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We aim to study organ penetrability and anti-inflammatory effect of Hydrocortisone-loaded nanoparticles (HC-nano) after inducing hypertrophy with previous very-high dose medium-term Nifedipine administration. Materials and methods: Experiment was conducted in two phases on 60 adult, healthy Wistar rats, randomly divided initially in two groups (Phase 1), respecting 1:1 ratio between males and non-pregnant females, within each group. Group A1 (control) included 20 rats (10M/10F) and received no medication. Group B1 included 40 rats (20M/20F) and received oral Nifedipine 100 mg/kg body weight daily (approximately 100x therapeutic human dose), for 4 weeks. When Phase 1 ended, 8 rats did not survive in Group B1, and 40% (approximated to nearest integer) of rats of each sex, within each group were sacrificed, organs were harvested and analyzed microscopically. The rest of living rats entered Phase 2: Group A2 (control) remained with 12 rats (6M/6F) continuing with no medication; Group B2 counted 18 rats (10M/8F) that were given oral HC-nano 2 mg/kg body weight daily (therapeutic dose), for another 4 weeks. After Phase 2 completion, all animals were sacrificed, and tissues were microscopically analyzed. Results: Nifedipine induced statistically significant hypertrophy in the studied organs, with impressive results in gingiva (capillaries, p0.05). Recorded hypergrowth did not differ significantly between sexes in Group B1, regardless of the organ (p>0.05), but 3 times more females died within Phase 1, due to very-high dose Nifedipine toxicity. After Phase 2, hypertrophy reduction was statistically significant in Group B2 (Hydrocortisone) compared with Group B1 (Nifedipine), in gums, heart (muscle fiber diameter) and kidneys (p0.05). Conclusions: Very-high dose medium-term Nifedipine induces similar hypertrophic effects like chronic administration. Hydrocortisone-loaded nanoparticles have potent effects on several tissues in rats.

(1) Background: The aortic arch (AA) branching model is challenging, considering the multiple anatomical variations documented in existing research. The bovine aortic arch (BAA) is the most prevalent anatomical variation among these. This variant of AA branching has long been considered a nonsymptomatic malformation, having been discovered incidentally during imaging investigations for other causes. However, more recent studies have demonstrated that BAA shows a frequent association with coarctation of the aorta (CoA), thoracic aortic disease (TAD), and stroke. At the same time, given the current context of increasing activity in the fields of interventional and surgical procedures in the aorta and its branches, it is very important to know the medical–surgical implications of this anatomical variant. (2) Methods: We conducted a comprehensive review using PubMed and Embase, focusing specifically on randomized trials and cohort analyses that examined the medical–surgical implications of BAA. We assessed information related to studied groups, medical procedures, and study outcomes. Initially, we identified 8454 studies, and after rigorous evaluation, we narrowed down our review to 25 articles. (3) Discussions: The intervention consisted of assessing the risks associated with BAA through different imaging investigation methods such as computer tomographic angiography (CTA), magnetic resonance imaging (MRI), or ultrasonography (US). The following results were evaluated: the prevalence of the BAA, the importance of imaging investigations in establishing the diagnosis and the therapeutic management and monitoring the evolution of patients with the BAA, the association of the BAA with CoA, TAD, and stroke, and the potential risks of interventional treatment in patients with the BAA. (4) Conclusions: The prevalence of the BAA differs both between different ethnic groups and between genders. Advanced imaging methods such as CTA and 4D flow MRI allow detailed descriptions of supra-aortic vascular anatomy and information about blood flow velocities, direction, and turbulence in the AA. US remains an easy and valuable imaging investigation, with the potential to detect and correctly diagnose the BAA and its hemodynamic implications. Anatomical variations in the AA are associated with increased rates of TAD, CoA, and stroke, necessitating early diagnosis and increased supervision of patients with such incidentally observed abnormalities. In addition, there is a need to further develop and refine the surgical techniques used and personalize them to the individual characteristics of patients with the BAA.

PurposeThe primary objective of this study was to develop and validate an AI algorithm as a screening tool for the detection of retinopathy of prematurity (ROP).ParticipantsImages were collected from infants enrolled in the KIDROP tele-ROP screening program.MethodsWe developed a deep learning (DL) algorithm with 227,326 wide-field images from multiple camera systems obtained from the KIDROP tele-ROP screening program in India over an 11-year period. 37,477 temporal retina images were utilized with the dataset split into train (n = 25,982, 69.33%), validation (n = 4,006, 10.69%), and an independent test set (n = 7,489, 19.98%). The algorithm consists of a binary classifier that distinguishes between the presence of ROP (Stages 1–3) and the absence of ROP. The image labels were retrieved from the daily registers of the tele-ROP program. They consist of per-eye diagnoses provided by trained ROP graders based on all images captured during the screening session. Infants requiring treatment and a proportion of those not requiring urgent referral had an additional confirmatory diagnosis from an ROP specialist.ResultsOf the 7,489 temporal images analyzed in the test set, 2,249 (30.0%) images showed the presence of ROP. The sensitivity and specificity to detect ROP was 91.46% (95% CI: 90.23%–92.59%) and 91.22% (95% CI: 90.42%–91.97%), respectively, while the positive predictive value (PPV) was 81.72% (95% CI: 80.37%–83.00%), negative predictive value (NPV) was 96.14% (95% CI: 95.60%–96.61%) and the AUROC was 0.970.ConclusionThe novel ROP screening algorithm demonstrated high sensitivity and specificity in detecting the presence of ROP. A prospective clinical validation in a real-world tele-ROP platform is under consideration. It has the potential to lower the number of screening sessions required to be conducted by a specialist for a high-risk preterm infant thus significantly improving workflow efficiency.

