bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Supportive Care for Radiodermatitis in Patients with Head and Neck Cancer: Supplementary Analysis of an Exploratory Phase II Trial
Authors: Katsuta Tsuyoshi , Nishibuchi Ikuno , Nomura Megumi , Kondo Miho , Hamamoto Takao , Ueda Tsutomu , Batsuuri Bilegsaikhan , Sadatoki Takashi , Imano Nobuki , Hirokawa Junichi , Murakami Yuji
Published: September 2023

Self-care demonstrated efficacy in preventing severe acute radiation dermatitis among patients with head and neck squamous cell carcinoma undergoing chemoradiotherapy (CRT). This prospective trial aimed to confirm the feasibility and safety of transcutaneous electrical sensory stimulation while examining the relationship between changes in self-care behavior through supportive care interventions and the severity of acute radiation dermatitis during CRT. Patients underwent assessments for dermatitis grading (Grades 1 to ≥3) and were interviewed regarding self-care practices. The self-care questionnaires comprised six items, and a point was deducted for each task that the patient could not perform independently. Statistical analysis was performed to determine the association between G3 radiation dermatitis and the lowest self-care behavior scores. Of the 10 patients enrolled, three experienced G3 dermatitis. During CRT, six patients maintained their initial scores and did not develop ≥G3 dermatitis. Meanwhile, three of four patients with decreased scores exhibited ≥G3 dermatitis. The group with ≥G3 dermatitis had significantly lower scores than those with ≤G2 dermatitis, suggesting that the inability of patients to perform self-care routinely may lead to severe acute radiation dermatitis. Further prospective studies are needed to confirm the potential of self-care interventions in preventing severe dermatitis.
Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review
Authors: Dajti Elton , Bruni Angelo , Barbara Giovanni , Azzaroli Francesco
Published: September 2023

Liver disease is not uncommon during pregnancy and is associated with increased maternal and fetal/neonatal morbidity and mortality. Physiological changes during pregnancy, including a hyperestrogenic state, increase in circulating plasma volume and/or reduction in splanchnic vascular resistance, and hemostatic imbalance, may mimic or worsen liver disease. For the clinician, it is important to distinguish among the first presentation or exacerbation of chronic liver disease, acute liver disease non-specific to pregnancy, and pregnancy-specific liver disease. This last group classically includes conditions such as hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, liver disorders associated with the pre-eclampsia spectrum, and an acute fatty liver of pregnancy. All of these disorders often share pathophysiological mechanisms, symptoms, and laboratory findings (such as elevated liver enzymes), but a prompt and correct diagnosis is fundamental to guide obstetric conduct, reduce morbidity and mortality, and inform upon the risk of recurrence or development of other chronic diseases later on in life. Finally, the cause of elevated liver enzymes during pregnancy is unclear in up to 30–40% of the cases, and yet, little is known on the causes and mechanisms underlying these alterations, or whether these findings are associated with worse maternal/fetal outcomes. In this narrative review, we aimed to summarize pragmatically the diagnostic work-up and the management of subjects with elevated liver enzymes during pregnancy.
The Power of Customized Clear Aligners in Closing Molar Edentulous Spaces: Clinical and Medico-Legal Considerations in a Scoping Review and Case Report
Authors: Putrino Alessandra , Marinelli Enrico , Zaami Simona
Published: September 2023

Successful closure of edentulous spaces with clear aligners (CAs) is influenced by many factors. CAs are tailored orthodontic devices whose predictability may have relevant medico-legal implications. This study presents a scoping review about missing molar space closure (MMSC) with CAs and a clinical case. This study aims to highlight the feasibility of molar space closure by mesialization with CAs without hybrid supports. Following PRISMA Sc-review guidelines, English-written randomized/non-randomized/observational clinical studies on PubMed, Scopus, Cochrane and Lilacs were searched. An 18-year-old patient, with upper and lower edentulous spaces due to the loss of two first molars, was rehabilitated with CAs (Sorridi®, Sorridi srl, Latina, Italy) without hybrid supports and attachments. The therapy was carried out over 10 months. Currently, there are no studies documenting MMSC by mesialization with only CAs. Existing articles document the closure of premolar or incisor spaces. The upper and lower left second molars replaced the missing first molars, and erupting third molars replaced adjacent teeth. The biomechanical effects in space closure with CAs related to extraction cases appear as priorities of clinical/medico-legal interest. Our case turns attention to this movement of CAs without attachments/hybrid supports, indicating that even such a complex treatment can be comfortable for patients and safely predictable for specialists.
Revolutionizing Cancer Research: The Impact of Artificial Intelligence in Digital Biobanking
Authors: Frascarelli Chiara , Bonizzi Giuseppina , Musico Camilla Rosella , Mane Eltjona , Cassi Cristina , Guerini Rocco Elena , Farina Annarosa , Scarpa Aldo , Lawlor Rita , Reggiani Bonetti Luca , Caramaschi Stefania , Eccher Albino , Marletta Stefano , Fusco Nicola
Published: September 2023

