

Son elli yılda küresel ekonominin entegrasyonu ve çok uluslu şirketlerin dış kaynak kullanımı faaliyetleri ile bağlantılı olarak, gelişmekte olan ülkeler ve gelişmiş ülkeler arasındaki endüstri içi ticaret giderek artmaktadır. Küresel ölçekte artan doğrudan yabancı yatırımlarla ilişkili firma içi ticaretin de genişlemesi, yatırımın kaynağı ve ev sahibi ülke arasındaki endüstri içi ticaretin büyümesini yönlendiren ana faktörlerden biri olarak kabul edilmektedir. Bu çalışmanın amacı doğrudan yabancı sermaye yatırımları ile endüstri-içi ticaret arasındaki ilişkiyi ampirik olarak test etmektir. Araştırmada seçilmiş AB ülkeleri (Çek Cumhuriyeti, Hırvatistan, Macaristan, Avusturya, Bulgaristan, Polonya, Romanya, Slovakya, Slovenya) ile Türkiye’nin 1996-2019 dönemi verileri kullanılarak Grubel-Lloyd endeksi hesaplaması yapılmıştır. Hesaplanan endüstri-içi ticaret seviyeleri ile birlikte doğrudan yabancı sermaye yatırımları net giriş ve net çıkışları iki model kullanılarak Westerlund eşbütünleşme ve Dumitrescu-Hurlin panel nedensellik analizi ile incelenmiştir. Analiz sonuçlarına göre doğrudan yabancı sermaye yatırımları net girişlerinden (FDI) endüstri-içi ticarete doğru tek yönlü bir nedenselliğe rastlanırken doğrudan yabancı sermaye yatırımları net çıkış (FDIO) ile endüstri-içi ticaret arasında çift yönlü bir nedensellik ilişkisi bulunduğu saptanmıştır.
SAĞLIK ÇALIŞANLARINDA STRESLE BAŞA ÇIKMANIN EMPATİK EĞİLİM DAVRANIŞINA ETKİSİNDE KİŞİLİK ÖZELLİKLERİNİN ARACI ETKİSİ
Authors: HAYIROĞLU ALTINTAŞ Ümmügülsüm , METE Mustafa
Published: September 2023

Sağlık çalışanları, hizmetlerinin insan hayatına doğrudan etkisi, fazla mesai, iş güvenliği riskleri (şiddet ve hastalık yayma tehdidi) ve orantısız derecede yüksek iş yükü nedeniyle toplumdaki en stresli işgücünü oluşturmaktadır. Öte yandan empati, sağlıkta dikkate alınması gereken önemli bir motivasyondur çünkü bir kişiye sosyal uzlaşma sağlarken ileri düzeyde şefkat, gelişmiş farkındalık, iletişim becerileri ve duygusal beceriler, sinirlilik ve öfke gibi diğer antisosyal davranışları yönetmeye yardımcı olur. Kişilik özelliklerinin bu tür durum ve değişimlerle karşılaşan her insanda farklı davranış ve tutum biçimleriyle ortaya çıkabileceğine dair literatürde birçok çalışma bulunmaktadır. Bu nedenle personelin stresle baş edebilmesi ve hastanın ihtiyaçlarını anlaması kaliteli sağlık hizmeti sunumu için önemlidir. Çalışmanın amacı farklı görev ve kurumda 585 sağlık çalışanın stresle başa çıkmanın empatik eğilim davranışına etkisinde kişilik özelliklerinin aracı etkisinin araştırılması amaçlanmıştır.Çalışma sonucunda, kişilik özelliklerinin stresle başa çıkmanın empatik eğilime etkisinde aracılık rolünün olduğu gözlenmiştir. Stresle başa çıkma empatik eğilim üzerinde pozitif yönlü ilişkili çıkmıştır. Stresle başa çıkma düzeyi artıkça empatik eğilim de artmaktadır.
BRICS-T ÜLKELERİNDE İNOVASYONUN REKABETE ETKİSİ: EKONOMETRİK BİR ANALİZ
Authors: AKTAŞ Nur
Published: September 2023