This study aimed to provide environmental surveillance data for evaluating the risk of acquiring SARS-CoV-2 in public areas with high foot traffic in a university. Air and surface samples were collected at a university that had the second highest number of COVID-19 cases among public higher education institutions in the U.S. during Fall 2020. A total of 60 samples were collected in 16 sampling events performed during Fall 2020 and Spring 2021. Nearly 9800 students traversed the sites during the study period. SARS-CoV-2 was not detected in any air or surface samples. The university followed CDC guidance, including COVID-19 testing, case investigations, and contact tracing. Students, faculty, and staff were asked to maintain physical distancing and wear face coverings. Although COVID-19 cases were relatively high at the university, the possibility of acquiring SARS-CoV-2 infections at the sites tested was low.

(1) Background: The aortic arch (AA) branching model is challenging, considering the multiple anatomical variations documented in existing research. The bovine aortic arch (BAA) is the most prevalent anatomical variation among these. This variant of AA branching has long been considered a nonsymptomatic malformation, having been discovered incidentally during imaging investigations for other causes. However, more recent studies have demonstrated that BAA shows a frequent association with coarctation of the aorta (CoA), thoracic aortic disease (TAD), and stroke. At the same time, given the current context of increasing activity in the fields of interventional and surgical procedures in the aorta and its branches, it is very important to know the medical–surgical implications of this anatomical variant. (2) Methods: We conducted a comprehensive review using PubMed and Embase, focusing specifically on randomized trials and cohort analyses that examined the medical–surgical implications of BAA. We assessed information related to studied groups, medical procedures, and study outcomes. Initially, we identified 8454 studies, and after rigorous evaluation, we narrowed down our review to 25 articles. (3) Discussions: The intervention consisted of assessing the risks associated with BAA through different imaging investigation methods such as computer tomographic angiography (CTA), magnetic resonance imaging (MRI), or ultrasonography (US). The following results were evaluated: the prevalence of the BAA, the importance of imaging investigations in establishing the diagnosis and the therapeutic management and monitoring the evolution of patients with the BAA, the association of the BAA with CoA, TAD, and stroke, and the potential risks of interventional treatment in patients with the BAA. (4) Conclusions: The prevalence of the BAA differs both between different ethnic groups and between genders. Advanced imaging methods such as CTA and 4D flow MRI allow detailed descriptions of supra-aortic vascular anatomy and information about blood flow velocities, direction, and turbulence in the AA. US remains an easy and valuable imaging investigation, with the potential to detect and correctly diagnose the BAA and its hemodynamic implications. Anatomical variations in the AA are associated with increased rates of TAD, CoA, and stroke, necessitating early diagnosis and increased supervision of patients with such incidentally observed abnormalities. In addition, there is a need to further develop and refine the surgical techniques used and personalize them to the individual characteristics of patients with the BAA. [ABSTRACT FROM AUTHOR]

ABSTRACT Wastewater surveillance (WS), when coupled with advanced molecular techniques, offers near real-time monitoring of community-wide transmission of SARS-CoV-2 and allows assessing and mitigating COVID-19 outbreaks, by evaluating the total microbial assemblage in a community. Composite wastewater samples (24 h) were collected weekly from a manhole between December 2020 and November 2021 in Maryland, USA. RT-qPCR results showed concentrations of SARS-CoV-2 RNA recovered from wastewater samples reflected incidence of COVID-19 cases. When a drastic increase in COVID-19 was detected in February 2021, samples were selected for microbiome analysis (DNA metagenomics, RNA metatranscriptomics, and targeted SARS-CoV-2 sequencing). Targeted SARS-CoV-2 sequencing allowed for detection of important genetic mutations, such as spike: K417N, D614G, P681H, T716I, S982A, and D1118H, commonly associated with increased cell entry and reinfection. Microbiome analysis (DNA and RNA) provided important insight with respect to human health-related factors, including detection of pathogens and their virulence/antibiotic resistance genes. Specific microbial species comprising the wastewater microbiome correlated with incidence of SARS-CoV-2 RNA, suggesting potential association with SARS-CoV-2 infection. Climatic conditions, namely, temperature, were related to incidence of COVID-19 and detection of SARS-CoV-2 in wastewater, having been monitored as part of an environmental risk score assessment carried out in this study. In summary, the wastewater microbiome provides useful public health information, and hence, a valuable tool to proactively detect and characterize pathogenic agents circulating in a community. In effect, metagenomics of wastewater can serve as an early warning system for communicable diseases, by providing a larger source of information for health departments and public officials. IMPORTANCE Traditionally, testing for COVID-19 is done by detecting SARS-CoV-2 in samples collected from nasal swabs and/or saliva. However, SARS-CoV-2 can also be detected in feces of infected individuals. Therefore, wastewater samples can be used to test all individuals of a community contributing to the sewage collection system, i.e., the infrastructure, such as gravity pipes, manholes, tanks, lift stations, control structures, and force mains, that collects used water from residential and commercial sources and conveys the flow to a wastewater treatment plant. Here, we profile community wastewater collected from a manhole, detect presence of SARS-CoV-2, identify genetic mutations of SARS-CoV-2, and perform COVID-19 risk score assessment of the study area. Using metagenomics analysis, we also detect other microorganisms (bacteria, fungi, protists, and viruses) present in the samples. Results show that by analyzing all microorganisms present in wastewater, pathogens circulating in a community can provide an early warning for contagious diseases.

Invasive forms of aspergillosis of the nervous system are relatively rare and are usually diagnosed in immunocompromised patients. We present the case of a young female patient, treated in the last two months with corticosteroids and antifungal drug for pulmonary aspergillosis, who developed progressive paraparesis. An intramedullary abscess at the C7–D1 level was identified and the lesion was treated with a combination of surgery and antifungal therapy. Histopathologic findings of surgical specimens showed myelomalacia with Aspergillus hyphae and a peripheral rim of neutrophils. We consider that the use of multiple drugs and corticosteroids for our patient’s initial community pneumonia could be the factor that transformed her into a mildly immunocompromised individual and permitted the Aspergillus spp. to disseminate through the blood and into the spinal cord. Moreover, we highlight the fact that more attention should be paid to living and working conditions of the patients, as a simple colonization of the lung with Aspergillus spp. could develop, in a short time, into an invasive disease with a high risk of mortality.

