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Abstract Introduction Syphilis is a systemic bacterial infection caused by the spirochete Treponema pallidum. Head and neck mucosal manifestations of syphilis can be observed in each and all of primary, secondary and tertiary syphilis, especially in the secondary one. Therefore, oropharynx is an unusual localization of syphilitic lesions, mainly represented by ulcerous lesions, tissue hypertrophy, mucosal patches and cancer-like lesions. Serology is routinely considered the gold standard for the screening and diagnosis of syphilis. However, direct detection is routinely used during polymerase chain reaction (PCR) of oropharyngeal tissue and suspicious cervical lymphadenopathies. Methods PRISMA 2020 guidelines were applied to make a systematic literature review with the aim to make an overview of clinical manifestations and diagnostic tools of oropharyngeal syphilitic infection. A computerized MEDLINE search was performed using the PubMed, Web of Science and Cochrane databases. Results The intended analysis was based on 38 papers, including a total of 55 cases. The main localization of oropharyngeal infection was the tonsil (71%), followed by lateral and posterior wall of oropharynx (16%). Ulcerous lesions were the most frequently encountered lesions in the primary syphilis (56%) and secondary syphilis (36%), whereas gumma’s lesions were encountered in the tertiary syphilis (57%). Diagnosis based on serological assays was used in combination with non-treponemal methods to determine disease activity (80% cases). Conclusions Oropharyngeal syphilis has historically been referred to as the “great imitator” due to its highly variable manifestations, which can resemble malignancies. Physicians have to recognize oropharyngeal luetic features early, in order to set up an effective diagnostic and therapeutic work-up.

BACKGROUND AND OBJECTIVES: Biochar has gained prominence as a sustainable solution in agriculture and environmental management, with benefits of enhancing soil fertility, improving crop yield, and mitigating the climate change. This study sought to conduct a bibliometric analysis of biochar research within the context of agricultural applications, with the objective of evaluating its progression, thematic development, and patterns of global collaboration.METHODS: A search was conducted in the Scopus database on September 1, 2024 using a pre-determined keyword combination. The retrieved data were analyzed using the Bibliometrix package in RStudio to evaluate publication trends, research theme evolution, and international collaboration networks. The authors' keywords were employed in a co-occurrence analysis to discern principal research themes and their interrelations. The analysis on research theme evolution utilized a single time split, dividing the datasets into 2006−2021 and 2022−2025. The collaboration network was established with a minimum edge threshold of 4, and it is illustrated in a mapped format. .FINDINGS: The search using a predetermined keyword combination identified 4,402 publications related to biochar, with 2,857 focused specifically on its application in agriculture. A pronounced increase in research output was observed after 2016. China is spearheading the investigation in this domain, having produced 1,319 publications from individual countries and 564 from various international collaborations. In the second leading position, the United States has produced 382 publications, where 101 of which were published along with authors from other countries. The thematic analysis revealed a transition from the original focal points, which included carbon sequestration, to newly emerging subjects such as microbial biomass and the remediation of heavy metals.CONCLUSION: There is an increasing significance of biochar research worldwide, where the thematic evolution and patterns of international collaborations have been successfully synthesized in this study. The thematic shifts suggest the growing interest in microbial biomass and heavy metal remediation-related themes, indicating the multiple applications of biochar in both environmental management and agricultural productivity. Given the robust framework of international research collaboration, it is essential to undertake a unified global initiative aimed at standardizing biochar application techniques, enhancing production processes, and evaluating the long-term effects of biochar usage. The production and utility of biochar in agricultural sector could be optimized through international collaboration and policy development aiming to improve soil health, and subsequently food security. The study has effectively mapped the landscape of biochar studies within the realm of environmental management, with a particular focus on its roles in enhancing microbial biomass and remediating heavy metal contamination.