Ekonomilerin rekabet üstünlüğü elde edebilmesi için önemli unsurlardan biri de inovasyondur. Özellikle gelişmekte olan ülkeler, yüksek büyüme hedefli oldukları için, gelir yaratıcı faaliyetler olan inovatif faaliyetleri desteklemek durumundadırlar. Bu çalışmanın amacı, gelişmekte olan ülke grubu BRICS-T (Brezilya, Rusya, Hindistan, Çin, Güney Afrika ve Türkiye)’de inovasyonun rekabet gücüne etkisini belirlemektir. Bu sebeple, BRICS-T ülkelerinin 2011-2021 dönemine ilişkin Küresel Rekabet Endeksi, Küresel İnovasyon Endeksi ve GSYH verileri kullanılarak panel eşbütünleşme ile analiz edilmiştir. Analiz sonucunda, panel geneli için ülke grubunda ele alınan bağımsız değişkenler inovasyon ve GSYH rekabet üzerinde pozitif yönde istatistik anlamlı ilişkili çıkmıştır. Panel genelinde, Küresel İnovasyon Endeksi değişkeni Küresel Rekabet Endeksi değişkenini %18.4 artırmakta, ayrıca GSYH değişkeni küresel rekabet değişkenini %13.5 artırıcı yönde etkilemektedir. BRICS-T ülke grubunda ele alınan ülkelere göre; inovasyonun rekabeti en çok etkilediği ülke Rusya ve Çin, en az etkilediği ülke Güney Afrika ve Türkiye olarak belirlenmiştir. Gelişmekte olan ülke grubu olan BRICS-T ülkelerinde inovasyonun rekabet gücüne etkisi GSYH’dan daha fazla olduğu tespit edilmiştir.
Experimental histomorphological substantiation of the effectiveness of the combined use of multipotent stem cells and an osteogenesis stimulator in periodontitis
Authors: Valeeva Gulnara A.
Published: September 2023

BACKGROUND: Periodontal disease treatment should be as comprehensive and individualized as possible, which determines the feasibility of conducting experimental clinical studies to find methods aimed at activating recovery processes in periodontal tissues and increasing the effectiveness of patients with chronic periodontitis.
OBJECTIVE: To develop a method for treating chronic periodontitis using multipotent mesenchymal stem cells (MMSCs) from human tooth pulp and an osteogenesis-stimulating drug.
MATERIALS AND METHODS: MMSCs were isolated from the pulp of a removed retinated human tooth. Experimental modeling of bone tissue destruction in periodontal disease was performed on the upper jaw in the second molar area and the lower jaw incisors of 50 sexually mature Wistar rats. The MMSCs were combined with an osteogenesis stimulant drug. The combination was injected into the bone (periodontal) pockets of rats. A Septopak protective bandage was used to fix the mass. The procedure was repeated every 5 days for 15 days. The course of treatment included three procedures with an interval of 5 days. The rats were monitored after the course of treatment for a period ranging from 5 days to 12 months.
RESULTS: The therapeutic efficacy of using the method of treatment of destructive changes in the alveolar bone in periodontitis, the possibility of complete restoration of the dentoalveolar papillae, and regeneration of periodontal tissues in the area of experimental destruction of bone tissue in periodontitis during the first 35 days was determined. During treatment with mesenchymal stem cells and an osteogenesis stimulator, there were no signs of inflammation (bleeding, pathological mobility of teeth, and gum discharge during palpation).
CONCLUSION: When the nature of clinical and histomorphological changes in the tissues of a pathologically altered periodontal was studied in an experiment with the use of mesenchymal stem cells in the treatment of periodontal bone destruction, it was found that a decrease in the intensity and prevalence of gingival inflammation begins on the 11th day. After introducing the resultant mixture of MMSCs and osteogenesis stimulator into the periodontal pockets of rats on the 30th day, there were no signs of inflammation in the animals.
Pyotr Fedorovich Fedorov: The founder of the Russian Military Dentistry
Authors: Grebnev Gennadii A. , Soldatov Ivan K. , Borisov Dmitrii N. , Podkaura Oksana V. , Dadasheva Leila N. , Dzhinikashvili Kristina D.
Published: September 2023

Pyotr Fedorovich Fedorov, an outstanding Russian dentist and private associate professor of Odontology, graduated from the Gatchina Nikolaevsky Institute and, in 1976, entered the Imperial Medical and Surgical (later Military Medical) Academy (IMHA, IVMA), from which he graduated from in 1881 and worked for more than 20 yr. He was the creator of the system for training dental specialists, as well as the inspiration for the establishment of his own Department of Odontology in IVMA. After graduating from IVMA, P.F. Fedorov decided to follow his fate with the sea and serve as a naval doctor in Arkhangelsk. The Academys Conference decided in 1891 to establish a private doctorate in dental diseases, the head of which was appointed Pyotr Fedorovich. As the initiator of this event, P.F. Fedorov is today recognized as the creator of the Russian Military Dentistry, and 1891 marks the official birth of military dentistry as a distinct clinical discipline. P.F. Fedorov in 1892 developed a training program for teaching dental disease treatment. Lectures for IVMA students were later initiated. P.F. Fedorov worked hard to establish the Department of Dentistry of the Academy and the system for training medical specialists for the Russian Army and Navy.
Sensory integration: the body perception in chan chuang practice
Authors: Li Dongchen , Green Thomas A. , Zhang Guodong
Published: September 2023