Objetivo: Evaluar el efecto del nivel de oferta de ensilaje de Avena sativa L., variedad Altoandina, en el consumo de materia seca total de la dieta y la productividad de las vacas lactantes en pastoreo en el municipio de Pasto, Colombia. Materiales y Métodos: Se utilizaron 12 vacas F1 (Kiwi cross x Holstein), de 450 kg de peso vivo promedio, en un diseño de sobre cambio. Se establecieron dos tratamientos, que correspondieron a dos niveles de inclusión de ensilaje: 20 (T1) y 35 % (T2) del consumo de materia seca total. Se evaluaron períodos de 12 días, siete de adaptación y cinco de medición. Se estimó el consumo de materia seca, la calidad y la producción de leche, así como los indicadores del perfil metabólico (glucosa, colesterol y nitrógeno ureico en sangre). La información se procesó mediante un análisis de varianza y la prueba de comparación de medias Tukey. Resultados: Hubo efecto significativo (p < 0,05) para las variables consumo de materia seca total del ensilaje (2,8 vs 1,4 kg/MS/vaca/día para 35 y 20 % de inclusión de ensilaje de avena, respectivamente). La producción de leche fue de 14,9 vs 14,3 kg/vaca/día, para 35 y 20 % de inclusión de ensilaje de avena, respectivamente. El nitrógeno ureico en leche y el nitrógeno ureico en sangre resultaron superiores en T1 con respecto a T2 (15,8 y 3,1 vs 14,5 y 2,8, respectivamente). Conclusiones: La introducción en la dieta de ensilaje de A. sativa, variedad Altoandina (20 y 35 %), afectó el consumo de materia seca total. Además, la inclusión de 35 % del ensilaje influyó positivamente en la producción de leche, al aumentar en 4 %.

The Romanian fruit market has a high growth potential but, to a great degree, after 1989 it has registered a reverse phenomenon. The fruit estate, consisting of orchards and nurseries, totaled in the 80s around 290.000 ha, representing 2% of the agricultural area of the country. Nowadays, the fruit heritage is a lot diminished. In 2010, Romania had 196,000 hectares of orchards, these surfaces decreasing by 2016 when they totaled 138,000 hectares, representing 1% of the agricultural area of the country. For the recovery of this sector, it is necessary to renew the fruit plantations. Also, the range of fruit products needs to be diversified so that Romania can enter the European markets. In addition, Romanian producers should be encouraged by introducing tax exemptions and by granting new types of subsidies. In this way, Romania will be able to become competitive on the European and global market. The studies carried out on Research and Development Station for Fruit Growing (RDSFG) Iasi show how using high performance hybrids, as well as widening the range of products and maintaining a distribution process with no intermediaries have helped the company preserving a significant market share and increasing its turnover in the last years.

Alternaria blight in mustard cause heavy damage to the foliar parts resulting into poor growth and development of plants and thereby reduces seed yield. Inorder to manage Alternaria infestation in mustard seed for yield maximization, an experiment was conducted in the plant protection laboratory in Nepal Polytechnic Institute, Bharatpur, Chitwan in 2018, using Completely Randomized Design (CRD) with four replicates. Five treatments i.e.Uthane M-45 (2g/kg), Neem powder (3 g/kg), Bojho powder (4g/kg), Trichoderma harzianum, (107 Conidia/mL) and control (without treatment) were used for seed treatment of local variety of Mustard. Four hundred seeds for each treatment (25 seeds in each petriplate) were plated using triple layers of moistened blotter paper in petriplate and incubated at (27±20C) for 2 days and followed deep freezing for 24 hrs. Data of disease incidence and seed germination were recorded in 3, 7 and 10 days after incubation (DAI). Seedling vigor and seedling weight were also recorded at 5 DAI. The percentage of Alternaria spp incidence on seeds at different DAI showed highly significant with respect to different treatments. Application of Uthane M-45 and T. harzianum significantly reduced the seed-borne infection of Alternaria spp. as compared to control. At 3 DAI Uthane M-45 completely checked the pathogen however, only 4% and 5% disease incidence was observed in 7 DAI and 10 DAI respectively. Bio control agent Trichoderma harzianum was found next best alternative after Uthane M-45 to control disease. Plant extract Bojho powder and Neem powder were found better than control to check the disease. Furthermore, highest germination (76%) was observed in Trichoderma treatment whereas, lowest germination was found in control.

Celiac disease (CD) comprises over 1% of the world’s population and is a chronic multisystem immune-mediated condition manifested by digestive and/or extradigestive symptoms caused by food intake of gluten. This review looked at the risk of children diagnosed with CD developing SARS-CoV-2 infection and possible severe forms of COVID-19. A better understanding of the interaction and effects of SARS-CoV-2 infection in CD is very important, as is the role of environmental and genetic factors, but especially the molecular mechanisms involved in modulating intestinal permeability with impact on autoimmunity. CD inspired the testing of a zonulin antagonist for the fulminant form of multisystem inflammatory syndrome in children (MIS-C) and paved the way for the discovery of new molecules to regulate the small intestine barrier function and immune responses. Original published works on COVID-19 and CD, new data and points of view have been analyzed because this dangerous virus SARS-CoV-2 is still here and yet influencing our lives. Medical science continues to focus on all uncertainties triggered by SARS-CoV-2 infection and its consequences, including in CD. Although the COVID-19 pandemic seems to be gradually extinguishing, there is a wealth of information and knowledge gained over the last two years and important life lessons to analyze, as well as relevant conclusions to be drawn to deal with future pandemics. Zonulin is being studied extensively in immunoengineering as an adjuvant to improving the absorption of new drugs and oral vaccines.

