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Objective: Osteoarthritis (OA) is a degenerative disease of the joints characterized by inflammation and cartilage degeneration. Zinc finger E-box binding homeobox 2 (ZEB2) contains various function domains that interact with multiple transcription factors involved in various cellular functions. However, the function of ZEB2 in OA has not been clearly illustrated. Method: Interleukin-1β (IL-1β) was used to establish an OA model in vitro. We quantified the ZEB2 expression in cartilage tissues from OA patients and IL-1β-induced chondrocytes through reverse transcription–quantitative polymerase chain reaction and Western blot. We then used functional assays to explore the function of ZEB2 during OA progression. Results: ZEB2 expression was increased in OA cartilage tissues and chondrocytes. The silencing of ZEB2 increased aggrecan and collagen II levels, and reduced the content of matrix metalloproteinase-3 (MMP-3), MMP-9, and MMP-13. ZEB2 knockdown inhibited the effects of IL-1β on the production of nitric oxide and prostaglandin E2, and the expression of inducible nitric oxide synthase and cyclooxygenase-2. ZEB2 inhibition also suppressed the levels of IL-6 and tumour necrosis factor-α, and increased the IL-10 level in IL-1β-treated cells. Mechanically, ZEB2 knockdown blocked the activation of the Wnt/β-catenin pathway in chondrocytes. Conclusion: Knockdown of ZEB2 alleviated IL-1β-induced cartilage degradation and the inflammatory response through the Wnt/β-catenin pathway in chondrocytes. [ABSTRACT FROM AUTHOR]

Key Clinical Message: It is important to consider the diagnosis of Sump syndrome in patients with a history of open cholecystectomy, particularly in those who migrate from developing countries where alternative biliary interventions may be limited. The presentation may range from acute severe, mimicking acute ascending cholangitis, to chronic recurrent abdominal pain without evidence of inflammation. Management is a case‐by‐case decision, with principal management aims to decompress the biliary tract and address any underlying sepsis. Sump syndrome is a rare and often long‐term complication of choledochoduodenostomy (CDD). The presentation and severity are variable, and management should be tailored to each patient based on several factors. Herein, we report three cases of sump syndrome, each demonstrating unique diagnostic dilemmas and therapeutic modalities. Case I describes a woman presenting with acute cholangitis, managed with percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP). Case II illustrates a similar presentation complicated by myocardial infarction, necessitating urgent biliary decompression via PTC and subsequent unsuccessful endoscopic stenting. Case III highlights the diagnostic difficulty in a stable patient with inconclusive diagnostic imaging. This case series emphasizes the importance of considering sump syndrome diagnosis in patients with a history of CDD or open cholecystectomy, especially in elderly patients and those who come from regions where alternative biliary interventions may be limited. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether continuous non-invasive pCO2 monitoring by transcutaneous pCO2 monitor (TCpCO2) among extremely low birth weight (ELBW) premature infants, during the first week of life, will decrease the rate of high-grade intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL) or the combined outcome of IVH/PVL and death. Methods: This was a prospective, observational, multicenter study. Due to ethical constraints, allocation was based on TCpCO2 monitor availability. ELBW infants were either monitored by TCpCO2 monitor (Sentec, Therwil, Switzerland) (study group), or recruited to the control group if a TCpCO2 monitor was not available. Results: A total of 132 ELBW infants participated in the study. The size of the study group (106 infants) and the control group (26 infants) differed because monitor availability increased during the study period reflecting change in standard of care. The groups had comparable gestational age and baseline characteristics. No difference was found in the rate of IVH/PVL in the study vs. control groups (10% vs. 4%; p = 0.7, respectively), or in the combined outcome of PVL/IVH and death (16% vs. 15%; p = 1.0, respectively). Conclusions: This study demonstrates the challenges in conducting a prospective controlled trial in a rapidly evolving medical field. While the study began with a clear equipoise, this balance shifted as the care team gained more experience with TCpCO2 monitoring among the study population, despite the absence of new clinical evidence to justify such a shift. Consequently, the small control group limited our ability to draw definitive conclusions regarding the study's objective. However, our findings may increase awareness of continuous non-invasive pCO2 monitoring in extremely premature infants. [ABSTRACT FROM AUTHOR]