Abstract Background Tumor heterogeneity is a main contributor of resistance to anti-cancer targeted agents though it has proven difficult to study. Unfortunately, model systems to functionally characterize and mechanistically study dynamic responses to treatment across coexisting subpopulations of cancer cells remain a missing need in oncology. Methods Using single cell cloning and expansion techniques, we established monoclonal cell subpopulations (MCPs) from a commercially available epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer cell line. We then used this model sensitivity to the EGFR inhibitor osimertinib across coexisting cell populations within the same tumor. Pathway-centered signaling dynamics associated with response to treatment and morphological characteristics of the MCPs were assessed using Reverse Phase Protein Microarray. Signaling nodes differentially activated in MCPs less sensitive to treatment were then pharmacologically inhibited to identify target signaling proteins putatively implicated in promoting drug resistance. Results MCPs demonstrated highly heterogeneous sensitivities to osimertinib. Cell viability after treatment increased > 20% compared to the parental line in selected MCPs, whereas viability decreased by 75% in other MCPs. Reduced treatment response was detected in MCPs with higher proliferation rates, EGFR L858R expression, activation of EGFR binding partners and downstream signaling molecules, and expression of epithelial-to-mesenchymal transition markers. Levels of activation of EGFR binding partners and MCPs’ proliferation rates were also associated with response to c-MET and IGFR inhibitors. Conclusions MCPs represent a suitable model system to characterize heterogeneous biomolecular behaviors in preclinical studies and identify and functionally test biological mechanisms associated with resistance to targeted therapeutics.

This study investigates the practices and rules of Genoese gilding, drawing insights from a 16th-century manuscript containing regulations for gold leaf production. Employing X-ray and ion beam techniques, we quantitatively assess the manuscript’s gold leaf thickness without destructive sampling. Artisanal goldbeater-produced leaves of different thicknesses, applied with a guazzo or mordant technique, served as standards. Further analysis of samples with unknown thickness from the furniture of Palazzo Spinola di Pellicceria in Genoa (Italy) has confirmed the method’s applicability to practical cases. External beam Rutherford backscattering spectrometry (RBS) and particle-induced X-ray emission (PIXE) analyses were carried out using 3 MeV protons at the LABEC accelerator laboratory in Florence. A linear relationship between Gold Lα peak yield and leaf thickness, as measured by RBS, has been established for optimal calibration of portable or hand-held X-Ray fluorescence (XRF) instrumentation for in situ measurements. Moreover, the caratage of the gold foil preserved in the manuscript has been assessed.

Em um processo colaborativo de formação inicial docente, buscamos compreender o papel das Histórias em Quadrinhos (HQs), no formato digital, e da Resolução de Problemas no ensino da Matemática. A pesquisa contou com a participação de 12 acadêmicos do curso de Licenciatura em Matemática de uma universidade pública do estado de Mato Grosso e foi realizada em uma das disciplinas de seu curso. A pesquisa é de cunho experimental e foi utilizada a abordagem qualitativa para a produção e análise dos dados. A análise foi realizada a partir das capturas de prints das produções dos colaboradores, dos diálogos inferidos em uma roda de conversa e da observação dos acadêmicos durante o desenvolvimento do experimento didático-formativo. A pesquisa revelou que tais recursos favorecem o diálogo entre professor e estudante, permitem a fala e a expressão por diferentes formas de linguagem e abrem espaço para uma formação mais social, onde o estudante se coloca de acordo com sua identidade e contexto social e cultural no processo de produção de conhecimento.

Abstract Lower limb amputation is a medical intervention which causes motor disability and may compromise quality of life. Several factors determine patients’ health outcomes, including an appropriate prosthetic provision and an effective rehabilitation program, necessitating a thorough quantitative observation through different data sources. In this context, the role of interoperability becomes essential, facilitating the reuse of real-world data through the provision of structured and easily accessible databases. This study introduces a comprehensive 10-year dataset encompassing clinical features, mobility measurements, and prosthetic knees of 1006 trans-femoral amputees during 1962 hospital stays for rehabilitation. The dataset is made available in both comma-separated values (CSV) format and HL7 Fast Healthcare Interoperability Resources (FHIR)-based representation, ensuring broad utility and compatibility for researchers and healthcare practitioners. This initiative contributes to advancing community understanding of post-amputation rehabilitation and underscores the significance of interoperability in promoting seamless data sharing for meaningful insights into healthcare outcomes.

Abstract Real‐time and in‐line transversal monitoring of ionizing radiation beams is a crucial task for several applications which span from medical treatments to particle accelerators in high energy physics. Here a flexible and large area device based on 2D hybrid perovskite thin films (phenylethylammonium lead bromide), fabricated onto a thin flexible polyimide substrate, able to map the transversal beam profile of high energy radiation beams is reported. The performance of this novel tool is here compared with the one offered by standard commercial large‐area technology, namely radiochromic sheets. The great potential of this class of devices is demonstrated by successfully mapping in real‐time a 5 MeV proton beam at fluxes between 108 and 1010 H+ s−1 cm−2, confirming the capability to operate in a radiation‐harsh environment without output signal saturation issues. The versatility and scalability of here proposed detecting system are demonstrated by the development of a multipixel array able to map in real‐time a 40 kVp X‐ray beam spot (dose rate 8 mGy s−1). Perovskite thin film‐based detectors are thus assessed as a very promising class of thin, flexible devices for real‐time, in‐line, large‐area, conformable, reusable, transparent, and low‐cost transversal beam monitoring of different ionizing radiation.

