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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.

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 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.

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.

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]

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]