A tracheoesophageal fistula (TEF) is a communication between the trachea and esophagus that is acquired or congenital. Congenital TEF, without other conditions like esophageal atresia, is usually diagnosed after birth or during infancy, as the baby will develop respiratory symptomatology, mostly severe, due to fluid/food aspiration in the trachea. In adults, TEFs can be caused by malignant conditions, blunt trauma, iatrogenic injury, prolonged mechanical ventilation and excessive inflation pressure of the endotracheal tube. We report a male patient of 86 years of age who presented at the "St. Spiridon" Emergency County Hospital in January 2022, accusing breathing difficulty, productive cough and occasional stabbing pain in the posterior thorax, within the previous week. Clinical exam was typical for pneumonia, but since the patient mentioned coughing episodes during eating/drinking since December 2021, together with a history of general anesthesia for abdominal surgery in mid-November 2021, a CT scan was performed. It confirmed a TEF of 7/16 mm (transverse/cranio-caudal) in size, located at the level of T2 vertebral body. The particularity of the case resides in the uncertain etiology of the fistula. If this patient had a clear iatrogenic injury, aspiration pneumonia should have occurred within days after the intubation event. However, after the surgery the patient was fine and discharged home without any symptomatology relevant for TEF. Only after one month, he started experiencing coughing during eating, that leads us to the assumption that he might have been born with a very small and asymptomatic tracheoesophageal defect, and the intubation for general anesthesia, even if done in a correct manner, represented a trigger event which led to development of a TEF. There are very few cases reported in literature with adult patients presenting a minor structural defect that remained unnoticed for a very long time. [ABSTRACT FROM AUTHOR]

Background: The celiac trunk represents an unpaired visceral branch of the abdominal aorta, which detaches at the level of the 12th cervical vertebra. It has a trajectory of 1-2 cm and a caliber of 5-8 mm, having relations with the parietal peritoneum, the vestibule of the omental bursa, the diaphragmatic lymph nodes and the diaphragmatic pillar muscles, the caudate lobe of the liver, the vertical portion of the small gastric curvature and the median arcuate ligament. The celiac trunk trifurcates into three terminal branches: the left gastric artery, the common hepatic artery and the splenic artery. Each of these branches has a specific trajectory and relations, vascularizing the corresponding organs. Given its importance as a source of vascularization, any anatomical variation is eloquent and necessary to be known for the diagnosis and treatment of conditions at this level. Methods: The selection of articles that were included in this paper was made using the PubMed database, where the following keywords were used: variation of celiac trunk, celiac trunk and laparoscopic surgery, clinical implications of celiac trunk, celiac trunk and oncologic extensive surgery. Entering the mentioned keywords generated an initial number of 5428 references. They were subjected to a filtering process: duplicates were removed, only free full-text articles were selected, and inclusion and exclusion criteria were applied. Subsequently, the most appropriate articles for the topic of the paper were chosen, according to the Web of Science Impact Factor and suitability criteria, resulting in a final number of 28 articles. Literature review: These 28 articles were reviewed based on the criteria: anatomical variants in the branching of the celiac trunk, implications of anatomical variations of the celiac trunk in: laparoscopic surgery - treatment of median arcuate ligament syndrome, abdominal oncological surgery, liver transplant and interventional radiology. Conclusions: The anatomical variations of the celiac trunk have a significant impact on abdominal surgery, whether oncological or not, liver transplant, as well as minimally invasive radiological procedures. A correct knowledge of the up-mentioned variations significantly decreases the rate of intra- and post-interventional complications, accompanied by a smaller recovery time in the possible event of a complication, and also the general healing time following surgery. [ABSTRACT FROM AUTHOR]

The primary objective of our article is to emphasize a potential evolution of the Romanian literary language across the one hundred and twenty-five years of confrontation with Jules Verne’s novels. The successive translations of the French author’s works reflect passing from the fixation of the Romanian supradialectal literary language, to its use and emphasis in diachronic and diastratic versions corresponding to the evolution of the Romanian society. We proceed from the idea that the solutions found by the Romanian translators in the lexical-semantic field, that of morpho-syntactic structures, of the transmitted pragmatic-stylistic values, have constituted true contributions to enriching, emphasising and plasticizing the Romanian literary language. Upon carrying out this analysis, we have, of course, called upon the work principles, methods and instruments of the two sciences of the word - valorised in any such undertaking - traductology on the one hand, and diachronic linguistics, on the other hand. Obviously, in both cases, we will be starting from the contrastive-typological grammar data, with frequent references to descriptive, normative grammar, to elements of pragmatics and stylistics, to the particularities of dialectology, in certain situations.

El objetivo del estudio fue evaluar tres cultivares de ryegrass (Lolium perenne L.) con vacas lecheras, en el trópico alto de Nariño-Colombia, en dos localidades: Pasto (PAS) y Cumbal (CUM). En cada localidad se utilizaron nueve vacas, en un diseño cuadrado latino (3 x 3) con tres tratamientos (T), correspondientes a cada cultivar a evaluar: T1: ryegrass Columbia, T2: ryegrass Samson, T3: ryegrass Ohau. Se estimó el consumo de materia seca (CMS) y la producción de leche (PL), y se recolectaron muestras para analizar: grasa, proteína, sólidos totales y nitrógeno ureico en leche (MUN). No hubo diferencia estadística en el CMS entre los ryegrass en las localidades. En PAS se hallaron diferencias significativas entre cultivares en la variable producción de leche (p < 0,05); con Samson y Ohau se obtuvo mayor producción (17,5 y 17,1 kg/vaca/día) respecto al Columbia (15,5 kg/vaca/día). En el contenido de grasa y sólidos no grasos en leche, no hubo diferencias entre los tratamientos en ninguna de las dos localidades. En cambio, se encontró diferencia significativa (p < 0,05) en la proteína en leche en PAS (3,48; 3,61 y 3,47 % para Columbia, Samson y Ohau, respectivamente). Para la variable MUN (mg/dL), se observó diferencia significativa (p < 0,05) en la localidad de PAS. Se concluye que los cultivares de L. perenne presentaron características nutricionales similares en las dos localidades donde se establecieron. La respuesta en producción y calidad composicional láctea se consideró buena, teniendo en cuenta que los animales no recibieron suplementación y el experimento se realizó en la época de seca, en la cual los rendimientos de las pasturas disminuyen.