Chan chuang, a psychophysical practice renowned for its beneficial effects, has been favored by martial artists and traditional Chinese medicine practitioners since ancient times. With the onset of the COVID-19 pandemic, chan chuang has garnered increased attention and recognition. However, existing research primarily focuses on the efficacy of chan chuang, rather than exploring the practice itself. Consequently, there is a dearth of scientific and experiential guidance available to current practitioners of chan chuang. To address this gap, the present study employs an in-depth interview method within a qualitative research framework, conducting follow-up interviews with eight martial artists who regularly engage in chan chuang practice. By gaining insights into the physical and mental states of these practitioners, this paper aims to elucidate their embodied experiences of chan chuang from the perspective of “body perception”. The findings reveal that the practitioners’ perception of their bodies during chan chuang practice can be characterized by three key aspects: stillness, naturalness, and qi. The sense of stillness signifies a state of tranquility in both body and mind. The sense of naturalness represents a harmonious equilibrium of body and mind, at times even resulting in a loss of self-awareness. Finally, the sense of qi conveys a serene mental state accompanied by the smooth flow of life energy and blood. These three dimensions guide chan chuang practitioners toward attaining physical and mental well-being.
Central nervous system immunity in relation to aging and AD
Authors: Yang Chunhui , Schneider Julie , Mehta Rupal , Chen Tong , Wei Zhimin , Nag Sukriti , Huang Rongwei
Published: September 2023

The present report discusses the immune and clearance system of the central nervous system (CNS) in terms of its anatomical, physiological, and biochemical properties. There is now a growing body of evidence that progressive dysfunction of the meningeal lymphatic system should be considered as a risk factor for aging-related brain disorders. In addition, the activity of meningeal lymphatics may alter the access of CSF-carried immune neuromodulators to brain parenchyma, which is also involved in the onset of aging and AD. In the CNS clearance system, impairment of the BBB and small arteries, as well as the major protein of the end feet of astrocytes, AQP4, are associated with aging or AD. The idea of maximizing brain "waste discharge" as a new preventive or therapeutic target for neurodegenerative diseases in the context of healthy aging has been accepted.
Status Epilepticus Revealing Creutzfeldt-Jakob Disease: A Case Report
Authors: E Mabchour , O Maghrabi , W Machrouh , B Charra
Published: September 2023

Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative disease of undetermined etiology, In Creutzfeldt-Jakob syndrome the symptomatology is quite variable and it consist of predominantly progressive dementia with a rapid onset, myoclonus, and also cerebellar, pyramidal, extrapyramidal and visual signs, the evolution of this disease is uniformly fatal, most patients die within 12 months, we present a case of a 72 year old women, who was admitted for a status epilepticus, She was later diagnosed with sporadic CJD.
The Emerging Role of Photobiomodulation in COVID-19 Therapy – Part I
Authors: Williams Richard
Published: September 2023