Background. Biobanks are vital research infrastructures aiming to collect, process, store, and distribute biological specimens along with associated data in an organized and governed manner. Exploiting diverse datasets produced by the biobanks and the downstream research from various sources and integrating bioinformatics and “omics” data has proven instrumental in advancing research such as cancer research. Biobanks offer different types of biological samples matched with rich datasets comprising clinicopathologic information. As digital pathology and artificial intelligence (AI) have entered the precision medicine arena, biobanks are progressively transitioning from mere biorepositories to integrated computational databanks. Consequently, the application of AI and machine learning on these biobank datasets holds huge potential to profoundly impact cancer research. Methods. In this paper, we explore how AI and machine learning can respond to the digital evolution of biobanks with flexibility, solutions, and effective services. We look at the different data that ranges from specimen-related data, including digital images, patient health records and downstream genetic/genomic data and resulting “Big Data” and the analytic approaches used for analysis. Results. These cutting-edge technologies can address the challenges faced by translational and clinical research, enhancing their capabilities in data management, analysis, and interpretation. By leveraging AI, biobanks can unlock valuable insights from their vast repositories, enabling the identification of novel biomarkers, prediction of treatment responses, and ultimately facilitating the development of personalized cancer therapies. Conclusions. The integration of biobanking with AI has the potential not only to expand the current understanding of cancer biology but also to pave the way for more precise, patient-centric healthcare strategies.
Assessing the Accessibility and Equity of Urban Green Spaces from Supply and Demand Perspectives: A Case Study of a Mountainous City in China
Authors: Jin Yawen , He Rongxiao , Hong Jingke , Luo Dan , Xiong Guoling
Published: September 2023

Urban green space accessibility is an essential consideration in determining environmental liveability and the well-being of individuals, and the spatial inequity of urban green space supply and demand has become a research focus. However, few studies have conducted a multidimensional and comprehensive assessment of the influences on accessibility from the different perspectives of supply and demand. To address this, our study centred on the mountainous Chongqing region and established a comprehensive research framework examining the spatial pattern of accessibility of urban green spaces and its correlation with physical geographical elements and socioeconomic factors. We reveal the spatial distribution characteristics of urban green space accessibility by using Gaussian-based two-step floating catchment area and network analysis methods and further observe the spatial clustering features utilising hotspot analysis. The ordinary least squares (OLS) model and the spatial lag model were used to evaluate the physical geographical and socioeconomic disparities. Our findings reveal explicit blind spots in urban green space accessibility, primarily within the 30 min travel threshold in the city’s marginal area. A discernible supply–demand imbalance existed in the urban core, constituted by implicit blind spots. Furthermore, we identified that the relationship between urban green space accessibility and elevation under different methods is not always consistently significant over space because spatial heterogeneity may exist. Most concerningly, the study found inequities in urban green space accessibility, particularly impacting vulnerable demographics such as the elderly and lower-income groups. These results can inform urban planners and policymakers about the blind spots of urban green space accessibility and sufficiently consider the physical and socioeconomic heterogeneity of the space to determine where and how to implement inclusive urban greening policies or planning schemes. It is also of great significance in increasing awareness of vulnerable groups and preventing environmental inequality.
The Regional Effect of Land Transfer on Green Total Factor Productivity in the Yangtze River Delta: A Spatial Econometric Investigation
Authors: Yan Wenqin , Yan Dongsheng
Published: September 2023

This paper investigates the spatial mechanisms and impacts of land transfer on green total factor productivity (GTFP) in the economically dynamic Yangtze River Delta region of China. Using urban-level panel data from 2007 to 2020 and applying spatial econometric models, the study examines the relationship between land transfer and GTFP. The results of the spatial econometric analysis show that land transfer in the overall Yangtze River Delta region contributes positively to the improvement of GTFP. The mediating mechanism of industrial restructuring and upgrading shows statistically significant effects. Further investigation reveals differences in the spatial interdependence of land transfer on the GTFP among cities in different regions. Land transfer in the core area has significant indirect effects on the GTFP of neighboring cities, while the impact of land transfer in peripheral cities on the GTFP of surrounding cities is less discernible. This suggests that there is still a need for further deepening and development of integration in peripheral cities, as factor integration is still insufficient. The findings of this study provide useful insights for local governments in optimizing land transfer practices and promoting industrial transformation, upgrading, and sustainable green development.
Assessing Peri-Urban Land Management Using 8Rs Framework of Responsible Land Management: The Case of Peri-Urban Land in Ekiti State, Nigeria
Authors: Babalola Kehinde Hassan , Hull Simon , Whittal Jennifer
Published: September 2023

The 8Rs framework for responsible land management (RLM) is designed to evaluate individual land management projects or interventions. This paper describes such an evaluation of land management interventions in peri-urban areas of Ekiti State, Nigeria, with a focus on the structures, processes, and impact of these interventions. Primary data were collected using semi-structured interviews and survey questionnaires. This article uses the 8Rs framework for RLM to show how responsible the land management interventions are in Ekiti State. The findings show that most elements of the 8Rs frameworks are missing from the interventions and need to be addressed. The RLM matrix shows that the structures, processes, and impact of the interventions need improvement. This study provides an understanding of the 8Rs framework for RLM and the state of responsibleness of land management in Ekiti State, which is crucial for politicians, policymakers, practitioners, and stakeholders. The findings will help these officials design an inclusive and collaborative land management system.
Spatiotemporal Variation of Per Capita Carbon Emissions and Carbon Compensation Zoning in Chinese Counties
Authors: Chen Juan , Wu Sensen , Zhang Laifu
Published: September 2023