The post-synthesis modification is a highly efficient method for the modification of Metal-organic framework (MOF) materials, which has been used to synthesize MOF materials purposefully that cannot be prepared by direct synthesis and impregnation method. In this work, amino modified ZIF8 with 5-aminotetrazole was prepared by the post synthesis modification method and was employed to reversibly remove SO2 from flue gas. Based on the characterization and analysis of X-ray diffraction (XRD), Scanning Electron Microscope (SEM), and Brunner Emmet Teller (BET), it was found that the functionalized ZIF8 (Zn(5-ATZ)1.5) was a microporous material with a two-dimensional nano-layered structure. According to the SO2 adsorption experiments, the adsorption capacity of SO2 at the concentration of 1.6% vol can reach to 122 mg/g under the optimal conditions (25 °C, 2865 h−1). Five successive adsorption-desorption experiments exhibited that Zn(5-ATZ)1.5 had excellent regeneration performance. The characterization results of Raman Spectra (Raman) and X-ray photoelectron spectroscopy (XPS) as well as the DFT simulation calculations revealed that SO2 mainly interacted with Zn(5-ATZ)1.5 by hydrogen bonds between O of SO2 and amino H in the Zn(5-ATZ)1.5, and the interaction of SO2 with amino N and 5-aminotetrazole N by forming a non-covalent charge transfer complex. This work suggested that Zn(5-ATZ)1.5 is an excellent potential sorbent for SO2 removal.

Background: The influence of the early COVID-19 pandemic on non-COVID-19 emergencies is uncertain. We conducted a systematic review and a meta-analysis to evaluate the impact of the first months of the COVID-19 pandemic on the presentation, management, and prognosis of patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods: We searched the PubMed, Scopus, and Embase databases from January to August 2020. A meta-analysis of studies comparing the profile, STEMI severity at presentation, reperfusion delay, and in-hospital mortality for patients presenting before and during the early COVID-19 pandemic was conducted. Fifteen cross-sectional observational studies including 20,528 STEMI patients from the pre-COVID period and 2190 patients diagnosed and treated during the first months of the COVID-19 pandemic met the inclusion criteria. Results: Patients presenting with STEMI during the pandemic were younger and had a higher comorbidity burden. The time interval between symptoms and first medical contact increased from 93.22 ± 137.37 min to 142 ± 281.60 min (p < 0.001). Door-to-balloon time did not differ significantly between the two periods (p = 0.293). The pooled odds ratio (OR) for low left ventricular ejection fraction at presentation during the pandemic was 2.24 (95% confidence interval (CI) 1.54–3.26) and for a presentation delay >24 h was 2.9 (95% CI 1.54–5.45) relative to before the pandemic. In-hospital mortality did not increase significantly during the outbreak (p = 0.97). Conclusion: During the first months of the COVID-19 pandemic, patients presenting with STEMI were addressed later in the course of the disease with more severe left ventricular impairment. In-hospital emergency circuits and care functioned properly with no increase in door-to-balloon time and early mortality.

RESUMEN El experimento se realizó en el centro de investigación Obonuco de Agrosavia (2 réplicas), Pasto (Nariño-Colombia), donde se evaluó la respuesta productiva y perfil metabólico de vacas lactantes, de acuerdo al suministro de ensilaje de avena (AvenaSativa-L). Se utilizaron seis vacas primer parto F1 kiwi-cross x Holstein, durante el primer tercio de lactancia, en pastoreo, en un cuadrado latino replicado 3x3, el ensilaje se suministró en tres tratamientos TTOS: T1=0;T2=0,8 y T3=1,4% según peso vivo (PV) del animal. Cada periodo evaluado comprendió 12 días (d), 5 fueron de acostumbramiento y 7 de medición; la leche se midió durante los 12 d y los últimos 3 d se recolectaron en ordeño muestras de leche/animal, se evaluó: producción de leche litros (L)/día (d) (PL); %proteína (P), %grasa (G), %solidos totales (ST) y nitrógeno ureico en leche (MUN miligramos (mg) / decilitro (dL)). El d 12 se tomó muestra de sangre, vía punción coccígea determinando en suero indicadores de perfil metabólico (GlucosaColesterol-BUM-milimol -mmol/L), La información se procesó en el software R-Project, con análisis de varianza y pruebas de comparación de medias (Tukey0,05) entre TTOS. Se concluye que la suplementación con ensilaje de Avena sativa en vacas lecheras Kiwi cross x Holstein puede ser una estrategia nutricional para aumentar la producción de leche en épocas de escases de pasturas, en el trópico alto andino de Nariño, Colombia. ABSTRACT This experiment was carried out in the Obonuco Research Center of Agrosavia (2 replication), Pasto (Nariño-Colombia). The productive response and metabolic profile of lactating cows were evaluated according to the supply of oat silage (Avena-Sativa-L). Six first calving cows F1 kiwi-cross x Holstein, during the third lactation period, were used; in grazing, in a 3x3 replicated Latin square, silage was supplied in three treatments TTOS: T1=0,T2=0.8 and T3=1,4% according to live weight (LW) of the animal. Each period consisted of 12 days (d), 5 d for rest and 7 d for measurement, milk was measured during the 12 d and the last 3 d were collected in milking milk/animal samples, it was evaluated: milk production liters (L)/day (d) (PL); %protein (P), %fat (G), %total solids (ST) and urea nitrogen in milk (MUN milligrams (mg) / deliciters (dL)). On d 12, blood samples were taken from coccygeal puncture, determining in serum indicators of metabolic profile (Glucose-Cholesterol-BUM-millimol (mmol)/L)). The information was processed with the R-Project software, with variance analysis and mean comparison tests (Tukey0,05) between TTOS. It is concluded that supplementation with Sativa oats silage in Kiwi cross x Holstein dairy cows may be a nutritional strategy to increase milk production during pastures shortage in the high Andean tropics of Nariño, Colombia.