Background Implementing hepatitis B vaccination is an important strategy to reduce hepatitis B virus infection and disease burden. Suboptimal adult hepatitis B vaccination coverage limits the further reduction of hepatitis B virus infection. Methods A multistage stratified random sampling method was adopted to survey the permanent population aged 1–59 in 2006 and 2024. We calculated the vaccination coverage rate, hepatitis B surface antibody (HBsAb)–positive rate, rate difference, and their 95% confidence intervals (CIs) of the 2 survey populations, and used the 95% CI and χ2 test to determine whether the difference in rate was statistically significant. Results Six hundred twenty-three people were surveyed in 2006 and 606 people were surveyed in 2024. From 2006 to 2024, the hepatitis B vaccination coverage among people aged 1–59 years increased from 54.1% to 78.9%, and the HBsAb-positive rate increased from 46.2% to 57.6%. There was no significant difference in vaccination coverage in the population <15 years of age, but the antibody-positive rate increased significantly. The vaccination coverage rate of the 15–59 age group increased significantly, but there was no statistical difference in the antibody positivity rate of the 15–49 age group, and the antibody positivity rate of the 50–59 age group increased significantly. Conclusions Hepatitis B vaccination coverage among adults was still insufficient. Hepatitis B vaccine-mediated immunity was low in adults aged 30–49 years. It is recommended to update the guidelines for hepatitis B vaccination of adults in China, cancel the assessment of risk factors and prevaccination serological screening, and emphasize universal vaccination of all unvaccinated adults to increase coverage. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Neonatal sepsis is a severe medical condition that contributes significantly to neonatal mortality. However, early diagnosis and treatment can help manage the condition effectively. Predictive analytics can assist neonatal sepsis diagnosis and treatment and offer a reassuring solution. This study presents a systematic literature review of various predictive analytics methods for neonatal sepsis diagnosis and treatment. It thoroughly reviews 16 studies between 2014 and 2024, including retrospective and prospective data and utilizing various predictive modeling techniques, such as Machine Learning (ML) and Deep Learning (DL). The review unveils that the Predictive analytics models can rapidly detect early and late-onset neonatal sepsis. This detection aids clinicians in decision-making and improves healthcare management for neonates, especially in low-resource settings. This study lays the groundwork for utilizing advanced analytics technologies to address challenges in this domain. It inspires further research in innovative and unexplored methods for neonatal sepsis diagnosis. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) stands as the leading cause of morbidity and mortality among children, as evidenced by the most contemporary statistics. Undernutrition in pediatric TBI (PTBI) leads to increased mortality, heightened infectious complications, and more severe neurological consequences. Therefore, timely and effective nutritional therapy is crucial in managing PTBI to improve patient prognosis and outcomes. Limited investigations have been conducted on the nutritional requirements specific to these patients and management often relies on data from adults with TBI for guidance. We have meticulously searched different databases to compile a broad range of the most up-to-date clinical research. This review analyses the challenges associated with providing nutritional support to children with TBI and provides a clearer understanding of the current evidence-based recommendations for optimal nutritional therapy. The review primarily focuses on recommendations and suggestions for energy requirements, nutritional assessment, initiation of nutrition, various feeding methods offered, identification of malnutrition, the impact of malnutrition on patient outcomes, and areas of further research. [ABSTRACT FROM AUTHOR]

Candida spp. is rarely found in neonatal early-onset sepsis (EOS) etiology. However, candidemia is associated with increased mortality and morbidity, as in late-onset sepsis. Congenital candidiasis may present as a mucocutaneous infection or, more rarely, as a systemic infection in term and preterm infants. This paper presents case reports of two cases of congenital systemic candidiasis (CSC) caused by Candida albicans and a review of the data in the literature. An electronic search of PubMed, Scopus, and Google Scholar was performed to identify publications on congenital candidiasis. Both neonates were male, born vaginally, with risk factors for congenital candidiasis. One of the infants was born at term and presented with an almost generalized maculopapular rash at birth and congenital candidemia; parenteral fluconazole was used successfully. The other infant was born prematurely at 28 weeks of gestation; blood culture, gastric aspirate, and maternal vaginal cultures sampled at birth were positive for C. albicans. Liver and kidney involvement became apparent on the third day of life, while lung involvement was clinically evident on the fourth day. Prolonged parenteral fluconazole was administered due to multiple organ involvement and persistent candidemia. Our experience with the presented cases, similar to data in the literature, suggests that CSC may occur at any gestational age, with various clinical pictures, sometimes mimicking bacterial sepsis, and even in the absence of the rash. Careful anamnesis and a high index of suspicion are important for the prompt recognition and treatment of CSC, optimizing the short- and long-term outcomes. Further research should focus on CSC to improve its diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Oxidative stress has crucial roles in the pathogenesis of periodontal disease. The balance between oxidant and antioxidant biochemical parameters is detrimental in the progression of periodontal diseases. This study aims to assess the levels of myeloperoxidase (MPO), glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) in serum and saliva samples from patients who have periodontal disease. Methods: The study enrolled on 88 individuals divided into 4 groups: (1) periodontally healthy, (2) gingivitis, (3) stage I-II periodontitis, and (4) stage III-IV periodontitis. The participants had their serum and saliva samples taken. Clinical periodontal parameters were measured to determine the periodontal status. Then MPO, MDA, CAT, SOD, and GSH expressions were analyzed with appropriate methods. Results: Salivary-MPO levels improved in parallel with the periodontal disease's severity. The healthy patients had the highest serum-MDA expressions, which decreased as the severity of the disease increased. Glutathione and SOD concentrations were similar in each group. Catalase expressions in serum reached the highest level in stage I-II periodontitis patients. Nonetheless, there were no significant differences between the groups. Conclusion: In conclusion, our results revealed that GSH, SOD, MDA, CAT, and MPO levels are not affected by the progression of periodontal diseases. [ABSTRACT FROM AUTHOR]

