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BackgroundDiagnosis and treatment of skin disease in sea workers is an unmet need. The purpose of this study is to highlight how remote management of dermatological conditions appears inadequate in this scenario.ObjectiveThis study aimed to identify the best epidemiology for seafarers' diseases and analyze the adequacy of medical assistance in the diagnosis of dermatological maritime diseases.Material and methodsA total of 420 cases of requests for dermatological diseases received by the Telemedical Maritime Assistance Service of the International Medical Radio Center (C.I.R.M.). in a referral year were included in this cross-sectional study. All pictures of cutaneous lesions had been submitted to both C.I.R.M. doctors and an expert dermatologist who provided their diagnosis.ResultsThe most frequent diagnosis in both groups was infectious or inflammatory skin diseases. The main differences are represented by the amount of “unclassified dermatitis” or descriptive diagnosis, such as “cutaneous eruption” which were the most frequent diagnosis of C.I.R.M. doctors (p < 0.05 and p > 0.0001). In these cases, Cohen's K was

Objective: From medicine via radio to telemedicine, personalized medical care at sea has improved significantly over the years. Currently, very little research has been conducted on telemedicine services and tools at sea. This study aims to review real-time case studies of seafarers’ personalized treatment via telemedical devices published in medical journals. Methods: A literature search was conducted using three libraries such as PubMed (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), BioMed Central, and Google Scholar. The Medical Subject Headings (MeSH) were used for information retrieval and document selection was conducted based on the guidelines of preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 flowchart. Selected articles were subjected to quality checks using the Newcastle–Ottawa scale (NOS). Results: The literature search produced 785 papers and documents. The selection was conducted in three stages such as selection, screening, and inclusion. After applying predefined inclusion and exclusion criteria, only three articles on real-time medical assistance with telemedical tools were identified. It is reported that medical attention is delivered to seafarers in real time thanks to advancements in telemedicine, satellite technology, and video conferencing. Conclusions: By improving the quality of medical care and reducing response times for medical emergencies at sea, lives have been saved. There are still several gaps despite these advancements. Medical assistance at sea should therefore be improved to address many of the still unsolved issues.

Ozone therapy (OT) is used for the treatment of multiple musculoskeletal disorders. In recent years, there has been a growing interest in its use for the treatment of osteoarthritis (OA). The aim of this double-blind randomized controlled trial was to evaluate the efficacy of OT compared with hyaluronic acid (HA) injections for pain relief in patients with knee OA. Patients with knee OA for at least three months were included and randomly assigned to receive three intra-articular injections of ozone or HA (once a week). Patients were assessed at baseline and at 1, 3, and 6 months after the injections for pain, stiffness, and function using the WOMAC LK 3.1, the NRS, and the KOOS questionnaire. Out of 55 patients assessed for eligibility, 52 participants were admitted to the study and randomly assigned into the 2 groups of treatment. During the study, eight patients dropped out. Thus, a total of 44 patients, reached the endpoint of the study at 6 months. Both Group A and B consisted of 22 patients. At 1-month follow-up after injections, both treatment groups improved statistically significantly from baseline in all outcomes measured. At 3 months, improvements remained similarly consistent for Group A and Group B. At 6-month follow-up, the outcomes were comparable between the 2 groups, showing only a worsening trend in pain. No significant differences were found between the two groups in pain scores. Both therapies have proven to be safe, with the few recorded adverse events being mild and self-limiting. OT has demonstrated similar results to HA injections, proving to be a safe approach with significant effects on pain control in patients affected by knee OA. Due to its anti-inflammatory and analgesic effects, ozone might be considered as a potential treatment for OA.