Abstract Objectives The aim of this study was to introduce the MOCART 2.0 ankle score and evaluate its utility and reproducibility for the radiological assessment of cartilage repair tissue in the ankle joint. Methods The MOCART 2.0 ankle score evaluates seven individual variables, including “volume fill of (osteo)chondral defect,” “Integration into adjacent cartilage and bone,” “surface of the repair tissue,” “signal intensity of the repair tissue,” “bony defect and bony overgrowth,” “presence of edema-like-marrow signal,” and “presence of subchondral cysts.” Overall, a MOCART 2.0 ankle score between 0 and 100 points may be reached. Two independent readers assessed the 3-T MRI examinations of 48 ankles, who had undergone cartilage repair of a talar cartilage defect using the new MOCART 2.0 ankle score. One of the readers performed two readings. Intra- and interrater reliability were assessed using intraclass correlation coefficients (ICCs) for the overall MOCART 2.0 ankle score. Results Forty-eight ankles (mean age at surgery 30.2 ± 11.2 years) were evaluated. The overall interrater (ICC = 0.75; 95%CI 0.60–0.85), as well as the intrarater (ICC = 0.83; 95%CI 0.72–0.90) reliability of the MOCART 2.0 ankle score was good. For individual variables the interrater reliability ranged from a kappa value of 0.29 (95%CI 0.01–0.57) for “surface of the repair tissue” to 0.83 (95%CI 0.71–0.95) for “presence of subchondral cysts”. Conclusions The newly introduced MOCART 2.0 ankle score, which encompasses the distinct anatomy of the ankle joint, demonstrates good intra- and interrater reliability. Critical relevance statement The newly introduced MOCART 2.0 ankle score may facilitate the standardized assessment of cartilage repair in the ankle joint and allow an objective comparison of the morphological outcome between alternative treatment options and between different studies. Key Points This study introduces the MOCART 2.0 ankle score. The MOCART 2.0 ankle score demonstrated good intra- and interrater reliability. Standardized reporting may improve communication between radiologists and other physicians. Graphical Abstract

Microalgae are being recognized as the key contributor to sustainability in many sectors, starting from energy up to food industries. The microorganism has also been utilized as environmental remediator, capable of converting organic compounds into economically valuable biomass. To optimize the use of microalgae in these sectors, researchers have explored various approaches, of which is the use of bacteria. The interaction between bacteria and microalgae can potentially be harnessed, but its complexity requires extensive research. Herein, we present the bibliometric analysis on microalgal-bacterial interactions. The metadata of published literature was collected through Scopus database on August 4, 2023. The downloaded.csv file was uploaded to VOSViewer and biblioshiny for network visualization. We found that the research has gained a lot of attention from researchers since 2012 with an exponential increase of the publication number. The United States and China are leading the research with a strong collaboration. Based on the research sub-topic clusters, the interaction is mostly studied for wastewater treatment, biomass production, and algal bloom control. Updated reviews on this topic reveal that researchers are now focus on optimizing the efficacy of microalgae-bacteria system, investigating the modes of actions, and identifying challenges in its real-world implementation. The microalgal-bacterial interaction is a promising approach for microalgae utilization in wastewater treatment, biomass production, and algal bloom control.

Vital capacity (VC) tests are an important tool in assessing the functioning of the respiratory system. Low levels of vital capacity can indicate health problems such as asthma, chronic obstructive pulmonary disease, and other respiratory conditions. The volume of VC depends on many factors, especially the strength of the respiratory muscles, body and chest structure, lung and chest compliance, airway patency, gender, environmental factors, and physical activity. The aim of this study is to determine the level of vital capacity (VC) in girls and boys aged 10-13 who practice trampoline jumping, and to compare the results with reference values for a given gender and age category. The research was conducted among 100 trampoline jumpers (including 57 girls and 43 boys) aged 10-13. As part of the research, spirometric measurement was performed using the portable EasyOne model 2001 spirometer. The obtained results were then compared to reference values calculated on the basis of a study by the European Respiratory Society. The average level of vital capacity in the girls aged 10 was 2.2 liters, in 11-year-olds - 2.45 l, in 12-year-olds 2.54 l, and in 13-year-olds it was 3.02 l. The average level of vital capacity of the examined boys aged 10 was 2.36 l, in 11-year-olds 2.56 l, in 12-year-olds 2.89 l, and in 13-year-olds 3.33 l. These research results indicate that trampoline jumpers show a VC value within the reference values (between the LLN and ULN values). The girls stand out with higher percentage of predicted values for VC at the age of 11 (95.26%) and 13 (100.34%), in comparison with boys at the age of 10 (96.38%) and 12 (96.23%).