The per capita carbon balance and carbon compensation zoning of Chinese counties from the perspective of major function-oriented zones is important for realizing the carbon peaking and carbon neutral target. In this study, the Kernel-K-means++ algorithm is used and a more comprehensive per capita carbon compensation zoning model is constructed. Based on this, combined with the major function-oriented zones, Chinese counties are divided into per capita carbon compensation-type zones. Further, spatial and temporal characteristics are detected, and suggestions for optimizing low-carbon development are put forward. The main results are as follows: (1) From 2000 to 2017, the per capita carbon emissions (PCO2) of Chinese counties were large and showed a trend of stable expansion and a southeast–northwest pattern; (2) the per capita carbon emissions of key development zones accounted for the largest proportion of emissions; (3) there were 1410 payment zones, 170 balanced zones, and 242 compensated zones among China’s counties; and (4) 11 types of carbon compensation space optimization zones were finally formed, and low-carbon development directions and strategies were proposed for each type of area. Based on this, this study promotes regional carbon emissions management and reduction in China and provides a reference for other regions to reduce emissions.
The Spatiotemporal Change in Land Cover and Discrepancies within Different Countries on the Qinghai–Tibet Plateau over a Recent 30-Year Period
Authors: Chen Yan , Xu Erqi
Published: September 2023

The Qinghai–Tibet Plateau is a unique global natural geographical unit with a high altitude and fragile ecology, where land cover change has been affecting its regional ecological security and sustainable development. The plateau covers nine countries with different variations in climate change and human activities, which cause significant spatial variations in its land cover change. This paper uses land cover data to reveal the spatiotemporal characteristics and multi-country differences in land cover change on the Qinghai–Tibet Plateau from 1992 to 2020 by applying spatiotemporal characteristic analysis and mapping methods. The results show that grassland (65.70%), bare land (15.56%), and woodland (10.25%) are the main types of land cover on the plateau, accounting for 91.51% of the total area. The interconversion of bare land and grassland was dominant in 1992–2020, with an area share of 67.83%. The turning point year of grassland change occurred in 2015. The grassland area increased by 6312 km2 in 1992–2015, while it decreased by 14,646 km2 in the plateau in 2015–2020. The areas of woodland, cropland, and water increased by 2.77%, 5.85%, and 7.57%, respectively, and the area of built-up land increased from 299.17 km2 to 1206.29 km2. Overall, a warming and wetting trend of the climate in the Qinghai–Tibet Plateau has driven the expansion of natural vegetation and water in the central plateau within China, with its natural vegetation area increasing by 0.11%. However, the development of regional warming and drying caused local grassland degradation, where Kyrgyzstan and India within the Qinghai–Tibet Plateau experienced the most prominent vegetation degradation. Human activities are relatively frequent in the Qinghai–Tibet Plateau within China and India, causing higher growth rates of built-up land and cropland than in other countries. The establishment of reserves and effective forest management policies have led to significant increases in woodland areas in China and Nepal within the plateau, while weak forest management and limited investment in forest conservation have led to high rates of deforestation in India and Myanmar. Accelerated temperature rises and regional differences in precipitation are the main drivers of large-scale land cover change on the plateau and differences in human activities and land use policies are responsible for the dramatic and diverse localized land cover change.
Potential Mechanism of Optimal Tillage Layer Structure for Improving Maize Yield and Enhancing Root Growth in Northeast China
Authors: Zheng Hongbing , Li Ruiping , Sui Pengxiang , Wang Hao , Ren Ying , Yuan Ye , Tian Shengtao , Zhou Siqi , Liu Wuren , Luo Yang , Zheng Jinyu
Published: September 2023

A field experiment was conducted to evaluate the effect of different tillage structures on soil physical properties, soil chemical properties, maize root morphological and physiological characteristics, and yield. Four tillage structures were designed. Soil tillage plays a prominent role in agricultural sustainability. The different tillage layer structures affected soil physical properties. An enhancement in the optimal tillage layer structure improved soil structure. The MJ tillage layer structure created an improved soil structure by regulating the soil physical properties so that the soil compaction and soil bulk density would be beneficial for crop growth, increase soil water content, and adjust the soil phrase R value and GSSI. Soil nutrients are significantly affected by soil depth, with the exception of available potassium. However, soil nutrients are influenced by different tillage layer structures with soil depth. Soil nutrient responses with depth are different for MJ layer treatment compared with other tillage layer structures. Soil organic matter (SOM) is affected with an increase in depth and is significantly influenced by different tillage layer structures, except at 20–30 cm soil depth. MJ treatment increased by 10–20% compared with other tillage layer structures. In addition, QS treatment enhanced the increased pH value in soil profile compared to others. The root morphology characteristics, including root length, root ProjArea, root SurfArea, root AvgDiam, and root volume, were affected by years, depth, and the tillage layer structures. The MJ tillage layer structure enhanced root growth by improving tillage soil structure and increasing soil air and water compared with other tillage layer treatments. Specifically, the MJ layer structure significantly increased root length and root volume via deep tillage. However, the differences in root physiological properties were not significant among treatments. The root dry weight decreased with an increase in soil depth. Most of the roots were mainly distributed in a 0–40 cm soil layer. The MJ treatment enhanced the increase in root dry weight compared with others by breaking the tillage pan layer. Among the different tillage layer structures, the difference in root dry weight was smaller with an increase in soil depth. Moreover, the MJ treatment significantly improved maize yield compared with others. The yield was increased by 14.2% compared to others under MJ treatment via improvements in the soil environment. In addition, the correlation relationship was different among yield and root morphology traits, root physiology traits, soil nutrients, and soil physical traits. So, our results showed that the MJ tillage layer structure is the best tillage structure for increasing maize yield by enhancing soil nutrients, improving the soil environment and root qualities.
Spatiotemporal Evolution of Urban Resilience and Spatial Spillover Effects in Guangdong Province, China
Authors: Deng Haojian , Liu Kai
Published: September 2023