Objectives: The incidence of acute cardiac events is one of the main reasons for medical consultation, disembarkation, repatriation, and death among seafarers at sea. Managing cardiovascular risk factors, particularly those that can be modified, is the key to preventing cardiovascular disease. Therefore, this review estimates the pooled prevalence of major CVD risk factors among seafarers. Methods: We conducted a comprehensive search of studies published between 1994 and December 2021 in four international databases, namely PubMed/Medline, Scopus, Google Scholar, and Web of Science (WOS). Each study was evaluated for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. The DerSimonian–Laird random-effects model with logit transformations was used to estimate the pooled prevalence of major CVD risk factors. The results were reported in accordance with the Preferred Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Results: Out of all 1484 studies reviewed, 21 studies with 145,913 study participants met the eligibility criteria and were included in the meta-analysis. In the pooled analysis, the prevalence of smoking was found to be 40.14% (95% CI: 34.29 to 46.29%) with heterogeneity between studies (I2 = 98%, p < 0.01). The prevalence of hypertension, overweight, obesity, diabetes mellitus, and alcohol consumption was 45.32%, 41.67%, 18.60%, 12.70%, and 38.58%, respectively. However, the sensitivity analysis after excluding studies showed a pooled prevalence of hypertension, overweight, obesity, and diabetes mellitus of 44.86%, 41.87%, 15.99%, and 16.84%, respectively. The subgroup analysis demonstrated that smoking prevalence among seafarers had decreased significantly after 2013. Conclusion: This study demonstrated that CVD risk factors, particularly hypertension, overweight, smoking, alcohol consumption, and obesity, are prevalent among seafarers. These findings may serve as a guide for shipping companies and other responsible bodies in order to prevent CVD risk factors among seafarers. PROSPERO Registration: CRD42022300993.

A potent nontoxic antitumor drug, 2-hydroxyoleic acid (6, 2OHOA) used for membrane lipid therapy, was selected as a self-assembly inducer due to its ability to form nanoparticles (NPs) in water. For this purpose, it was conjugated with a series of anticancer drugs through a disulfide-containing linker to enhance cell penetration and to secure drug release inside the cell. The antiproliferative evaluation of the synthesized NP formulations against three human tumor cell lines (biphasic mesothelioma MSTO-211H, colorectal adenocarcinoma HT-29, and glioblastoma LN-229) showed that nanoassemblies 16–22a,bNPs exhibit antiproliferative activity at micromolar and submicromolar concentrations. Furthermore, the ability of the disulfide-containing linker to promote cellular effects was confirmed for most nanoformulations. Finally, 17bNP induced intracellular ROS increase in glioblastoma LN-229 cells similarly to free drug 8, and such elevated production was decreased by pretreatment with the antioxidant N-acetylcysteine. Also, nanoformulations 18bNP and 21bNP confirmed the mechanism of action of the free drugs.

The ongoing vaccination program in the control of novel coronavirus (COVID-19)is providing an opportunity to public health authorities to emerge from the current pandemic crisis.Covid vaccination which protects from getting Covid may have some minor side effects and in rare cases was accompanied by severe or immediate reactions. The development of hyaluronic acid soft tissue filler delayed inflammatory reactions following COVID-19 vaccination was reported. Treatments based on hyaluronic acid represent one of the most largely used practice of aesthetic medicine. In this we present a case of a 38-year-old female patient with a confirmed hypersensitivity reaction after having the BNT162b2 vaccine (Pfizer, USA). This case indicates that an adequate patient knowledge prior to hyaluronic acid injections to avoid adverse effect of a delayed-type hypersensitivity response after COVID-19 vaccination is desirable.

INTRODUZIONE

The novel coronavirus disease (COVID-19) is an ongoing pandemic with large global attention. However, spreading false news on social media sites like Twitter is creating unnecessary anxiety towards this disease. The motto behind this study is to analyses tweets by Indian netizens during the COVID-19 lockdown. The data included tweets collected on the dates between 23 March 2020 and 15 July 2020 and the text has been labelled as fear, sad, anger, and joy. Data analysis was conducted by Bidirectional Encoder Representations from Transformers (BERT) model, which is a new deep-learning model for text analysis and performance and was compared with three other models such as logistic regression (LR), support vector machines (SVM), and long-short term memory (LSTM). Accuracy for every sentiment was separately calculated. The BERT model produced 89% accuracy and the other three models produced 75%, 74.75%, and 65%, respectively. Each sentiment classification has accuracy ranging from 75.88–87.33% with a median accuracy of 79.34%, which is a relatively considerable value in text mining algorithms. Our findings present the high prevalence of keywords and associated terms among Indian tweets during COVID-19. Further, this work clarifies public opinion on pandemics and lead public health authorities for a better society.

Abstract The aim of this work is to define a new multidisciplinary pathway for dental and gingival problems. The method consists of three different instruments that can resolve dental, labial, and periodontal imperfections with minimal invasiveness.