Background. Infectivity, genomic variability, and symptomatic diversity of the SARS-CoV-2 virus represents a persistent challenge in the treatment of acute and long COVID-19 diseases. A direct consequence of pervasive ACE-2 receptors susceptible to the virion’s spike protein, disease trajectories commence as upper respiratory infection migrating into bronchia (presenting coughing, dyspnea, and fever), followed by viremic infection and circulatory distress from inflammation of visceral epithelium and vascular endothelia, decreased blood perfusion, and hypoxia. Severe cases include hyperinflammation, cytokine storms, and multisystem inflammatory syndrome with lung and nerve damage, and chronic cognitive deficits. Method. This paper (Part I) considers the requirements for treating acute and chronic COVID-19 with deep-tissue photobiomodulation (PBM) of sinuses, lungs and other ACE-2 populated organs using transdermal and transcranial light as a primary therapeutic modality. Analysis. A detailed analysis of optics, biophysics, numerical simulations, and quantum photochemistry for non-invasive deep tissue PBM of SARS-CoV-2 infected organs was performed including optical design, photonic control, irradiance, fluence, modulation, and protocols. Results. Analysis concludes large-area 3D bendable LED pads are best suited for deep-tissue PBM to transdermally treat whole-organ infection of the lungs, sinuses, abdominal cavity (and to transcranially treat long-COVID). Robotic laser scanning represents another viable option for deep-tissue PBM provided the optical angle of incidence is minimal. Penetration depth depends on wavelength (not optical power) with red (635nm) and NIR (850nm) shown to adequately penetrate through cutaneious tissue and parietal fascia into viscera. Conclusions. Red and NIR LEDs with average pulsed irradiances of 8.5 and 13.5 mW/cm2 respectively deliver hands-free whole-organ deep-tissue doses of between 0.5 to 4.0 J/cm2 in 60 min sessions from a surface dose of Pl/A = 40 J/cm2 depending on tissue transmission coefficients Yx at depth x>6mm. The designed photonic PBM system performs algorithmic variable frequency pulsed protocols covering up to 1,200 cm2. Duty factor control limits skin temperatures below 43°C irrespective of pulse modulating frequency. A mechanistic model for deep-tissue PBM, phenomenologically consistent with biophysics, photon penetration studies, COVID disease trajectories, and patient recovery profiles is presented. Part II details various acute and chronic case studies and positive outcomes thereof confirming PBM as a efficacious modality for COVID-19.
Principles of the Assessment of Food Additives Used in Food for Infants and Toddlers
Authors: Barmaz Stefania , Castle Laurence , Dusemund Birgit , Fürst Peter , Kyrkou Christina , Mech Agnieszka , Mortensen Alicja , Rincon Ana , Smeraldi Camilla , Tard Alexandra , Turck Dominique , Berendsen Dina , Wölfle Detlef , Remy Ursula
Published: September 2023

Food additives are substances added to food to maintain or improve its safety, freshness, taste, texture, or appearance. Until recently, the assessment of food additives taken up with the normal food was performed only for the population above an age of 12 weeks. With the better knowledge of the physiological specificities in the age group below 12 weeks of age and considering that milk formulae can be the unique dietary source for infants up to 16 weeks, special assessments are performed for food additives already on the market for this age group. This publication explains the background and relevant guidelines for the assessment, including special guidelines for the age group below 16 weeks, and the different sources of information used. The principles followed to assess food additives are described. The requirements for the assessment of food additives used in infants’ food includes testing in special animal models if human data are absent. The amount of food additives the infants are exposed to is estimated based on an exposure assessment. The aim of the assessment is to compare the estimated intake of the FA with milk formulae with safe concentrations taken from clinical studies in infants, special animal models and/or by comparing the exposure by the milk formulae with the content of breast milk whatever is appropriate. Two examples (locust bean gum, lecithin) illustrate the application of the principles. Of special interest is the concentration of impurities in the food additive with a toxic potential, such as lead, arsenic, cadmium, mercury, relevant for all food additives, or glycidyl esters, 3‐monochloropropane diol, erucic acid, and trans-fatty acids, relevant for mono- and diglycerides of fatty acids. The assessment of food additives intended to be used in food for infants below 16 weeks of age revealed that in most cases the maximum permitted regulatory levels of the food additive would result in an exposure which does not raise health concerns, besides lecithins and locust bean gum. However, the content of impurities with a toxic potential at the regulatory permitted levels is of concern for all food additives which indicates the need for lowering those levels.
Can Acupuncture help relieve muscle pain in Muscular Dystrophy?
Authors: Sautreuil Patrick
Published: September 2023

Can muscle or myofascial pain in muscular dystrophies be relieved by muscle-centred acupuncture? After a discussion of the key notions of "myofascial trigger points" and specific acupuncture needle manipulations, we report some complex clinical cases among patients with NeuroMuscular Diseases (NMD) and Charcot Marie Tooth (CMT) in whom myofascial pain could not be controlled by drug treatments and/or physical techniques. They were seen on outpatient basis between 2010 and 2017 at the Rothschild Hospital (Paris), in the Physical and Rehabilitation Medicine (PRM) department. After the initial medical appointment, several care strategies were proposed, including neuro-acupuncture performed by a PRM physician. This department was linked to the Expert Center for Rare NMD "Paris-Nord-Est-Ile-de- France"
The Quantity, Quality and Two Major Effector Functions of Antibodies to VAR2CSA and their Association with Pregnancy Outcomes in a Low Malaria Transmission Area
Authors: Lloyd Yukie , Bobbili Naveen , Salanti Ali , Gwanmesia Philomina , Fogako Josephine , Leke Rose , Taylor Diane
Published: September 2023