Tranexamic acid (TXA) is widely used among young women because of its ability to whiten skin and treat menorrhagia. Nevertheless, its potential effects on oocyte maturation and quality have not yet been clearly clarified. Melatonin (MT) is an endogenous hormone released by the pineal gland and believed to protect cells from oxidative stress injury. In the present study, we used an in vitro maturation model to investigate the toxicity of TXA and the protective role of MT in mouse oocytes. Compared with the control group, the TXA-exposed group had significantly lower nuclear maturation (57.72% vs. 94.08%, P < 0.001) and early embryo cleavage rates (38.18% vs. 87.66%, P < 0.001). Further study showed that spindle organization (52.56% vs. 18.77%, P < 0.01) and chromosome alignment (33.23% vs. 16.66%, P < 0.01) were also disrupted after TXA treatment. Mechanistically, we have demonstrated that TXA induced early apoptosis of oocytes (P < 0.001) by raising the level of reactive oxygen species (P < 0.001), which was consistent with an increase in mitochondrial damage (P < 0.01). Fortunately, all these effects except the spindle defect were successfully rescued by an appropriate level of MT. Collectively, our findings indicate that MT could partially reverse TXA-induced oocyte quality deterioration in mice by effectively improving mitochondrial function and reducing oxidative stress-mediated apoptosis. NEW & NOTEWORTHY: Tranexamic acid is increasingly used to whiten skin, reverse dermal damages, and treat heavy menstrual bleeding in young women. However, its potential toxicity in mammalian oocytes is still unclear. Our study revealed that tranexamic acid exposure impaired the mouse oocyte quality and subsequent embryo development. Meanwhile, melatonin has been found to exert beneficial effects in reducing tranexamic acid-induced mitochondrial dysfunction and oxidative stress. [ABSTRACT FROM AUTHOR]

Background/Aim: The frequency rate of injection site reactions (ISR) due to fosaprepitant meglumine (Fos APR) has been shown to vary depending on the types of combined anticancer drug. This study aimed to elucidate the impact of Fos APR on ISR in patients receiving paclitaxel and carboplatin, with and without bevacizumab therapy (TC±Bev). Patients and Methods: This study focused on patients with gynecologic cancer (n=93) who received TC±Bev administration at Fujita Health University Hospital from March 2016 to February 2020, and monitored up to six cycles. The patients were randomly assigned to the Fos APR group (n=47) and the Aprepitant (APR) group (n=46). Using Visual Infusion Phlebitis (VIP) scores, ISR was evaluated by comparing the VIP scores of all cycles using a linear mixed model. The risk factors that contribute to the occurrence of vascular pain throughout all cycles were also examined. Results: The VIP scores of all cycles showed a near significant intergroup difference (p=0.071). Factors that affected the development of vascular pain included Fos APR and age (p=0.027 and 0.049, respectively). Regarding age, patients aged <65 years had a higher risk. Four patients underwent a switch from the originally assigned neurokinin- 1 receptor antagonist; in all of these cases, Fos APR was changed to APR for vascular pain. Conclusion: Fos APR may increase the risk for ISR associated with TC±Bev therapy for gynecological cancer. [ABSTRACT FROM AUTHOR]

Copyright of Acta Pediatrica de Mexico is the property of Instituto Nacional de Pediatria (INP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mechanisms resulting from the physiological immaturity of the digestive system in children delivered before 32 weeks of gestation and, in particular, different interactions between the microbiome and the body have not been fully elucidated yet. Next-generation sequencing methods demonstrated the presence of bacterial DNA in the placenta and amniotic fluid, which may reflect bacterial populations that initiate intestinal colonization in utero. Numerous studies confirmed the hypothesis stating that intestinal bacteria played an important role in the pathogenesis of necrotizing enterocolitis (NEC) early- and late-onset neonatal sepsis (EONS and LONS). The model and scale of disorders within the intestinal microbiome are the subject of active research in premature infants. Neonatal meconium was primarily used as an indicator defining the environment in utero, as it is formed before birth. Metagenomic results and previous data from microbiological bacterial cultures showed a correlation between the time from birth to sample collection and the detection of bacteria in the neonatal meconium. Therefore, it may be determined that the colonization of the newborn's intestines is influenced by numerous factors, which may be divided into prenatal, perinatal, and postnatal, with particular emphasis put on the mode of delivery and contact with the parent immediately after birth. Background: The aim of this review was to collect available data on the intrauterine shaping of the fetal microbiota. Methods: On 13 March 2024, the available literature in the PubMed National Library of Medicine search engine was reviewed using the following selected keywords: "placental microbiome", "intestinal bacteria in newborns and premature infants", and "intrauterine microbiota". Results: After reviewing the available articles and abstracts and an in-depth analysis of their content, over 100 articles were selected for detailed elaboration. We focused on the origin of microorganisms shaping the microbiota of newborns. We also described the types of bacteria that made up the intrauterine microbiota and the intestinal microbiota of newborns. Conclusions: The data presented in the review on the microbiome of both term newborns and those with a body weight below 1200 g indicate a possible intrauterine colonization of the fetus depending on the duration of pregnancy. The colonization occurs both via the vaginal and intestinal route (hematogenous route). However, there are differences in the demonstrated representatives of various types of bacteria, phyla Firmicutes and Actinobacteria in particular, taking account of the distribution in their abundance in the individual groups of pregnancy duration. Simultaneously, the distribution of the phyla Actinobacteria and Proteobacteria is consistent. Considering the duration of pregnancy, it may also be concluded that the bacterial flora of vaginal origin dominates in preterm newborns, while the flora of intestinal origin dominates in term newborns. This might explain the role of bacterial and infectious factors in inducing premature birth with the rupture of fetal membranes. [ABSTRACT FROM AUTHOR]

Examines the activity of creatine kinase (CK)-BB isoenzyme in cerebrospinal fluid (CSF) in 80 children with meningitis. Correlation between central nervous system (CNS) infection and CK concentration; Possibility of utilizing CSF CK activity to differentiate between bacterial and viral meningitis in situations where a routine CSF examination is inconclusive.