Background. Patients with cervical spinal injury with quadriplegia are at an increased risk of developing serious gastrointestinal complications. We report an unusual case of spontaneous rectosigmoid perforation in a quadriplegic patient. Case Presentation. A 58-year-old man with diabetes mellitus and hypertension presented to the emergency department following a fall from 25 feet of height. He sustained a fifth cervical vertebral fracture with quadriplegia and neurogenic shock. One week later, he developed progressive abdominal distension with tachycardia, low blood pressure, and respiratory distress. His abdomen was soft but had impaired liver dullness. Imaging showed evidence of visceral perforation. He underwent an emergency laparotomy and was found to have a perforation of the antemesenteric border of the rectosigmoid junction with fecal contamination. The perforation was repaired primarily, and a temporary loop ileostomy was created. The patient received intensive care for 4 days, and thereafter, the recovery was uneventful. He was later transferred to the spinal unit for further management. The intraoperative findings, histology, and subsequent colonoscopy did not reveal any underlying cause for the perforation. Conclusions. Clinical signs and symptoms are generally absent in patients following spinal cord injury, and the diagnosis of serious gastrointestinal pathology can be difficult and challenging. We believe that ischemia at the rectosigmoid junction precipitated by multiple factors was the possible reason for the spontaneous perforation.

In recent years, cadmium (Cd) pollution in soil has increased with increasing industrial activities, which has restricted crop growth and agricultural development. The heavy metal ATPase (HMA) gene family contributes to heavy metal stress resistance in plants. In this study, 21 HMA genes (HvHMAs) were identified in barley (Hordeumvulgare L., Hv) using bioinformatics methods. Based on phylogenetic analysis and domain distribution, barley HMA genes were divided into five groups (A–E), and complete analyses were performed in terms of physicochemical properties, structural characteristics, conserved domains, and chromosome localization. The expression pattern analysis showed that most HvHMA genes were expressed in barley and exhibited tissue specificity. According to the fragments per kilobase of exon per million fragments values in shoots from seedlings at the 10 cm shoot stage (LEA) and phylogenetic analysis, five HvHMA genes were selected for expression analysis under Cd stress. Among the five HvHMA genes, three (HvHMA1, HvHMA3, and HvHMA4) were upregulated and two (HvHMA2 and HvHMA6) were downregulated following Cd treatments. This study serves as a foundation for clarifying the functions of HvHMA proteins in the heavy metal stress resistance of barley.

The paper investigates the main changes that have taken place in the Romanian fruits and vegetables supply chain over the past twenty years. Its sustainability is assessed using time-series data from different official and private data-bases applying statistic research methods. Results showed that the Romanian supply chain is dominated in terms of both inputs used and offer, by imports originating from different EU countries. The local subsistence and semi-subsistence farms cannot provide enough qualitative and quantitative products such as to penetrate the supermarkets, the main players from the market. Agritourism, a potential niche market, was investigated using sampling techniques. The guesthouses from one of the most important ecotourism destinations where assessed by face-to-face interviews. Results showed that even such short-marketing chains are unsustainable tools for the fresh fruits and vegetables products sectors. The lack of governance for the local producers does not allow them to enter on such niche market. All this findings can provide important incentives for better future targeted sectorial agricultural policies.

The aim of this study is to design a new dynamic mechanical analysis (DMA) measurement system that can operate for shear tests at frequencies as high as 10 kHz with strain amplitudes sufficient for viscoelastic materials operating in high-frequency deformation applications, such as tire rubbers. The available DMA systems in market cannot effectively operate for accurate and direct measurement of viscoelastic material properties for applications dealing with high-frequency deformation of materials. Due to this, the available DMA systems are used for indirect measurements at low frequencies and low temperatures, followed by using time-temperature superposition principle to predict the properties at high frequencies. The goal of this study is to make the range of the test broad enough to eliminate the use of the time-temperature superposition principle in the determination of properties of viscoelastic materials. Direct measurement of viscoelastic material properties and increasing the accuracy of results are the main motivations to design a new DMA system. For this purpose, the state-of-the-art technologies to achieve high frequencies and strain amplitudes as well as instrumentation and control of the system are studied. The design process is presented in this paper.

Single-crystal iron oxide nanorings have been proposed as a promising candidate for magnetic hyperthermia application because of their unique shape-induced vortex-domain structure, which supports good colloidal stability and enhanced magnetic properties. However, the synthesis of single crystalline iron oxide has proven to be challenging. In this article, we showed that chemically synthesized multigrain magnetite nanorings disfavor a shape-induced magnetic vortex-domain structure. Our results indicate that the multigrain Fe3O4 nanorings with an average outer diameter of ~110 nm and an inner to outer diameter ratio of ~0.5 do not show a shape-induced vortex-domain structure, which was observed in the single-crystal Fe3O4 nanorings of similar dimensions. At 300 Ks, multigrain magnetite nanorings showed an effective anisotropy field of 440 Oe, which can be attributed to its high surface area and intraparticle interaction. Both calorimetric and AC loop measurements showed a moderate inductive heating efficiency of multigrain magnetite nanorings of ~300 W/g at 800 Oe. Our results shed light on the magnetic ground states of chemically synthesized multigrain Fe3O4 nanorings.

We report a randomized controlled clinical trial of 2 dressing materials, viz., Vaseline gauze and collagen sheet, after split thickness skin graft in donor site for wound comfort and pain, surgical site infection, and epithelialization. It is a randomized control study registered with CTRI registration number of CTRI/2 020/02/023207. Enrolled patients were randomized with block randomization method with 50 patients in each group. Following STSG procedure, pain score was documented using numerical pain rating score. Surgical site infection and number of days required for complete epithelialization were also documented and analyzed. The results showed that distribution of mean pain score (NPR) for Vaseline gauze group was significantly higher than collagen sheet group. Similarly, number of days required for complete epithelialization was found to be more for Vaseline gauze group than collagen sheet group and there was no significant difference in surgical site infection between the two groups. The study concluded that collagen sheet dressing is better than Vaseline gauze dressing in reducing pain in STSG donor site. [ABSTRACT FROM AUTHOR]