Cardiac surgery with cardiopulmonary bypass results in global myocardial ischemia–reperfusion injury, leading to significant postoperative morbidity and mortality. Although cardioplegia is the cornerstone of intraoperative cardioprotection, a number of additional strategies have been identified. The concept of preconditioning and postconditioning, despite its limited direct clinical application, provided an essential contribution to the understanding of myocardial injury and organ protection. Therefore, physicians can use different tools to limit perioperative myocardial injury. These include the choice of anesthetic agents, remote ischemic preconditioning, tight glycemic control, optimization of respiratory parameters during the aortic unclamping phase to limit reperfusion injury, appropriate choice of monitoring to optimize hemodynamic parameters and limit perioperative use of catecholamines, and early reintroduction of cardioprotective agents in the postoperative period. Appropriate management before, during, and after cardiopulmonary bypass will help to decrease myocardial damage. This review aimed to highlight the current advancements in cardioprotection and their potential applications during cardiac surgery.

BackgroundRecent evidence suggests that anosognosia or unawareness of cognitive impairment in Alzheimer’s Disease (AD) may be explained by a disconnection between brain regions involved in accessing and monitoring information regarding self and others. It has been demonstrated that AD patients with anosognosia have reduced connectivity within the default mode network (DMN) and that anosognosia in people with prodromal AD is positively associated with bilateral anterior cingulate cortex (ACC), suggesting a possible role of this region in mechanisms of awareness in the early phase of disease. We hypothesized that anosognosia in AD is associated with an imbalance between the activity of large-scale resting-state functional magnetic resonance imaging (fMRI) networks, in particular the DMN, the salience network (SN), and the frontoparietal network (FPN).MethodsSixty patients with MCI and AD dementia underwent fMRI and neuropsychological assessment including the Anosognosia Questionnaire Dementia (AQ-D), a measure of anosognosia based on a discrepancy score between patient’s and carer’s judgments. After having applied Independent Component Analysis (ICA) to resting fMRI data we performed: (i) correlations between the AQ-D score and functional connectivity in the DMN, SN, and FPN, and (ii) comparisons between aware and unaware patients of the DMN, SN, and FPN functional connectivity.ResultsWe found that anosognosia was associated with (i) weak functional connectivity within the DMN, in posterior and middle cingulate cortex particularly, (ii) strong functional connectivity within the SN in ACC, and between the SN and basal ganglia, and (iii) a heterogenous effect concerning the functional connectivity of the FPN, with a weak connectivity between the FPN and PCC, and a strong connectivity between the FPN and ACC. The observed effects were controlled for differences in severity of cognitive impairment and age.ConclusionAnosognosia in the AD continuum is associated with a dysregulation of the functional connectivity of three large-scale networks, namely the DMN, SN, and FPN.

There has been continuous progress in diabetes management over the last few decades, not least due to the widespread dissemination of continuous glucose monitoring (CGM) and automated insulin delivery systems. These technological advances have radically changed the daily lives of people living with diabetes, improving the quality of life of both children and their families. Despite this, hypoglycemia remains the primary side-effect of insulin therapy. Based on a systematic review of the available scientific evidence, this paper aims to provide evidence-based recommendations for recognizing, risk stratifying, treating, and managing patients with hypoglycemia. The objective of these recommendations is to unify the behavior of pediatric diabetologists with respect to the timely recognition and prevention of hypoglycemic episodes and the correct treatment of hypoglycemia, especially in patients using CGM or advanced hybrid closed-loop systems. All authors have long experience in the specialty and are members of the Italian Society of Pediatric Endocrinology and Diabetology. The goal of treating hypoglycemia is to raise blood glucose above 70 mg/dL (3.9 mmol/L) and to prevent further decreases. Oral glucose at a dose of 0.3 g/kg (0.1 g/kg for children using “smart pumps” or hybrid closed loop systems in automated mode) is the preferred treatment for the conscious individual with blood glucose