Copyright of Archives of Gynecology & Obstetrics is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hyaluronic acid injection is commonly used clinically to slow down the development of osteoarthritis (OA). A newly developed therapeutic method is to implant chondrocytes/stem cells to regenerate cartilage in the body. The curative effect of stem cell therapy has been proven to come from the paracrine of stem cells. In this study, exosomes secreted by stem cells from human exfoliated deciduous teeth (SHED) and hyaluronic acid were used individually to evaluate the therapeutic effect in slowing down OA. SHED was cultured in a serum-free medium for three days, and the supernatant was collected and then centrifuged with a speed difference to obtain exosomes containing CD9 and CD63 markers, with an average particle size of 154.1 nm. SW1353 cells were stimulated with IL-1β to produce the inflammatory characteristics of OA and then treated with 40 μg/mL exosomes and hyaluronic acid individually. The results showed that the exosomes successfully inhibited the pro-inflammatory factors, including TNF-α, IL-6, iNOS, NO, COX-2 and PGE2, induced by IL-1β and the degrading enzyme of the extrachondral matrix (MMP-13). Collagen II and ACAN, the main components of the extrachondral matrix, were also increased by 1.76-fold and 2.98-fold, respectively, after treatment, which were similar to that of the normal joints. The effect can be attributed to the partial mediation of SHED exosomes to the NF-κB pathway, and the ability of exosomes to inhibit OA is found not inferior to that of hyaluronic acid. [ABSTRACT FROM AUTHOR]

Hemorrhagic hydrocephalus is a common pathology in neonates with high mortality and morbidity. Current imaging approaches fail to capture the mechanisms behind its pathogenesis. Here, we discuss the processes underlying this pathology, the metabolic dysfunction that occurs as a result, and the ways in which these metabolic changes inform novel methods of clinical imaging. The imaging advances described allow earlier detection of the cellular and metabolic changes, leading to better outcomes for affected neonates. [ABSTRACT FROM AUTHOR]

Background: Multiple magnet ingestion is increasingly reported in paediatrics and can cause significant morbidity. Various surgical approaches exist, though minimal literature compares outcomes between techniques. This review evaluates laparoscopic, laparoscopic-assisted, and open surgery with regard to outcomes. Method: Systematic review across MEDLINE, Embase, Scopus, and Web of Science identified reports of paediatric multiple magnet ingestion managed surgically between 2002 and 2022. Results: Ninety-nine studies were included, reporting data from 136 cases. Of these, 82 (60%) underwent laparotomy, 43 (32%) laparoscopic surgery, and 11 (8%) laparoscopic-assisted procedures. Sixteen laparoscopic cases were converted to open, often due to intraoperative findings including necrosis/perforation, or grossly dilated bowel. Bowel perforation occurred in 108 (79%); 47 (35%) required bowel resection, and 3 had temporary stoma formation. Postoperative recovery was uneventful in 118 (86%). Complications were reported following 15 (18%) open and 3 (7%) laparoscopic surgeries. No complications occurred following laparoscopic-assisted surgery. All post-laparoscopic complications were Clavien-Dindo (CD) Grade I. Following open surgery, 5 complications were CD grade I, 6 were CD grade II, and 4 were CD grade IIIb, requiring re-laparotomy. Median length of stay for open and laparoscopic-assisted procedures was 7 days, and for laparoscopic was 5 days (p < 0.001). Conclusion: Surgical management of multiple magnet ingestion often achieved uncomplicated recovery and no long-term sequelae. Whilst open laparotomy was the more common approach, laparoscopic surgery was associated with reduced length of stay and postoperative complications. Therefore, in experienced hands, laparoscopic surgery should be considered first-line, with the possibility of conversion to open if required. [ABSTRACT FROM AUTHOR]