Forensic identification is the means to highlight the unique characteristics of an entity and differentiate it from any other. The term identity derives from the Latin word "idem" meaning "same" or "identical". The identification of persons (living or deceased) is a process that is ideally achieved through the interdisciplinary collaboration of forensic medicine with the anthropologist, criminologist and judicial police. Gender estimation is a topic of great interest in forensic medicine, and numerous studies in the field have given rise to a database of diagnostic traits. The purpose of this paper is to demonstrate the reality of sexual dysmorphism based on anthropometric measurements of the orbit and to reinforce the importance of radiology in forensic practice. The study consists in 27 computed-tomography images on which we made some measurements of orbits cavities, after which a statistical analysis was performed. Following the measurements, a comparison was made between the values obtained for males and those obtained for females, confirming the hypothesis supported by many authors that these values are generally higher in men, thus helping identify unknown persons. The development of newer and better methodologies for gender estimation, as well as the reevaluation of existing ones, will continue to emerge, and the efforts of forensic researchers will lead to much more accurate results from indirect analyses of human bone structures through digital imaging. [ABSTRACT FROM AUTHOR]

Invasive forms of aspergillosis of the nervous system are relatively rare and are usually diagnosed in immunocompromised patients. We present the case of a young female patient, treated in the last two months with corticosteroids and antifungal drug for pulmonary aspergillosis, who developed progressive paraparesis. An intramedullary abscess at the C7–D1 level was identified and the lesion was treated with a combination of surgery and antifungal therapy. Histopathologic findings of surgical specimens showed myelomalacia with Aspergillus hyphae and a peripheral rim of neutrophils. We consider that the use of multiple drugs and corticosteroids for our patient's initial community pneumonia could be the factor that transformed her into a mildly immunocompromised individual and permitted the Aspergillus spp. to disseminate through the blood and into the spinal cord. Moreover, we highlight the fact that more attention should be paid to living and working conditions of the patients, as a simple colonization of the lung with Aspergillus spp. could develop, in a short time, into an invasive disease with a high risk of mortality. [ABSTRACT FROM AUTHOR]

The knee joint (Articulatio genus) is the largest joint of the body. The tibial plateaus represent the proximal, articular surface of the tibial condyles that articulate with the femoral condyles. The traumatic damage of these surfaces invariably leads to the change in the distribution of the forces of mechanical pressure, which results in uneven wear and the appearance of arthrosis. We conducted a review of the literature using the PubMed database in order to identify the optimal treatment of the tibial plateaus fractures, the evolution and the prognosis. Out of 3047 identified references, 26 articles were selected for analysis after the application of the exclusion criteria. There is a consensus among the majority of authors regarding recommended surgical treatment for displacement fractures and increased attention to frequently associated ligament and meniscal injuries. The most common surgical method chosen is open reduction and internal osteosynthesis. The complexity of these fractures sometimes makes it difficult to fit them into a classification system and the prognosis may be reserved, given the large number of immediate and late complications. [ABSTRACT FROM AUTHOR]

Background: The vertebral column represents the axial skeleton and has an indispensable role in the protection of the spinal cord. Early identification of its pathologies and an adequate treatment are essential for a favorable outcome. Methods: For the selection of the articles included in this review work, the PubMed database was searched, using the following queries: "acute lumbar back pain, chronic lumbar disc pain, intervertebral disc disease, lumbar intervertebral disc injury, lumbar spine intervertebral disc x -ray imaging, lumbar spine intervertebral disc magnetic resonance imaging, intervertebral lumbar disc treatment options". A total of 2756 articles resulted from the search with the previously mentioned keywords, and after identifying and removing duplicates, 2063 references remained. After applying the free full-text criterion, 532 articles resulted, and the subsequent application of the novelty criterion (articles from the last 5 years, 2018-2023) led to the selection of 241 references. The inclusion and exclusion criteria defined in the present paper were applied to these 241 references, resulting in 178 articles, of which 36 articles were finally included in the paper, following an impact-factor-based quality assessment. Literature review: These 36 articles were reviewed based on the criteria: etiology and etiopathogenesis of lower back pain, classification and description of lumbar disc diseases, as well as their diagnosis and treatment. Conclusions: Lumbar disc diseases are a real burden in the lives of patients from a psychological, social and professional point of view. They limit the ability to perform the previously-carried-out activities, thus reducing the quality of life of patients. An early diagnosis, followed by the initiation of treatment, are essential in the management of these pathologies that are increasingly common nowadays. [ABSTRACT FROM AUTHOR]

Spondilartrita anchilozantă este o boalǎ infl amatorie mediată imun, care include artrita axială şi periferică, infl amaţia locului unde tendoanele şi capsulele articulare se inseră pe os, precum şi degenerarea articulaţiilor sacro-iliace şi ale coloanei vertebrale, care conduce la fuziuni progresive ale vertebrelor. Introducerea în terapie a moleculelor imunomodulatoare, cu ţintă pe interleukine, cum ar fi pe factorul de necroză tumorală alfa, a fost considerată ca un progres major în tratamentul formelor severe de spondiliartrite ankilozante. Acest caz ilustrează evoluţia particulară a manifestărilor clinice în corelaţie cu traumatismul articular, infecţia digestivă şi consecinţele devastatoare ale spondilitei ankilozante active HLA-B27 pozitivă cu debut juvenil.

În ultimii ani, utilizarea unor metode complementare şi alternative în pediatrie a crescut considerabil, în special pentru afecţiunile cronice precum artrita juvenilă idiopatică, în care durerea poate fi o problemă semnifi cativă. Interesul crescut în abordările medicinei complementare şi alternative pentru simptomele durerii la copii şi adolescenţi, precum şi la populaţia adultă, a concentrat atenţia asupra problemelor de siguranţă şi efi cacitate ale acestor metode. Urmărirea unor intervenţii sigure, efi ciente şi rentabile pentru durerea cronică la copiii care suferă de artrită juvenilă, folosite în locul sau împreună cu abordările medicale convenţionale, este un obiectiv valoros, care ar trebui să fie abordat cu cea mai mare rigoare ştiinţifi că. Trebuie să gândim creativ şi diferit în scopul de a educa cadrele medicale, precum şi publicul larg, pentru a le schimba atitudinea.