In the context of global environmental changes, the frequency of various disasters and extreme events is increasing, and enhancing urban resilience has become an important guide for current urban development. Previous studies have mainly focused on changes in urban resilience, with less consideration for the impact of spatial spillover effects on urban resilience. Therefore, this paper aims to analyze the temporal and spatial evolution of urban resilience and its spatial spillover effects in Guangdong from 2012 to 2020 based on the urban resilience assessment model, the Getis-Ord Gi* model, and the improved Capello model. The results are as follows: Affected by COVID-19, the urban resilience of Guangdong Province declined from 2019 to 2020, and 42.86% of the cities demonstrated negative growth in their urban resilience. Urban resilience exhibited significant spatially non-equilibrium characteristics among different cities. The urban resilience of the cities in eastern, northern, and western Guangdong, which are the “collapse zone” of urban resilience, was lower than 0.229 from 2012 to 2020. The intensity of urban resilience spillover in Guangdong presented a typical three-level circle structure of “core-subcore-periphery”, which decreased from the core circle to the surrounding circle. COVID-19 caused a 27.21% decrease in the total urban resilience spillover in Guangdong from 2019 to 2020. Finally, we identified critical driving factors of urban resilience using the optimal-parameters geographical detector model. This study can provide a scientific reference for the Chinese government to build resilient cities and improve sustainable urban development.
Imperatives in Heritage Spanish: Lexical Access and Lexical Frequency Effects
Authors: López Otero Julio César
Published: September 2023

Along with declaratives and interrogatives, imperatives are one of the three major clause types of human language. In Spanish, imperative verb forms present poor morphology, yet complex syntax. The present study examines the acquisition of (morpho)syntactic properties of imperatives in Spanish among English-speaking heritage speakers of Spanish. With the use of production and acceptability judgment tasks, this study investigates the acquisition of verb morphology and clitic placement in canonical and negative imperatives. The results indicate that the acquisition of Spanish imperatives among heritage speakers is shaped by the heritage speakers’ productive vocabulary knowledge, lexical frequency and syntactic complexity. Indeed, most of the variability in their knowledge was found in their production of negative imperatives: heritage speakers show a rather stable receptive grammatical knowledge while their production shows signs of variability modulated by the heritage speakers’ productive vocabulary knowledge and by the lexical frequency of the verb featured in the test items.
Validating the Nutraceutical Significance of Minor Millets by Employing Nutritional–Antinutritional Profiling
Authors: Rana Shivani Singh , Tiwari Sushma , Gupta Neha , Tripathi Manoj Kumar , Tripathi Niraj , Singh Sangeeta , Bhagyawant Sameer S.
Published: September 2023

Millets are group of underutilized cereal crops with higher nutritional values. The present investigation used different classes of minor millets, including barnyard (sava), little (kutki), finger (ragi), kodo and foxtail millets, for evaluation of their nutritional parameters, i.e., the content of proteins, total amino acids, total sugars, insoluble fibers, soluble fibers, total dietary fibers, iron (Fe) and zinc (Zn), along with antinutritional and antioxidant parameters, viz., tannic acid, phytic acid, phenol, flavonoid, proline and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity. Alpha amylase and alpha glucosidase activity were also thought to elevate millets as a viable staple meal. Foxtail millet showed the maximum inhibition, with an IC50 value of 20.46 ± 1.80 µg mL−1 with respect to α-amylase. The coefficient of correlation between nutritional and antinutritional compositions showed that the starch content was significantly and positively correlated with insoluble fiber (r = 0.465) and dietary fiber (r = 0.487). Moreover, sugar was positively correlated with the phytic acid (r = 0.707), Fe and Zn (r = 0.681) contents. To determine the peptides responsible for anticancer activity, the foxtail protein was subjected to ultrafiltration; it was found that the 3 kDa fraction retained the greatest anticancer activity. Selected millet germplasm line(s) that have the best nutraceutical properties could be used in millet improvement programs.
Ultrasound Landmarks in the Approach to the Common Peroneal Nerve in a Sheep Model—Application in Peripheral Nerve Regeneration
Authors: Alvites Rui , Lopes Bruna , Sousa Patrícia , Sousa Ana Catarina , Coelho André , Moreira Alícia , Rêma Alexandra , Atayde Luís , Mendonça Carla , Luís Ana Lúcia , Maurício Ana Colette
Published: September 2023