Objectives: To determine the incidence, risk factors, and accuracy of a previously published risk estimator in predicting Bronchopulmonary dysplasia (BPD) in a very preterm cohort from India. Methods: A single-center prospective observational study was conducted in preterm neonates born at 23–30 wk of gestation with a birth weight of 501–1249 g. The incidence and risk factors of BPD were evaluated, and the accuracy of BPD prediction at six pre-specified time points using the National Institute of Child Health and Human Development (NICHD) BPD risk estimator was assessed by comparing the estimated risk with the observed rates. Results: A total of 310 neonates with mean gestation age of 28.7±1.5 wk and birth weight of 1023.6±171.4 g were enrolled in the study. The study cohort had 49.7% males and 32.3% neonates requiring resuscitation. Any BPD was observed in 54 (17.4%) neonates with severity being mild, moderate, and severe in 29 (53.7%), 17 (31.5%), and 8 (14.8%) neonates respectively. Hundred (32.3%) neonates died before discharge from the hospital. Sepsis, patent ductus arteriosus, retinopathy of prematurity, intraventricular hemorrhage, and blood transfusion were significant risk factors for the development of BPD. The calculator was accurate for the prediction of death or moderate-severe BPD on days 1 and 3 with the area under the curve of 0.82 and 0.77 respectively. Conclusions: The NICHD BPD estimator helped to accurately predict moderate-severe BPD early in Indian preterm infants. [ABSTRACT FROM AUTHOR]

As the most common energy source of spacecraft, photovoltaic (PV) power generation has become one of the hottest research fields. During the on-orbit operation of spacecraft, the influence of various uncertain factors and the unbalanced inertial force will make the solar PV wing vibrate and degrade its performance. In this study, we investigated the influence of mechanical vibration on the output characteristics of PV array systems. Specifically, we focused on a three-segment solar panel commonly found on satellites, analyzing both its dynamic response and electrical output characteristics under mechanical vibration using numerical simulation software. The correctness of the simulation model was partly confirmed by experiments. The results showed that the maximum output power of the selected solar panel was reduced by 5.53% and its fill factor exhibited a decline from the original value of 0.8031 to 0.7587, provided that the external load applied on the panel increased to 10 N/m2, i.e., the vibration frequency and the maximal deflection angle were 0.3754 Hz and 74.9871°, respectively. These findings highlight a significant decrease in the overall energy conversion efficiency of the solar panel when operating under vibration conditions. [ABSTRACT FROM AUTHOR]

Larix kaempferi is in high demand in Korea due to its value in timber and afforestation. However, it faces challenges in terms of propagation and the collection of physiological information for seedling production. In particular, moisture supply is crucial in seedling production. Therefore, establishing efficient irrigation regimes based on optical measurements is essential. Optical measurement methods are expected to be non-destructive, rapid, and reduce labor consumption in nursery systems. This study applied optical measurements using vegetation indices (VIs), chlorophyll fluorescence (FL) imaging, and thermal (TH) imaging to explore the efficient irrigation period for one-year-old Larix kaempferi seedlings in greenhouse conditions under drought stress and perform rehydration experiments. It was observed that all the seedlings survived without irrigation until day 4 (D4) (soil moisture content: 5.3%). Upon rehydration on D6, 83.33% of the seedlings survived until D14. According to the optical measurement results, the TH parameters, PRI (photochemical reflectance index), and Fm (maximum fluorescence in a dark-adapted state) showed sensitive stress responses in all drought treatment pots on D6. Among them, thermal imaging was found to have the highest potential for addressing limitations and being utilized in the greenhouse. The results of this study are expected to provide foundational data for the development of smart nursery systems for efficient irrigation in the future. [ABSTRACT FROM AUTHOR]

Detecting and treating severe hypoglycemia promptly after birth is crucial due to its association with adverse long-term neurodevelopmental outcomes. However, limited data are available on the optimal timing of glucose screening in asymptomatic high-risk neonates prone to hypoglycemia. Risk factors associated with asymptomatic high-risk neonates include late prematurity ≥35 and <37 weeks gestation (LPT), small-for-gestational-age (SGA), large-for-gestational-age (LGA), and infant-of-a-diabetic mother (IDM). This study aims to determine the incidence and the impact of individual risk factors on early hypoglycemia (defined as blood glucose ≤25 mg/dL in the initial hour after birth) in asymptomatic high-risk neonates. All asymptomatic high-risk neonates ≥35 weeks gestation underwent early blood glucose screening within the first hour after birth (n=1,690). A 2-year retrospective analysis was conducted to assess the incidence of early neonatal hypoglycemia in this cohort and its association with hypoglycemia risk factors. Out of the 9,919 births, 1,690 neonates (17 %) had risk factors for neonatal hypoglycemia, prompting screening within the first hour after birth. Incidence rates for blood glucose ≤25 mg/dL and ≤15 mg/dL were 3.1 and 0.89 %, respectively. Of concern, approximately 0.5 % of all asymptomatic at-risk neonates had a blood glucose value of ≤10 mg/dL. LPT and LGA were the risk factors significantly associated with early neonatal hypoglycemia. Asymptomatic high-risk neonates, particularly LPT and LGA neonates, may develop early severe neonatal hypoglycemia identified by blood glucose screening in the first hour of life. Additional investigation is necessary to establish protocols for screening and managing asymptomatic high-risk neonates. [ABSTRACT FROM AUTHOR]