Background: Women produce antibodies to VAR2CSA when infected with Plasmodium falciparum during pregnancy that reduce disease severity in the current and subsequent pregnancies. In addition to antibody quantity, antibody quality (e.g., avidity) and function (e.g., inhibition of binding and opsonic phagocytosis) are immunologically important. Studies comparing the quantity, avidity and effector mechanisms of antibodies to VAR2CSA in the same group of women with pregnancy outcomes, especially in low transmission areas, are limited. Aims: The purpose of this study was to characterize antibodies to VAR2CSA using four assays, determine the correlation among the assays, and relate this to pregnancy outcome. Methods: A panel of 310 plasma samples from women in Yaoundé (a city with low malaria transmission) who had antibodies to full-length VAR2CSA were screened in assays that measured i) level of antibodies to VAR2CSA, ii) antibody avidity, iii) reduction in binding (RiB) of fluorescent VAR2CSA-coupled beads to fluorescent-CSA-coupled beads, and iv) opsonic phagocytosis using VAR2CSA-coupled beads and human THP1 cells. Results from the assays were compared with clinical information from 614 women who were Ab-negative. Results: A modest association was found among the 4 assays, i.e., as the amount of antibodies increased, a small increase in avidity, RiB and phagocytosis was observed; however, the association between RiB and avidity was poor. When results were dichotomized to above and below the median, antibody avidity, but not antibodies in the other assays, was associated with a significant reduction in prevalence of placental malaria and lower placental parasitemia. However, women who had antibody values above the median in amount (p=0.03), avidity (p=0.006), reduction in binding (p=0.018) and probably phagocytosis (p=0.065) had significantly lower placental parasitemia than women who lacked Abs to VAR2CSA. Conclusions: In this urban setting, women with the highest (above the median) antibody levels, in the four assays had a lower prevalence of placental malaria and placental parasitemia than women who lacked anti-VAR2CSA antibodies. Thus, VAR2CA-based vaccine trials in low transmission areas should consider using all four assays before and after vaccination.
COVID vaccine immune response in hemodialysis patients
Authors: Gulzar Kashif , Alalawi Fakhriya , Alnour Hind , AlHadari Amna
Published: September 2023

Background: COVID-19 infection is associated with increased morbidity and mortality in chronic kidney disease patients, especially those on maintenance hemodialysis. The comparison of immunogenicity of different COVID vaccines in the dialysis populations is lacking especially in the middle east region. Methods: We conducted a retrospective observational study, that includes 164 hemodialysis patients (HD) and 54 health workers (HW), who received 2 doses of either Pfizer-BioNTech or Sinopharm vaccine. The primary endpoint was to report the rate of seroconversion and the factors affecting it. Results: HD patients have a significantly low seroconversion rate than HW (HD vs HW: 76.54% and 100%, p=<0.05), also S1 IgG antibody level was significantly low in HD patients (HD vs HW: 183.5 and 400 BAU/ml, p=<0.05). The type of vaccine and hypo-response to the HBV vaccine were two statistically significant factors affecting the seropositivity rate in HD patients. As compared to Sinopharm, Pfizer-BioNTech vaccinated HD patients exhibit not only higher seroconversion rate (Pfizer-BioNTech vs Sinopharm: 90.80% and 60%, p=<0.05) but also express high S1 antibody titer (Pfizer-BioNTech vs Sinopharm: 425 and 162 BAU/ml (p=<0.05), however, there is no significant difference in post-vaccine COVID infection rate among the two vaccines (Pfizer-BioNTech vs Sinopharm: 39.24% and 42.22% (p= 0.176). Conclusion: Lower Immune response to the COVID vaccine is observed in HD patients as compared to HW participants, also Pfizer-BioNTech vaccinated HD patients exhibit better seroconversion rates and higher antibody titer than Sinopharm vaccine in HD patients, so alternative vaccine strategies should be designed in dialysis patients.
Inflammation Describes and Explains the Adverse Effects of Aerosol Optical Depth-Particulate Matter on Cardiovascular Outcomes: A Literature Review Since 2012
Authors: Braggio John
Published: September 2023