Peripheral nerve injury (PNI) remains a medical challenge with no easy resolution. Over the last few decades, significant advances have been achieved in promoting peripheral nerve regeneration, and new assessment tools have been developed, both functional and imaging, to quantify the proportion and quality of nerve recovery. The exploration of new animal models, larger, more complex, and with more similarities to humans, has made it possible to reduce the gap between the results obtained in classic animal models, such as rodents, and the application of new therapies in humans and animals of clinical interest. Ultrasonography is an imaging technique recurrently used in clinical practice to assess the peripheral nerves, allowing for its anatomical and topographic characterization, aiding in the administration of anesthesia, and in the performance of nerve blocks. The use of this technique in animal models is scarce, but it could be a useful tool in monitoring the progression of nerve regeneration after the induction of controlled experimental lesions. In this work, sheep, a promising animal model in the area of peripheral nerve regeneration, were subjected to an ultrasonographic study of three peripheral nerves of the hind limb, the common peroneal, and tibial and sciatic nerves. The main aim was to establish values of dimensions and ultrasound appearance in healthy nerves and landmarks for their identification, as well as to perform an ultrasound evaluation of the cranial tibial muscle, an effector muscle of the common peroneal nerve, and to establish normal values for its ultrasound appearance and dimensions. The results obtained will allow the use of these data as control values in future work exploring new therapeutic options for nerve regeneration after induction of common peroneal nerve injuries in sheep.
First Record of the Genus Cartorhynchites Voss, 1958 (Coleoptera: Rhynchitidae) from Eocene Baltic Amber with a List of Fossil Tooth-Nosed Snout Weevils
Authors: Legalov Andrei A. , Bukejs Andris , Vanaga Anarina , Alekseev Vitalii I.
Published: September 2023

A new species of the genus Cartorhynchites (Rhynchitini, Rhynchitina) is described from Baltic amber. Cartorhynchites groehni Legalov, Bukejs et Alekseev sp. n. differs from C. struvei Zherikhin, 1992 from the Miocene of Germany in its smaller body size (2.6 mm), strongly convex eyes, narrower pronotum and wide elytra, and dark brown legs. A new species is studied and illustrated in detail using X-ray micro-computed tomography (μCT). It is the earliest fossil record of subtribe Rhynchitina. A list of fossil Rhynchitidae was compiled. A key to species of Rhynchitidae in Baltic amber was given. Fossil finds of the family Rhynchitidae were discussed. The assumption was made that the Recent distribution range of the genus Cartorhynchites is within the range of its host plant of the genus Symplocos. Probably, a new Eocene species developed on Symplocos kowalewskii, and the Oligocene C. struvei was associated with Symplocos myosotis (Unger).
Isorhamnetin Influences the Viability, Superoxide Production and Interleukin-8 Biosynthesis of Human Colorectal Adenocarcinoma HT-29 Cells In Vitro
Authors: Greifová Hana , Tokárová Katarína , Jambor Tomáš , Štefunková Nikola , Speváková Ivana , Dupák Rudolf , Balytska Olha , Bažány Denis , Capcarová Marcela , Lukáč Norbert
Published: September 2023

Isorhamnetin has gained research interest for its anti-inflammatory, anti-proliferative and chemoprotective properties. In this study, human colon adenocarcinoma cells were cultured in the presence or absence of different isorhamnetin concentrations (5–150 μM) for 24 h or 48 h of cultivation to explore the impact on several parameters of viability/proliferation (mitochondrial function using an MTT test, metabolic activity, cell membrane integrity and lysosomal activity using a triple test). The intracellular generation of superoxide radicals using an NBT test and ELISA analysis was performed to observe the biosynthesis of interleukin 8 (IL-8) in cells stimulated with zymosan, as well as in basal conditions. The antiproliferative activity of isorhamnetin was demonstrated by significantly reduced values of mitochondrial and metabolic activity, integrity of cell membranes and lysosomal activity. Its high prooxidant potential was reflected by the significantly elevated generation of superoxides even in cells with low viability status. The anti-inflammatory effect of isorhamnetin was evident due to decreased IL-8 production, and the most significant decline in IL-8 concentration was observed after 24 h treatment in cells with induced inflammation. We demonstrated that isorhamnetin can suppress the proliferation of HT-29 cells, and this effect was correlated with pro-oxidative and anti-inflammatory activity of isorhamnetin.
Antibiotic Prescribing for Lower Respiratory Tract Infections and Community-Acquired Pneumonia: An Italian Pediatric Emergency Department’s Real-Life Experience
Authors: Pierantoni Luca , Lasala Valentina , Dondi Arianna , Cifaldi Marina , Corsini Ilaria , Lanari Marcello , Zama Daniele
Published: September 2023

Background: Lower respiratory tract infections (LRTIs) and community-acquired pneumonia (CAP) are among the most frequent reasons for referrals to the pediatric emergency department (PED). The aim of this study is to describe the management of antibiotic prescription in febrile children with LRTI or CAP admitted to a third-level PED and to investigate the different variables that can guide physicians in this decision-making. Methods: This is an observational, retrospective, monocentric study including patients < 14 years old who were presented to the PED for a febrile LRTI or CAP during the first six months of the year 2017. Demographic and clinical data, PED examinations, recommended therapy, and discharge modality were considered. Two multivariate logistic regression analyses were performed on patients with complete profiles to investigate the impact of demographic, laboratory, and clinical variables on antibiotic prescription and hospital admission. Results: This study included 584 patients with LRTI (n = 368) or CAP (n = 216). One hundred and sixty-eight individuals (28.7%) were admitted to the hospital. Lower age, higher heart rate, and lower SpO2 were associated with an increased risk of hospitalization. Antibiotics were prescribed to 495 (84.8%) patients. According to the multivariate logistic regression, the diagnosis and duration of fever were substantially linked with antibiotic prescription. Conclusions: The present study reports real-life data about our PED experience. A high rate of antibiotic prescription was noted. In the future, it is necessary to improve antibiotic stewardship programs to increase clinical adherence to guidelines.
The Role of Microglial Exosomes and miR-124-3p in Neuroinflammation and Neuronal Repair after Traumatic Brain Injury
Authors: Mavroudis Ioannis , Balmus Ioana-Miruna , Ciobica Alin , Nicoara Mircea Nicusor , Luca Alina Costina , Palade Dragos Octavian
Published: September 2023