Selective serotonin reuptake inhibitors (SSRIs), including citalopram, are widely used antidepressants during pregnancy. However, the effects of prenatal exposure to citalopram on neurodevelopment remain poorly understood. We aimed to investigate the impact of citalopram exposure on early neuronal differentiation of human embryonic stem cells using a multi-omics approach. Citalopram induced time- and dose-dependent effects on gene expression and DNA methylation of genes involved in neurodevelopmental processes or linked to depression, such as BDNF, GDF11, CCL2, STC1, DDIT4 and GAD2. Single-cell RNA-sequencing analysis revealed distinct clusters of stem cells, neuronal progenitors and neuroblasts, where exposure to citalopram subtly influenced progenitor subtypes. Pseudotemporal analysis showed enhanced neuronal differentiation. Our findings suggest that citalopram exposure during early neuronal differentiation influences gene expression patterns associated with neurodevelopment and depression, providing insights into its potential neurodevelopmental impact and highlighting the importance of further research to understand the long-term consequences of prenatal SSRI exposure. [ABSTRACT FROM AUTHOR]

The role of hormones in gut–brain crosstalk is largely elusive, but recent research supports specific changes in hormone levels correlated with the gut microbiota. An interesting but unstudied area in microbial endocrinology is the interplay between the microbiota and sex hormones. The aim of this study is to investigate the effect of testosterone and sex on the mouse gut microbiome. We use in vitro experiments to test direct effects of testosterone on bacteria in fecal samples collected from male and female mice pre- and post-puberty. Sex-specific microbial and metabolic differences surrounding puberty are also examined in vivo. We then explore effects of testosterone supplementation in vivo, characterizing microbiota and metabolomes of male and female mice. We detect sex-specific differences in microbiota and associated metabolites of mice post-puberty, but in vitro experiments reveal that testosterone only affects microbiota of fecal samples collected before puberty. Testosterone supplementation in vivo affects gut microbiota and metabolomes in both male and female mice. Taking our results from in vitro and in vivo experiments, we conclude that the shift in the microbiome after puberty is at least partially caused by the higher levels of sex hormones, mainly testosterone, in the host. A study examining microbiome differences associated with puberty and sex and effects of testosterone on the microbiome in mice, finding shifts in the microbiome after puberty are partially caused by higher levels of sex hormones, mainly testosterone, in hosts. [ABSTRACT FROM AUTHOR]

Hypoglycemia is a common metabolic disorder that occurs in the neonatal period. Early identification of neonates at risk of developing hypoglycemia can optimize therapeutic strategies in neonatal care. This study aims to develop a machine learning model and implement a predictive application to assist clinicians in accurately predicting the risk of neonatal hypoglycemia within four hours after birth. Our retrospective study analyzed data from neonates born ≥35 weeks gestational age and admitted to the well-baby nursery between 1 January 2011 and 31 August 2021. We collected electronic medical records of 2687 neonates from a tertiary medical center in Southern Taiwan. Using 12 clinically relevant features, we evaluated nine machine learning approaches to build the predictive models. We selected the models with the highest area under the receiver operating characteristic curve (AUC) for integration into our hospital information system (HIS). The top three AUC values for the early neonatal hypoglycemia prediction models were 0.739 for Stacking, 0.732 for Random Forest and 0.732 for Voting. Random Forest is considered the best model because it has a relatively high AUC and shows no significant overfitting (accuracy of 0.658, sensitivity of 0.682, specificity of 0.649, F1 score of 0.517 and precision of 0.417). The best model was incorporated in the web-based application integrated into the hospital information system. Shapley Additive Explanation (SHAP) values indicated mode of delivery, gestational age, multiparity, respiratory distress, and birth weight < 2500 gm as the top five predictors of neonatal hypoglycemia. The implementation of our machine learning model provides an effective tool that assists clinicians in accurately identifying at-risk neonates for early neonatal hypoglycemia, thereby allowing timely interventions and treatments. [ABSTRACT FROM AUTHOR]

The stability of energy generation is crucial for the functioning of every country. Currently, the EU policy is moving towards becoming independent of fossil energy sources, which can be replaced with sources that are not exhaustible, for example, energy from the sun. Public awareness of renewable energy is increasing. People are willing to invest in natural solutions. However, planning large photovoltaic farm projects is difficult due to complex location requirements. The study aimed to analyse the interferences/barriers to be considered when searching for a suitable location to install a photovoltaic farm. The analysis was conducted for the territory of Poland. The study used a literature and local legislation query and the Delphi method. The Delphi method identified the most important interferences from the investor's perspective. Eleven interferences have been identified, classified into legal, spatial, technical, social, and financial groups. Several are locally determined and only exist in selected locations (e.g., technical determinants of the power grid condition, etc.). In contrast, others are unitary (e.g., concerns about the impact of PV on human health, etc.). The decision-makers are aware of the existing interferences/barriers, and the proposed administrative, legal, and technical solutions marginally mitigate barriers. System solutions are recommended, allowing an easier way to find a suitable location for a PV system. [ABSTRACT FROM AUTHOR]

With recent advances in neonatal intensive care, preterm infants are surviving into adulthood. Nonetheless, epidemiological data on the health status of these preterm infants have begun to reveal a worrying theme; prematurity and the supplemental oxygen therapy these infants receive after birth appear to be risk factors for kidney disease in adulthood, affecting their quality of life. As the incidence of chronic kidney disease and the survival time of preterm infants both increase, the management of the hyperoxia-induced renal disease is becoming increasingly relevant to neonatologists. The mechanism of this increased risk is currently unknown, but prematurity itself and hyperoxia exposure after birth may predispose to disease by altering the normal trajectory of kidney maturation. This article reviews altered renal reactivity due to hyperoxia, the possible mechanisms of renal injury due to hyperoxia, and the role of resveratrol in renal injury. Key Points Premature infants commonly receive supplementary oxygen. Hyperoxia can cause kidney damage via signal pathways. We should reduce the occurrence of late sequelae. [ABSTRACT FROM AUTHOR]