The success of remote sensing methodology to accurately estimate ambient particulate matter (PM) on the earth’s surface has resulted in the increased use of aerosol optical depth (AOD) AOD-PM 10 , AOD-PM 2.5 and AOD-PM 1 concentration level fused surfaces in cardiovascular epidemiologic and hypothesis-testing of inflammatory physiologic studies. Uniform space-time AOD-PM concentration level fused surfaces have been used as proxies for ambient PM monitor measurements in economically developed and developing counties as well as in densely populated urban regions with on-the-ground ambient PM monitors and in sparsely populated rural areas without ambient PM air monitors to determine the contribution of PM exposure to the subsequent occurrence of cardiovascular chronic diseases and circulatory-related adverse health outcomes. Since 2012, 45 published studies have evaluated the association between increased AOD-PM concentration level readings and adverse cardiovascular outcomes. Fifteen surveillance studies used inflammation as a descriptive physiologic mechanism and another nine publications mentioned another description. In contrast, another 20 investigations have used the inflammatory physiologic mechanism to explain how AOD-PM exposure changes the cardiovascular system and other organs connected to the cardiovascular system through the circulatory system and one report referred to some other explanation. The full extent of the adverse effects of AOD-PM exposure on the cardiovascular system only becomes evident when cardiovascular and other pathophysiological changes are also considered and evaluated. This review paper aims to demonstrate why AOD-PM and cardiovascular system studies are a new and useful source of information about how ambient PM exposure adversely impacts the cardiovascular system in diverse populations in different countries.
Intra-articular Glucose Injections for Orthoregeneration of Frozen Shoulder. A Clinical Case.
Authors: Kersschot Jan
Published: September 2023

Frozen shoulder or adhesive capsulitis is a difficult to treat disorder characterized by pain and loss of movement. Novel therapies such as hydraulic distension with orthobiologics may improve outcomes among individuals with this debilitating condition. The clinical case in this article describes the treatment of a patient with frozen shoulder using a series of joint injections using high volumes of sugar water. The positive outcome of this novel injection technique is an invitation to design clinical trials using orthobiologics for frozen shoulder.
The The Influence of Peer-Led Health Education Intervention on Medication Adherence Practices Among Youths Living with HIV In Nigeria
Authors: Asaolu Olugbenga , Alawode Gbadegesin , Ajike Saratu , Ogunsanmi Ololade , Bello Mustapha , Ibitoye John , Oyeyemi Adebusola , Adeniran Adeniyi , Emeka Chisom , Obembe Oluwagbemiga , Ojelade Olubunmi , Asaolu Olutayo , Ugwu Adaeze , Obanubi Christopher , Abubakar Abdulmalik , Asaolu Adekemi , Asaolu Olubayode , Nalda Nannim , Amao Adebayo , Folorunso-Ako Oladimeji , Salako Ishaq , Agbede Catherine
Published: September 2023

Medication adherence and antiretroviral therapy retention are required for successful durable, virologic suppression and treatment outcomes among youths. The use of peer-led health education in increasing medication adherence and antiretroviral therapy retention has been advocated. Therefore, this study investigated the effect of peer education on medication adherence and antiretroviral-therapy retention practices among Youth Living with HIV in Niger state, Nigeria. The study was a quasi-experimental design in two selected hospitals. One hospital was assigned to a one-hour peer-led health education session for six weeks, and the 2nd served as the control group. Data were collected at baseline, immediate post-intervention, and at the sixth-week follow-up. Data were analyzed using descriptive and inferential statistics at a 0.05 level of significance. Majority of respondents practice Islam and are within the ages of 20-24 years (control: 100%, 89%; intervention: 83%, 73%), from the Hausa Ethnic group (control: 62%; intervention: 56%). Majority of respondents in the control group have Islamic education (50%) and Secondary education (50%), while the majority of those in the intervention group have primary education (35%), secondary (29%), tertiary (19%) and Islamic (17%) respectively. Medication adherence and ART retention was higher in the intervention group (27%, 16%) compared with the control (17%, 9%). A significant association between knowledge and perception due to peer education on medication adherence was found (24%, 80%) in the intervention group and (11%, 36%) in the control group. Subsequently, the 6th week follow-up sustained findings from the intervention period on medication adherence and ART retention (27%, 16%) in the intervention group compared with control group (17%, 9%). Similarly, knowledge and perception follow-up post intervention was sustained (24%, 80%) in the intervention group and (11%, 36%) in the control group. Interventions leveraging peer-led health education enhanced HIV medication adherence and antiretroviral therapy retention practices among youths. Thus, we recommend scale-up of the structured peer-led curriculum and integration into the health systems to improve health outcomes among HIV positive youths, achieve epidemic control and accelerate progress for the UNAIDS 95:95:95 goals.
Personalized Immunotherapy of Patients: Defining by Single-cell RNA-seq with Artificial Intelligence
Authors: Li Biaoru
Published: September 2023