Background High blood pressure is a serious medical condition that significantly increases the risk of cardiovascular disease. Although overweight and high blood pressure are frequent consequences for the health of life at sea, there is a paucity of information on the contribution of body mass index (BMI) to high blood pressure (HBP) in seafarers. Objective The present study was aimed to examine the relationship between BMI and blood pressure and to analyze further BMI as a risk factor for high blood pressure through a modeling approach. Materials and Methods A retrospective analysis was performed on 603 seafarers’ medical examination records. The seafarer’s blood pressure and BMI were recorded and interpreted according to the WHO criteria. Pearson product-moment correlation was examined to determine the association between BMI and blood pressure. Multinomial logistic regression models were performed to estimate the strength of association between the BMI and the HBP. Results Out of a total of 603 seafarers under study, 44.4% and 55.6% were officers and non-officers, respectively. Mean SBP, DBP, and BMI were significantly higher among non-officers than officers. BMI was positively correlated (p

Background: Globally, stroke is the second leading cause of death and disability. In different studies conducted previously, the choline-containing phospholipids citicoline and choline alphoscerate have been proposed as adjuvants in the treatment of acute strokes. A systematic review was conducted to provide updated information on the effects of citicoline and choline alphoscerate in patients with acute and hemorrhagic strokes. Methods: PubMed/Medline, Scopus, and Web of Science were searched to identify relevant materials. Data were pooled, and odds ratios (OR) were reported for binary outcomes. Using mean differences (MD), we evaluated continuous outcomes. Results: A total of 1460 studies were reviewed; 15 studies with 8357 subjects met the eligibility criteria and were included in the analysis. In our study, citicoline treatment did not result in improved neurological function (NIHSS < 1, OR = 1.05; 95% confidence interval (CI): 0.87–1.27) or functional recovery (mRS < 1, OR = 1.36; 95% CI: 0.99–1.87) in patients with acute stroke. Choline alphoscerate improved neurological function and functional recovery in stroke patients based on the Mathew’s scale and the Mini-Mental State Examination (MMSE). Conclusion: Citicoline did not improve the neurological or functional outcomes in acute stroke patients. In contrast, choline alphoscerate improved neurological function and functional recovery and reduced dependency in stroke patients.

The ‘Signuredda’ bean is a local genotype of pulse with particular technological characteristics, cultivated in Sicily, Italy. This paper presents the results of a study to evaluate the effects of partial substitutions of durum wheat semolina with 5%, 7.5%, and 10% of bean flour to prepare durum wheat functional breads. The physico-chemical properties and the technological quality of flours, doughs, and breads were investigated, as well as their storage process up to six days after baking. With the addition of bean flour, the proteins increased, as did the brown index, while the yellow index decreased. The water absorption and dough stability according to the farinograph increased from 1.45 in FBS 7.5%, to 1.65 in FBS 10%, for both 2020 and 2021, and from 5% to 10% supplementation for water absorption. Dough stability increased from 4.30 in FBS 5%-2021 to 4.75 in FBS 10%-2021. According to the mixograph, the mixing time also increased. The absorption of water and oil, as well as the leavening capacity, were also examined, and results highlighted an increase in the amount of water absorbed and a greater fermentation capacity. The greatest oil uptake was shown with bean flour at 10% supplementation (3.40%), while all bean flour mixes showed a water absorption of approximately 1.70%. The fermentation test showed the addition of 10% bean flour significantly increased the fermentative capacity of the dough. The color of the crumb was darker, while the crust became lighter. During the staling process, compared with the control sample, loaves with greater moisture and volume, and better internal porosity were obtained. Moreover, the loaves were extremely soft at T0 (8.0 versus 12.0 N of the control). In conclusion, the results showed an interesting potential of ‘Signuredda’ bean flour as a bread-making ingredient to obtain softer breads, which are better able to resist becoming stale.