At the 151 years anniversary of official statistics in Romania (1859-2010) setting up the World Day of Statistics (October 20, 2010) to becelebrated in the whole world – represents for our country the recognition of importance and role of statistics, statisticians’ work along time, for development and modernization.

Tuberous sclerosis complex (TSC) is a rare disorder of tissue growth and differentiation, characterized by benign hamartomas in the brain and other organs. Up to 90% of TSC patients develop epilepsy and 50% become medically intractable requiring resective surgery. The surgical outcome of TSC patients depends on the accurate identification of the epileptogenic zone consisting of tubers and the surrounding epileptogenic tissue. There is conflicting evidence whether the epileptogenic zone is in the tuber itself or in abnormally developed surrounding cortex. Here, we report the localization of the epileptiform activity among the many cortical tubers in a four-year old patient with TSC-related refractory epilepsy undergoing magnetoencephalography (MEG), electroencephalography (EEG), and diffusion tensor imaging (DTI). For MEG, we used a prototype system that offers higher spatial resolution and sensitivity compared to the conventional adult systems. The generators of interictal activity were localized using both EEG and MEG with equivalent current dipole (ECD) and minimum norm estimation (MNE) methods according to the current clinical standards. For DTI, we calculated four diffusion scalar parameters for the fibers passing through four ROIs defined: (i) at a large cortical tuber identified at the right quadrant, (ii) at the normal appearing tissue contralateral to the tuber, (iii) at the cluster formed by ECDs fitted at the peak of interictal spikes, and (iv) at the normal appearing tissue contralateral to the cluster. ECDs were consistently clustered at the vicinity of the large calcified cortical tuber. MNE and ECDs indicated epileptiform activity in the same areas. DTI analysis showed differences between the scalar values of the tracks passing through the tuber and the ECD cluster. In this illustrative case, we provide evidence supporting the view that epileptiform activity may derive from abnormally developed tissue surrounding the tuber rather than the tuber itself.

This study presents effects of intravenous laser blood irradiation (ILBI) in a transient immunodeficiency patient with juvenile idiopathic arthritis (JIA) treated with an interleukin-6 receptor inhibitor (Tocilizumab). Biological agents induce JIA remission, but some patients do not respond favorably to this final therapeutic line of defense. ILBI was performed in a 16-year-old male patient, with JIA and transient immunodeficiency. When ILBI was introduced, the patient was receiving disease-modifying drugs, steroids, tocilizumab, and physical therapy. Because the disease was not well controlled, ILBI was applied in addition to other ongoing therapies. The patient underwent 1 session daily, and 10 successive sessions per month, repeated every 3 months, for 7 months. Patient evaluation was performed before ILBI was started and at 3, 6, 9, and 12 months after ILBI initiation, using the ACR Pediatric response. The outcome was evaluated using Pediatric 50, 70, and 90 responses and compared to initial status, after 3, 6, 9, and 12 months. At the end of study, the titre of IgA and IgG levels returned to normal. Synergistic anti-inflammatory effect of ILBI was evident, if applied additionally in combination with tocilizumab, in a patient with a therapy-resistant severe form of JIA and related subacute transient immunodeficiency.

Sublingual laser blood irradiation (SLBI) was applied into a randomized, single-blind, placebo-controlled study in juvenile idiopathic arthritis (JIA), aimed at inducing disease remission. 105 children with JIA, without an adequate response to classical treatment, were administrated a disease modifying drug (Methotrexate) and were randomly assigned to three groups. Group I (36 patients) received SLBI with the Weberneedle Lasershower Mouth Applicator with three wavelengths (635 nm, 536 nm, and 405 nm), 5 mW maximum output power each, in continuous mode, simultaneously, for 20 minutes daily, 7 successive sessions per month, repeated every 7 weeks, for three times. Group II (36 patients) received placebo SLBI. Group III (33 patients) received only treatment with Methotrexate. Evaluation was performed using American College of Rheumatology Pediatric criteria (ACR Pedi) at study enrollment and at 8, 16, 24, and 48 weeks. At the end of study, there was an improvement of the ACR Pedi 30 by 86.11% in SLBI group compared to only 61.11% in Group II, respectively, and 60.6% in Group III (P=0.001), with significant statistical differences. SLBI has reduced the pain, lowered the number of articulations with movement limitation, increased the quality of life, and made it possible to avoid the administration of biological agents.

Celiac disease (CD) comprises over 1% of the world's population and is a chronic multisystem immune-mediated condition manifested by digestive and/or extradigestive symptoms caused by food intake of gluten. This review looked at the risk of children diagnosed with CD developing SARS-CoV-2 infection and possible severe forms of COVID-19. A better understanding of the interaction and effects of SARS-CoV-2 infection in CD is very important, as is the role of environmental and genetic factors, but especially the molecular mechanisms involved in modulating intestinal permeability with impact on autoimmunity. CD inspired the testing of a zonulin antagonist for the fulminant form of multisystem inflammatory syndrome in children (MIS-C) and paved the way for the discovery of new molecules to regulate the small intestine barrier function and immune responses. Original published works on COVID-19 and CD, new data and points of view have been analyzed because this dangerous virus SARS-CoV-2 is still here and yet influencing our lives. Medical science continues to focus on all uncertainties triggered by SARS-CoV-2 infection and its consequences, including in CD. Although the COVID-19 pandemic seems to be gradually extinguishing, there is a wealth of information and knowledge gained over the last two years and important life lessons to analyze, as well as relevant conclusions to be drawn to deal with future pandemics. Zonulin is being studied extensively in immunoengineering as an adjuvant to improving the absorption of new drugs and oral vaccines. [ABSTRACT FROM AUTHOR]

A patient who had a small bowel mesentery perforation following insertion of a suprapubic catheter (SPC) is described. He had no bowel complaints immediately following the procedure, but presented 10 weeks later with insidious onset bowel obstruction due to the kink caused by the catheter. This complication occurred despite cystoscopy control and adequate bladder distension prior to the procedure. This isolated case illustrates the fact that regardless of the ease and frequency of SPC insertion, complications do occur.