Oral contraceptive pills, of all types, are used by approximately 151 million women worldwide; however, a clear understanding of the concentrations of endogenous and exogenous hormones across a 28-day combination monophasic oral contraceptive pill pack is not well described. In our study of 14 female participants taking various combination monophasic oral contraceptive pills, we found significant fluctuations in endogenous and exogenous hormone levels throughout the pill cycle. Our analysis revealed significantly greater levels of ethinyl estradiol on the 20th and 21st days of active pill ingestion, compared with days 1-2 (active) and days 27-28 (inactive pill ingestion). Conversely, estradiol concentrations decreased during active pill consumption, while progestin and progesterone levels remained stable. During the 7 days of inactive pill ingestion, estradiol levels rose sharply and were significantly higher at days 27-28 compared with the mid and late active phase time points, while ethinyl estradiol declined and progestin did not change. These findings challenge the previous assumption that endogenous and exogenous hormones are stable throughout the 28-day pill cycle. NEW & NOTEWORTHY The results from this study have wide-ranging implications for research and treatment in women’s health including considerations in research design and interpretation for studies including women taking oral contraceptives, the potential for more precise and personalized methods of dosing to reduce unwanted side effects and adverse events, and the potential treatment of a variety of disorders ranging from musculoskeletal to neurological with exogenous hormones. [ABSTRACT FROM AUTHOR]

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Antibiotic, analgesic sedative, and antiseizure medications are among the most commonly used medications in preterm/sick neonates, who are at high risk of nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe and potentially life-threatening complications may have serious short- and long-term consequences and should be prevented and/or promptly treated. The reported variability in the medications used in neonates indicates the lack of adequate neonatal studies regarding their effectiveness and safety. Important obstacles contributing to inadequate studies in preterm/sick infants include difficulties in obtaining parental consent, physicians' unwillingness to recruit preterm infants, the off-label use of many medications in neonates, and other scientific and ethical concerns. This review is an update on the use of antimicrobials (antifungals), analgesics (sedatives), and antiseizure medications in neonates, focusing on current evidence or knowledge gaps regarding their pharmacokinetics, indications, safety, dosage, and evidence-based guidelines for their optimal use in neonates. We also address the effects of early antibiotic use on the intestinal microbiome and its association with long-term immune-related diseases, obesity, and neurodevelopment (ND). Recommendations for empirical treatment and the emergence of pathogen resistance to antimicrobials and antifungals are also presented. Finally, future perspectives on the prevention, modification, or reversal of antibiotic resistance are discussed. [ABSTRACT FROM AUTHOR]

Background: We aimed to conduct a systematic review and meta-analysis to evaluate the fetoscopic tracheal occlusion in patients with isolated severe and left-sided diaphragmatic hernia. Methods: Cochrane Library, Embase, and PubMed (Medline) databases were searched from inception to February 2024 with no filters or language restrictions. We included studies evaluating the outcomes of fetoscopic intervention compared to expectant management among patients with severe congenital diaphragmatic hernia exclusively on the left side. A random-effects pairwise meta-analysis was performed using RStudio version 4.3.1. Results: In this study, we included 540 patients from three randomized trials and five cohorts. We found an increased likelihood of neonatal survival associated with fetoscopic tracheal occlusion (Odds Ratio, 5.07; 95% Confidence Intervals, 1.91 to 13.44; p < 0.01) across general and subgroup analyses. Nevertheless, there were higher rates of preterm birth (OR, 5.62; 95% CI, 3.47–9.11; p < 0.01) and preterm premature rupture of membranes (OR, 7.13; 95% CI, 3.76–13.54; p < 0.01) in fetal endoscopic tracheal occlusion group compared to the expectant management. Conclusions: Our systematic review and meta-analysis demonstrated the benefit of fetoscopic tracheal occlusion in improving neonatal and six-month postnatal survival in fetuses with severe left-sided CDH. Further studies are still necessary to evaluate the efficacy of tracheal occlusion for isolated right-sided CDH, as well as the optimal timing to perform the intervention. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is a process for not only nourishing infants but also for building a unique emotional bond between mother and child. Therefore, the ideal contraception during lactation should not affect lactation (milk composition, milk volume) and offspring development. Objectives: This study aims to analyze the literature on the safety of progestogen hormonal contraceptive methods during lactation. Methods: We conducted a thorough search across various databases, including the National Library of Medicine (PubMed), and the Cochrane Database, Drugs and Lactation Database (LactMed). Our search utilized specific phrases such as: "lactation" and "breastfeeding" and "oral contraception" with "drospirenone" or "desogestrel", with "subcutaneous etonogestrel implant" or "etonogestrel implant", with "levonorgestrel-releasing intrauterine system", and "emergency contraception", with "levonorgestrel" or "ulipristal acetate". Conclusions: Based on published scientific reports, progestogen hormonal contraceptives can be considered a relatively safe solution for women desiring to continue feeding their infant with their milk while using hormonal contraception. It is important to seek guidance on selecting the best contraception method based on the latest medical knowledge, tailored to the individual needs and clinical circumstances of each woman and place of residence. A woman should always be informed of the potential risks of such a treatment and then allowed to make her own decision based on the knowledge received from a specialist. [ABSTRACT FROM AUTHOR]