(1) Background: In this study, we aimed to explore the regulatory mechanism of miR-124-3p microglial exosomes, as they were previously reported to modulate neuroinflammation and promote neuronal repair following traumatic brain injury (TBI). (2) Methods: Studies investigating the impact of microglial exosomal miRNAs, specifically miR-124-3p, on injured neurons and brain microvascular endothelial cells (BMVECs) in the context of TBI were reviewed. (3) Results: Animal models of TBI, in vitro cell culture experiments, RNA sequencing analysis, and functional assays were employed to elucidate the mechanisms underlying the effects of miR-124-3p-loaded exosomes on neuroinflammation and neuronal repair. Anti-inflammatory M2 polarization of microglia, mTOR signaling suppression, and BMVECs-mediated autophagy were reported as the main processes contributing to neuroprotection, reduced blood-brain barrier leakage, and improved neurologic outcomes in animal models of TBI. (4) Conclusions: Microglial exosomes, particularly those carrying miR-124-3p, have emerged as promising candidates for therapeutic interventions in TBI. These exosomes exhibit neuroprotective effects, attenuate neuroinflammation, and promote neuronal repair and plasticity. However, further research is required to fully elucidate the underlying mechanisms and optimize their delivery strategies for effective treatment in human TBI cases.
COVID-19 Vaccination and Serological Profile of a Brazilian University Population
Authors: Barreto Marina dos Santos , Silva Beatriz Soares da , Santos Ronaldy Santana , Silva Deise Maria Rego Rodrigues , Silva Eloia Emanuelly Dias , Moura Pedro Henrique Macedo , Souza Jessiane Bispo de , Santana Lucas Alves da Mota , Fonseca Dennyson Leandro M. , Filgueiras Igor Salerno , Guimarães Adriana Gibara , Cabral-Marques Otavio , Schimke Lena F. , Borges Lysandro Pinto
Published: September 2023

Background: COVID-19 led to the suspension academic activities worldwide, affecting millions of students and staff. Methods: In this study, we evaluated the presence of IgM and IgG anti-SARS-CoV-2 antibodies in an academic population during the return to classes after a one-year suspension. The study took place over five months at a Brazilian university and included 942 participants. Results: We found that most participants had reactive IgG and non-reactive IgM. All received at least one dose, and 940 received two or more doses, of different COVID-19 vaccines. We obtained a higher average of memory antibodies (IgG) in participants who received the CoronaVac/ChAdOx1 combination. IgG was consistently distributed for each vaccine group, but individuals who completed the vaccination schedule had higher levels. There were no differences between antibodies and gender, presence of symptoms, and previous COVID-19 infection, but older participants (>53 years) and contacts of infected individuals had higher IgM levels. Conclusion: This study makes significant contributions to the assessment of antibodies in the academic environment, allowing us to infer that most participants had memory immunity and low indications of recent infection when returning to face-to-face classes, as well as demonstrating the need to monitor immunity and update vaccinations.
Influence of Body Mass Index and Duration of Disease on Chromosome Damage in Lymphocytes of Patients with Diabetes
Authors: Šiaulienė Laura , Kazlauskaitė Jūratė , Jurkėnaitė Dalia , Visockienė Žydrūnė , Lazutka Juozas R.
Published: September 2023

It is well-established that patients with diabetes mellitus (DM) have a higher incidence of several types of cancer. The precise mechanisms of this association are still unknown, but obesity and chronic inflammation-induced reactive oxygen species (ROS) are thought to be the main risk factors. ROS may produce different DNA damage, which could eventually lead to cancer. The main objective of this study was to evaluate the relation of chromosome aberrations (CA) with disease status, demographics, and clinical parameters in 33 subjects with type 1 DM (T1DM), 22 subjects with type 2 DM (T2DM), and 21 controls. CAs were analyzed in cultured peripheral blood lymphocytes and subdivided into chromatid (CTA)- and chromosome (CSA)-type aberrations. Compared with controls, higher levels of CTAs and CSAs were observed in T1DM (p = 0.0053 and p = 0.0203, respectively) and T2DM (p = 0.0133 and p = 0.00002, respectively). While there was no difference in CTAs between T1DM and T2DM, CSAs were higher in T2DM (p = 0.0173). A significant positive association between CTAs and disease duration (rs = 0.2938, p = 0.0099) and between CSAs and disease duration (rs = 0.4306, p = 0.0001), age (rs = 0.3932, p = 0.0004), and body mass index (BMI) (rs = 0.3502, p = 0.0019) was revealed. After multiple regression analysis, duration of disease remained significant for CTA, CSA, and CAs (p = 0.0042, p = 0.00003, and p = 0.00002, respectively). For CSA, BMI and the use of statins were the other important confounding variables (p = 0.0105 and p = 0.0763). Thus, this study demonstrated that both T1DM and T2DM patients had a higher number of all types of aberrations than controls, which increases with the prolonged disease duration. Higher BMI was associated with a higher frequency of CSA. The use of statins might be beneficial for reducing chromosome damage, but further investigations are needed to confirm this association.
Effects of Anticoccidial Vaccination and Taraxacum officinale Extract on the Growth Performance, Biochemical Parameters, Immunity, and Intestinal Morphology of Eimeria-Challenged Chickens
Authors: Arczewska-Włosek Anna , Świątkiewicz Sylwester , Tomaszewska Ewa , Muszyński Siemowit , Dobrowolski Piotr , Józefiak Damian
Published: September 2023