Abstract Introduction Optical coherence tomography angiography (OCT-A) is a novel tool that allows the detection of retinal vascular changes. We investigated the association of macular vessel density (VD) in the superficial plexus assessed by OCT-A with measures of cerebrovascular pathology and atrophy quantified by brain magnetic resonance imaging (MRI) in non-demented individuals. Methods Clinical, demographical, OCT-A, and brain MRI data from non-demented research participants were included. We analyzed the association of regional macular VD with brain vascular burden using the Fazekas scale assessed in a logistic regression analysis, and the volume of white matter hyperintensities (WMH) assessed in a multiple linear regression analysis. We also explored the associations of macular VD with hippocampal volume, ventricle volume and Alzheimer disease cortical signature (ADCS) thickness assessed in multiple linear regression analyses. All analyses were adjusted for age, sex, syndromic diagnosis and cardiovascular variables. Results The study cohort comprised 188 participants: 89 with subjective cognitive decline and 99 with mild cognitive impairment. No significant association of regional macular VD with the Fazekas categories (all, p > 0.111) and WMH volume (all, p > 0.051) were detected. VD in the nasal quadrant was associated to hippocampal volume (p = 0.007), but no other associations of macular VD with brain atrophy measures were detected (all, p > 0.05). Discussion Retinal vascular measures were not a proxy of cerebrovascular damage in non-demented individuals, while VD in the nasal quadrant was associated with hippocampal atrophy independently of the amyloid status.

Abstract This study aimed to validate a wearable device’s walking speed estimation pipeline, considering complexity, speed, and walking bout duration. The goal was to provide recommendations on the use of wearable devices for real-world mobility analysis. Participants with Parkinson’s Disease, Multiple Sclerosis, Proximal Femoral Fracture, Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and healthy older adults (n = 97) were monitored in the laboratory and the real-world (2.5 h), using a lower back wearable device. Two walking speed estimation pipelines were validated across 4408/1298 (2.5 h/laboratory) detected walking bouts, compared to 4620/1365 bouts detected by a multi-sensor reference system. In the laboratory, the mean absolute error (MAE) and mean relative error (MRE) for walking speed estimation ranged from 0.06 to 0.12 m/s and − 2.1 to 14.4%, with ICCs (Intraclass correlation coefficients) between good (0.79) and excellent (0.91). Real-world MAE ranged from 0.09 to 0.13, MARE from 1.3 to 22.7%, with ICCs indicating moderate (0.57) to good (0.88) agreement. Lower errors were observed for cohorts without major gait impairments, less complex tasks, and longer walking bouts. The analytical pipelines demonstrated moderate to good accuracy in estimating walking speed. Accuracy depended on confounding factors, emphasizing the need for robust technical validation before clinical application. Trial registration: ISRCTN – 12246987.

There is evidence that the overproduction of apoB-100-containing lipoproteins by the liver is the underlying event in some forms of dyslipoproteinemia. This metabolic status is associated to an increased risk of developing premature coronary artery disease CAD. The conclusions from previous studies suggested that the availability to the hepatocytes of cholesterol that is readily esterified is an important determinant for VLDL and LDL secretion. In the present study, we set out to investigate the effect of the specific stimulation and inhibition of the rate-limiting enzyme of the cholesterol esterification, acyl-CoA:cholesterol acyltransferase (ACAT, E.C. 2.3.1.26), on the lipid and on the apoB-100 secretion rate from a human hepatoma cell line (HepG2). When the specific ACAT inhibitor FCE 27677 (10-5 M) was added to the cultures, a decrease of the cellular cholesteryl ester content and at the same time a significant reduction of the neutral lipids and of the apoB-100 secretion rate were noticed. The stimulation of ACAT by 25-hydroxycholesterol (20 microgram/ml) caused a 4-fold increase of the cellular cholesteryl ester content and a 2-fold increase of the lipoprotein secretion rate. FCE 27677 (10-5 M to 10-7 M) prevented the effects elicited by the oxysterol. On the contrary, lovastatin (10-6 M) and gemfibrozil (10-6 M) had no effect. The analysis of the lipid and of the apolipoprotein composition of the lipoproteins secreted in the medium revealed that ACAT inhibition had the dual effect of both decreasing the number of apoB-100-containing lipoproteins secreted as well as their cholesteryl ester load. Altogether, these data support the idea of a close relationship between ACAT activation, leading to increased cholesteryl ester availability, and apoB-100-containing lipoprotein secretion. It is speculated that ACAT inhibitors may prove useful for the treatment of human dyslipoproteinemias caused by the hepatic overproduction of apoB-100-containing lipoproteins.