Epidural and subdural hematomas are commonly associated with traumatic brain injury. While surgical removal is the primary intervention for these hematomas, it is also critical to prevent and reduce complications such as post-traumatic epilepsy, which may result from inflammatory responses in the injured brain areas. In the present study, we observed that high mobility group box-1 (HMGB1) decreased in the injured brain area beneath the epidural hematoma (EDH) in rats, concurrent with elevated plasma levels of HMGB1. Anti-HMGB1 monoclonal antibody therapy strongly inhibited both HMGB1 release and the subsequent increase in plasma levels. Moreover, this treatment suppressed the up-regulation of inflammatory cytokines and related molecules such as interleukin-1-beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and inducible nitric oxide synthase (iNOS) in the injured areas. Our in vitro experiments using SH-SY5Y demonstrated that hematoma components—thrombin, heme, and ferrous ion— prompted HMGB1 translocation from the nuclei to the cytoplasm, a process inhibited by the addition of the anti-HMGB1 mAb. These findings suggest that anti-HMGB1 mAb treatment not only inhibits HMGB1 translocation but also curtails inflammation in injured areas, thereby protecting the neural tissue. Thus, anti-HMGB1 mAb therapy could serve as a complementary therapy for an EDH before/after surgery. [ABSTRACT FROM AUTHOR]

Objective: The present systematic review explored the involvement of enzymatic and nonenzymatic antioxidants in periodontitis, drawing from established literature. Materials and Methods: The research approach encompassed an extensive electronic search from 2000 to 2023 across databases such as PubMed, Science Direct, and Wiley Online Library and cross‐referencing using specific keywords. Results: The initial literature exploration generated a total of 766 articles. After thoroughly examining the abstracts, 693 articles were excluded from consideration due to duplication and lack of relevance to the central research inquiry. Following that, 73 articles were left for in‐depth evaluation. Following a qualitative assessment, 35 studies that satisfied the inclusion criteria were chosen, while 38 were removed for not meeting the necessary standards. Within this selection, a meta‐analysis was conducted on 11 articles that provided consistent data for quantitative synthesis. Specifically, the analysis of glutathione (GSH) levels in serum samples revealed a standardized mean difference (SMD) of −5.552 µg/mL (CI 95%: −9.078 to −2.026; P‐0.002). In contrast, the analysis of glutathione peroxidase (GPx) enzymes in gingival crevicular fluid (GCF) samples displayed an overall SMD of 2.918 ng/µL (CI 95%: 0.372–5.465; P‐0.025), while salivary samples exhibited an overall SMD value of 0.709 U/l (95% CI: −1.907–3.325; P‐0.596) which is of insignificant. Conclusion: The systematic review findings suggest a notable decrease in antioxidant enzymes across various systemic biological samples among patients with periodontitis, contrasting with the results from gingival tissue samples meta‐analysis of GPx enzyme. [ABSTRACT FROM AUTHOR]

Orthodontic acrylic resin is used in the construction of orthodontic appliances. It lacks antimicrobial properties and is prone to microbial infection. So, the infection associated with it can be reduced via modification of orthodontic acrylic resin with nanoparticles (NPs) incorporation. The study directed to evaluate the antifungal properties of modified orthodontic acrylic resin incorporated with magnesium oxide (MgO)-NPs and silver (Ag)-NPs. NPs were mixed with polymethylmethacrylate (PMMA) in ethanol-assisted mixing method. Disc samples (10 mm in diameter and 2 mm thick) of PMMA-MgO, PMMA-Ag nanocomposites and PMMA alone (as control) were prepared. Then, C. albicans was isolated and identified clinically through taking swabs from acrylic denture base orthodontic appliances, cultured on a Sabouraud Dextrose Agar medium, followed by transferring on HiCrome™ candida Differential agar which is a selective and differential medium to distinguish distinct Candida species. The polymerase chain reaction was performed and the amplicon was separated by 2% gel electrophoresis and then visualized by ethidium bromide. DNA sequencing was performed on the sample at Sanger sequencing/ ABI 3500. Antifungal activity of PMMA-MgO and PMMA-Ag (1%, 3% and 5% of NPs) was conducted through disc diffusion assay and colony forming unit counts. The result showed a decrease in the number of adhered Candida albicans (C. albicans) of all concentrations of both nanocomposite and the decrease was statistically significant (P<0.05) in all experimental groups except MgO-NPs 1% and 3%. Increasing the concentration of NPs was associated with decrease in the adhered C. albicans. It was concluded that PMMA-MgO and PMMA-Ag nanocomposites showed anti-adherence activities against clinically isolated C. albicans in concentration dependent manner. [ABSTRACT FROM AUTHOR]