A total of 160 Ross 308 male chickens were used in a 2 × 2 factorial design to examine the effects of anticoccidial vaccination (ACV; lack or 1× dose recommended by the manufacturer) and dietary supplementation with Taraxacum officinale (dandelion) extract (DE; with or without) on growth performance, immunity, biochemical parameters, and intestinal morphology in broiler chickens challenged with Eimeria spp. At 20 days of age, all birds were challenged with a 25× dose of ACV, including Eimeria acervulina, E. maxima, E. mitis, and E. tenella. No interaction between ACV and DE was observed in terms of growth performance. Vaccinated birds showed increased feed intake (FI) and feed conversion ratio (FCR) during the 11–20 day period. Meanwhile, DE supplementation led to decreased FI and body weight gain (BWG) during the 1–10 day period. ACV effectively induced immunity against Eimeria, as evidenced by reduced oocyst shedding and less intestinal lesions, decreased levels of pro-inflammatory interleukin-6, and improved BWG during both the post infection (PI) period (21–35 days) and the entire growth period. DE supplementation lowered FCR and increased BWG during the 35–42 day period, increased the concentration of butyric acid in the cecal digesta, and lowered oocyst shedding PI. In vaccinated birds, DE elevated levels of plasma total protein and immunoglobulin M, and influenced tight junction proteins zonula occludens-1 and claudin-3, indicating a more robust epithelial barrier. DE also lowered alanine aminotransferase activity in unvaccinated birds. Both ACV and DE independently improved intestinal morphology in the jejunum, decreasing crypt depth and increasing the villus height-to-crypt ratio. These findings suggest that both ACV and DE could be effective strategies for managing coccidiosis in broiler chickens.
Association of Parental Support with Reduced Stereotypy in Children with Autism Spectrum Disorder: A Cross-Sectional Study
Authors: Reis Renandro de Carvalho , Souza Isadora Noanda Barbosa , Dias Maria Carolina Rodrigues , Mendes Cíntia Maria de Melo , Almeida Kelson James
Published: September 2023

Background and Objectives: To analyze the influence of parental presence and use of risperidone on social interaction and apathy among patients with Autism Spectrum Disorder (ASD). Materials and Methods: Cross-sectional study in a reference center for patients with ASD in a city in northeastern Brazil. The research was carried out using a sociodemographic questionnaire, the Dimensional Apathy Scale, and the Social Communication Questionnaire (SCQ) with the domains of social interaction, language, stereotypy, and communication. The referred questionnaire was answered by the parents or guardians of the children with ASD according to the DSM V criteria. Data were analyzed via independent t-test using the SPSS software version 20. Results: Interviews were conducted with 51 parents/guardians of autistic children with a mean age of 8.8 years (±2.95) and a predominance of males, 34 (66.7%). Of this total, 49 (96.1%) of the children attended school; 40 (78.4%) children were on medication, of which 38 (74.5%) were on risperidone. Those children on risperidone had a higher score on the SCQ scale (p = 0.049) and on the domain of stereotyped behaviors (p = 0.033), which indicated greater impairment. Another statistically relevant variable was the presence of married parents, whereby children who did not have the presence of married parents had a higher average of stereotyped behaviors compared to those who had married parents. Conclusions: The results showed differences in the means of social interactions for children on risperidone, especially regarding stereotyped behaviors. However, it is not possible to state whether this difference was due to the use of risperidone or whether they used risperidone precisely because of these behaviors. Also important was that children who had the presence of married parents showed fewer stereotyped behaviors. There was no difference in apathetic behavior between children.
Comment on Muth et al. Assessing Critical Flicker Fusion Frequency: Which Confounders? A Narrative Review. Medicina 2023, 59, 800
Authors: Mankowska Natalia D. , Sharma Rita I. , Grzywinska Malgorzata , Marcinkowska Anna B. , Kot Jacek , Winklewski Pawel J.
Published: September 2023

We first want to thank the authors of the excellent review for their contributions to summarizing the confounders associated with critical flicker fusion frequency (CFFF) [...]
Effect of Virtual Reality Therapy on Quality of Life and Self-Sufficiency in Post-Stroke Patients
Authors: Dąbrowská Marcela , Pastucha Dalibor , Janura Miroslav , Tomášková Hana , Honzíková Lucie , Baníková Šárka , Filip Michal , Fiedorová Iva
Published: September 2023