Immunotherapy, including immune cell therapy and targeted therapy, is gradually developed through the ongoing discovery of molecular compounds or immune cells. Choosing the best one or the best combination of target compounds and immune-cell therapy is a challenge for clinical scientists and clinicians. We have found variable efficacy individually after tumor-infiltrating lymphocyte (TIL) therapy, and now TILs have been discovered in a group of heterogeneous immune cells. To select the best immunotherapy for each patient, we started to study TIL genomics, including single-cell mRNA differential display from TIL published in 2007 and single-cell RNA-seq from TIL published in 2013, set up TIL quantitative network in 2015, researched machine-learning model for immune therapy in 2022. These manual reports single-cell RNA-seq data combined with machine learning to evaluate the optimal compounds and immune cells for individual patients. The machine-learning model, one of artificial intelligence, can estimate targeting genomic variance from single-cell RNA-seq so that they can cover thirteen kinds of immune cell therapies and ongoing FDA-approved targeted therapies such as PD1 inhibitors, PDL1 inhibitors, and CTLA4 inhibitors, as well as other different treatments such as HDACI or DNMT1 inhibitors, FDA-approved drugs. Moreover, also cover Phase-1, Phase-2, Phase-3, and Phase-4 of clinical trials, such as TIL, CAR T-cells, TCR T-cells. Single-cell RNA-seq with an Artificial intelligence estimation system is much better than our published models from microarrays or just cell therapy. The medical goal is to address three issues in clinical immunotherapy: the increase of efficacy; the decrease of adverse effects and the decrease of the cost in clinical applications.
Preservation of Erectile Function after Stereotactic Radiosurgery with CyberKnife for Prostate Cancer
Authors: Pavlov Stefan , Syuleyman Gyulhan , Popov Veselin
Published: September 2023

Prostate carcinoma is one of the most significant social oncological diseases among the male population. With the improvement of early diagnosis through PSA screening, new therapeutic options are open to patients. After the introduction of prostatectomy, it was clear the curative treatment for prostate cancer could have unpleasant effect on the erectile function and in this way to worsen the sexual health of men. The alternative of radical surgical treatment is radiotherapy. For that reason, the treatment by Stereotactic Body Radiation Therapy with Cyberknife for low- and intermediate-risk prostate cancer is gaining more and more popularity and scientific evidence. Even that the preservation of the erectile function after prostate radiation is still an ongoing challenge for the modern radiation oncology and the question of how to improve therapeutic techniques to achieve better results remains open
COVID-19 Mortality Is Attenuated at High Tropical and Subtropical Altitude: An Observational Study of a Database Covering Five Latin American Countries
Authors: DeUrioste Natalia , Reyes Christian , Sanchez Lida , Subieta Nestor , Luna Alfredo , Solarte Ivan , Kanashiro Raffo , Suazo Jose , Poma Enrique , Aguilar Rosalinda , Aracena Jose , Bascope Alberto , Vera Roberto , DeUrioste Rafaela , Rossel Ninoska , Lilio Yeshua , Quilla Gary , Leon Luis , Salazar Santiago , Cordova Francisco , Coronel Fausto , Deindl Elisabeth , Sheldon Ricki , Accinelli Roberto , Gasser Edith , Soliz Jorge , Calleja Gustavo
Published: September 2023

The COVID-19 pandemic, caused by the SARS-COV-2 virus, has had devastating consequences worldwide. Remarkably, the incidence, virus transmission capacity, and severity of COVID-19 have been reported to be significantly decreased in high-altitude human populations. The clinical significance of these findings is enormous, as they suggest that permanent inhabitants of high altitudes have developed adaptive protective changes against certain pathologies. However, these observations have been overshadowed by contradictory reports on the COVID-19 mortality rate at high altitude, ascribed to low population densities. These interpretations, however, fail to consider that the environmental conditions of high-altitude regions of the temperate and tropical geographical zones are radically different from each other. Contrary to common thought, the conditions of high-altitude areas of countries within the tropical zone are so benign that they have favored the growth and development of densely populated cities. In this work, we use data from a COVID-19 database covering five Latin American countries in the tropical and subtropical geographic zone that corresponded to the period between the start of the pandemic and the end of 2020, when no vaccine was yet available. Our results reveal that residing above 1,000 m in tropical countries was a protective factor against COVID-19 mortality. Interestingly, this protective effect was independent of population size. The findings presented here, and those from other similar studies, substantiate the need for more research to reveal the secrets of the physiology of permanent high-altitude residents. In conclusion, our findings clearly demonstrate that the high-altitude environment in tropical and subtropical geographic zones significantly contributes to the decreased mortality impact of the SARS-COV-2 virus in high-altitude-exposed populations.
Simultaneous Evaluation of Stiffness and Histology in Orthopedic Diseases Using Scanning Acoustic Microscope
Authors: Miura Katsutoshi , Iwashita Toshihide
Published: September 2023