Background and Objectives: The consequences of stroke have a significant impact on self-sufficiency and health-related quality of life (HRQoL). Virtual reality (VR)-based rehabilitation has the potential to impact these modalities, but information on timing, volume, and intensity is not yet available. The aim of this randomized controlled trial (1:1) was to evaluate the impact of conventional rehabilitation combined with VR on self-care and domains of HRQoL in patients ≤6 months post-stroke. Materials and Methods: The intervention group completed a total of 270 min of conventional VR + rehabilitation sessions. The control group underwent conventional rehabilitation only. Primary assessments with the WHO disability assessment schedule 2.0 (WHODAS 2) questionnaire were conducted before rehabilitation (T0), after completion of the intervention (T1), and at the 4-week follow-up (T2); secondary outcomes included self-sufficiency and balance assessments. Results: Fifty patients completed the study (mean age 61.2 ± 9.0 years, time since stroke 114.3 ± 39.4 days). There were no statistically significant differences between the groups in WHODAS 2, self-sufficiency, and balance scores (p > 0.05). Conclusions: In the experimental group, there was a statistically significant difference in WHODAS 2, assessment of self-sufficiency, and balance scores before and after therapy (p < 0.05). VR appears to be a suitable tool to supplement and modify rehabilitation in patients after stroke.
Efficiency of the Cerebroplacental Ratio in Identifying High-Risk Late-Term Pregnancies
Authors: Martin-Alonso Raquel , Rolle Valeria , Akolekar Ranjit , de Paco Matallana Catalina , Fernández-Buhigas Irene , Sánchez-Camps Maria Isabel , Giacchino Tara , Rodríguez-Fernández Miguel , Blanco-Carnero Jose Eliseo , Santacruz Belén , Gil María M.
Published: September 2023

Background and Objectives: Over the last few years, great interest has arisen in the role of the cerebroplacental ratio (CPR) to identify low-risk pregnancies at higher risk of adverse pregnancy outcomes. This study aimed to assess the predictive capacity of the CPR for adverse perinatal outcomes in all uncomplicated singleton pregnancies attending an appointment at 40–42 weeks. Materials and Methods: This is a retrospective cohort study including all consecutive singleton pregnancies undergoing a routine prenatal care appointment after 40 weeks in three maternity units in Spain and the United Kingdom from January 2017 to December 2019. The primary outcome was adverse perinatal outcomes defined as stillbirth or neonatal death, cesarean section or instrumental delivery due to fetal distress during labor, umbilical arterial cord blood pH < 7.0, umbilical venous cord blood pH < 7.1, Apgar score at 5 min < 7, and admission to the neonatal unit. Logistic mixed models and ROC curve analyses were used to analyze the data. Results: A total of 3143 pregnancies were analyzed, including 537 (17.1%) with an adverse perinatal outcome. Maternal age (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01 to 1.04), body mass index (OR 1.04, 95% CI 1.03 to 1.06), racial origin (OR 2.80, 95% CI 1.90 to 4.12), parity (OR 0.36, 95% CI 0.29 to 0.45), and labor induction (OR 1.79, 95% CI 1.36 to 2.35) were significant predictors of adverse perinatal outcomes with an area under the ROC curve of 0.743 (95% CI 0.720 to 0.766). The addition of the CPR to the previous model did not improve performance. Additionally, the CPR alone achieved a detection rate of only 11.9% (95% CI 9.3 to 15) when using the 10th centile as the screen-positive cutoff. Conclusions: Our data on late-term unselected pregnancies suggest that the CPR is a poor predictor of adverse perinatal outcomes.
The Effect of the COVID-19 Pandemic on Early Adolescent Fractures in the Republic of Korea
Authors: Park HyunSeo , Kang Hogyeong , Yoon Siyeong , Jeong Simho , Lee Soonchul
Published: September 2023

Background and Objectives: Restrictions on daily activities to slow down the propagation of COVID-19 have changed the epidemiological pattern of pediatric fractures in many countries. However, the effect of the pandemic on pediatric fractures has not been fully studied. In this study, we investigated the impact of COVID-19 on early adolescent fractures in Korea. Materials and methods: We conducted a retrospective follow-up on a nationwide cohort of Korean early adolescents born between 2006 and 2009. The prevalence and incidence of pediatric fractures and the frequency of surgical treatment were compared between two different eras. Results: The prevalence and incidence of fractures during the pandemic have both shown a significant decrease: prevalence reduced from 34,626 to 24,789 (p < 0.001), while incidence decreased from 29,804 to 18,898 (p < 0.001). Considering sex, the shift in fracture prevalence was statistically significant (p = 0.020), whereas the incidence was not (p = 0.862). The decline in both fracture prevalence and incidence exhibited significant variation across birth year groups (prevalence, p < 0.001; incidence, p < 0.001), with a more pronounced reduction observed in the older age groups. While the proportion of patients who required surgeries has increased, the mean frequency of surgical treatment per patient remained at a similar level (by prevalence, p = 0.181; by incidence, p = 0.735). The decline in both fracture prevalence and incidence has shown significant variation in relation to fracture sites (prevalence, p < 0.001; incidence, p < 0.001), with a decrease in distal limb fractures and an increase in forearm and axial body fractures. Conclusions: The pediatric fracture pattern in Korea has been notably influenced by the COVID-19 pandemic, warranting further investigation into causal factors. Our findings should help predict epidemiology in the post-pandemic period and thus aid policymaking and patient management.