Organs with different levels of stiffness support the musculoskeletal system. Light microscopy cannot evaluate organ stiffness, whereas scanning acoustic microscopy (SAM) discriminates stiffness based on speed-of-sound (SOS) because sound waves pass faster in stiffer tissues. This study aimed to evaluate SOS imaging for orthopedic diseases using formalin-fixed paraffin-embedded sections. SOS imaging in SAM uses unstained light microscopic (LM) sections to prevent the bias of staining variation. Digital SOS values are comparable in different organ components and diseases. Mouse organs with the lowest mean SOS values included the adipose tissue, bone marrow, calcified cartilage, and nucleus pulposus; those with intermediate values included hyaline cartilages, osteoid, skeletal muscles, cortical and trabecular bones, and ligaments; and those with the highest values comprised fibrocartilages of the vertebral disc and meniscus. Water contents and delipidating procedures decreased SOS values. Collagenous density and arrangement affected higher SOS values. The trabecular bones of mice were thinner and showed significantly lower values of SOS than those of humans. Various orthopedic diseases and disorders displayed the characteristic SOS images. In osteoporosis, the trabecular bone becomes thin with lower SOS, indicating lesser stiffness to cause fractures. Comparison of woven and lamellar bones revealed that woven bones with lower SOS had lesser stiffness to fracture. Changes in SOS values indicated intramembranous bone formation. The trabecular bone develops from the connective tissues with an abrupt increase in SOS values. The regenerating process of bone fractures was monitored using SOS images, in which the granulation tissues transformed into calli in the osteoid to grow a new mineralized bone. The stiffness increased in phases, which appeared in SOS values. Although several methods have been used to visualize the stiffness of biological tissues, SAM only needs 10-µm unstained slides and can simultaneously compare mechanical stiffness and histology. SOS images provide informative mechanical alterations of the bone, cartilage, and connective tissues to assess the status and diagnose a disorder.
Meeting the COVID-19 Pandemic: Complex Health, Socioeconomic, Gender, and Cultural Nexuses in Mexico
Authors: Spring Oswald
Published: September 2023

COVID-19 met Mexico with a fragmented healthcare system, where governmental and private corruption limited the reconstruction of hospitals after the earthquakes in 2017. Monopolies in the purchase of drugs, lack of trained medical personnel, badly equipped hospitals, obesity, and chronic diseases produced excess mortality from SARS-COV-2. Further, industrialized countries monopolized vaccines and protective gear against the pandemic and the UN-COVAX system for buying them failed. Mexico was forced to purchase vaccines worldwide at speculative prices. The country received also specialists from Cuba, purchased ventilators, trained hospital staff, and separated hospitals only for COVID-19 attention, while 145 private hospitals provided medical attention at public prices. In December 2020 first vaccines arrived and in July 2022 71.3% of the adult population was immunised. The government rejected the pressure of the International Monetary Fund for supporting big companies. Instead, direct money transfers for survival to elderlies, students, youth in apprenticeship, and peasants planting timber and fruit trees alleviated rising poverty and unemployment during the confinement. The cash for youth also moved them away from organised crime and drug production. Agreements with supermarkets and producers lowered the inflation in basic food prices and systematic increases in minimum wage improved Mexicans' purchasing power parity. Less corruption permitted the construction of new megaprojects in the poorest regions. Infrastructure in these marginalised regions recovered formal jobs, generating also labour for Central American migrants, thus reducing the political tensions on both national borders. Additionally, energy transition and subsidies of internal oil prices strengthened economic stability and the peso against the US dollar without new foreign debts. This rigorous macroeconomic policy, free vaccination, the start of a new public health system, and direct cash transfers allowed Mexico to recover in March 2022 from the 12.5 million lost jobs. The unemployment rate was in March 2023 2.4%. The complex nexuses of socioeconomic, health, youth, and gender policies promoted also an alternative social care system, reduced excess mortality and improved the living conditions of the impoverished population in the indigenous southern regions.
Bidirectional Relationship Between the Central Nervous System and Peripheral Tumours
Authors: Mackay Smith
Published: September 2023

The brain and its central nervous system circuitry communicate with all peripheral tissues through neuroendocrine, neuroimmune and neurovascular systems as well as peripheral neuronal networks. This applies to the abnormal situation of a tumour as much as normal biological function. The central nervous system can affect tumour development and metastases though activation or dysregulation of specific brain centres. It has also become apparent that the tumour is capable of building up local autonomic and sensory nerve networks and along with adipokines, cytokines, neurotrophic factors and afferent nerve inputs which can signal back to the brain to promote cancer initiation, growth and dissemination. An attempt is made to unravel this complex of relationships with an understanding that there is a common language spoken between the elements but also with an appreciation that these mechanisms are still only partially understood.