This study investigates sustainable extraction protocols for the recovery of bioactive compounds from by-products of various pomegranate (Punica granatum L.) cultivars, including Acco, Hicaz, Jolly Red, Parfianka, Valenciana, and Wonderful, generated during the industrial processing of the fruits. Advanced extraction technologies, including ultrasounds, microwaves, and hydrodynamic cavitation, have been compared to conventional extraction procedures and utilized to enhance extraction efficiency while also minimizing environmental impact. Water-based extraction methods have been utilized to promote the development of sustainable and eco-friendly processes. The comparison between conventional extractions and ultrasound-assisted extractions (UAEs) and microwave-assisted extractions (MAEs) demonstrated notable improvements in extraction yields, particularly for ellagitannins (punicalins, punicalagins, and ellagic acid) and total polyphenols, with increases ranging from about 45 to 200%. However, the increases directly comparing UAEs to MAEs ranged from about 4 to 6%. This indicates that while both UAEs and MAEs offer notable improvements over conventional extractions, the differences in extraction efficiency between the two advanced methods were relatively modest. These advancements were observed across various pomegranate cultivars, highlighting the versatility and effectiveness of these methods. Notably, hydrodynamic cavitation-based extractions (HC) emerged as particularly promising, consistently yielding the highest levels of bioactive compounds (ellagitannins and total polyphenols), especially when operated at higher frequencies. Compared to conventional extractions, HC exhibited substantial increases in extraction yields for Wonderful pomegranate by-products, surpassing the efficiency of both UAEs and MAEs (approximately 45 and 57% for UAE and MAE, respectively, versus about 80% for HC). Among these advanced techniques, HC has emerged as particularly promising, yielding the most favorable results and leading to significant improvements in the yield of bioactive compounds. When directly compared to UAEs and MAEs, HC increased extraction yields by over 20%. Furthermore, HC allowed for shorter extraction times. The Wonderful cultivar consistently exhibited the highest levels of ellagitannins and the highest total polyphenol content among all types of extraction procedures used, whether conventional or advanced. This highlights the great potential of the Wonderful cultivar in terms of bioactive compound extraction and underscores its significance in research and applications related to pomegranate processing and utilization. This study suggests that the implementation of these advanced technologies into extraction processes represents a significant advancement in the field, offering a promising avenue for the development of efficient and environmentally friendly extraction methods for obtaining valuable bioactive compounds from pomegranate processing by-products. [ABSTRACT FROM AUTHOR]

Background and Objectives: The focus on mild cognitive dysfunction in adults is of great interest, given the risk of worsening and conversion to dementia. Cognitive dysfunctions are characterized by a decrease in the weight and volume of the brain, due to cortical atrophy, with a widening of the grooves and flattening of the convolutions. Brain atrophy that mainly involves the hippocampus is related to the progression of cognitive impairment and the conversion from mild cognitive dysfunction to dementia. Currently, there is no treatment for MCI. Results from a trial on Alzheimer's disease (ASCOMALVA trial) suggest that a sustained cholinergic challenge can slow the progression of brain atrophy typical of Alzheimer's disease associated with vascular damage. This study intends to evaluate the efficacy of choline alphoscerate in patients with mild cognitive impairment (MCI) and associated vascular damage, in stabilizing and/or slowing brain atrophy typical of adult-onset cognitive dysfunction, and in improving and/or slowing the progression of cognitive and behavioral symptoms associated with MCI. Materials and Methods: This randomized controlled trial will recruit 60 patients that will be evaluated and randomized in a 1:1 ratio to receive choline alphoscerate (1200 mg/day) or placebo, for 12 months. Analyses will be carried out using SPSS vesion No 26 the Statistician in charge of this study, with the statistical significance level chosen as 0.05. Discussion: This trial may provide evidence about the efficacy of treatment with the cholinergic precursor choline alphoscerate in patients with mild cognitive dysfunction. The results of this study will be published in peer-reviewed journals. Registration: EudraCT number: 2020-000576-38 [ABSTRACT FROM AUTHOR]

Microbial communities associated with plants growing in harsh conditions, including salinity and water deficiency, have developed adaptive features which permit them to grow and survive under extreme environmental conditions. In the present study, an ex-situ plant trapping method has been applied to collect the culturable microbial diversity associated with the soil from harsh and remote areas. Oryza sativa cv. Baldo and Triticum durum Primadur plants were used as recruiters, while the soil surrounding the roots of Oryza glaberrima plants from remote regions of Mali (West Africa) was used as substrate for their growth. The endophytic communities recruited by the two plant species belonged to Proteobacteria and Firmicutes, and the dominant genera were Bacillus, Kosakonia , and Enterobacter. These endophytes were characterized by analyzing some of the most common plant growth promoting traits. Halotolerant, inorganic phosphate-solubilizing and N-fixing strains were found, and some of them simultaneously showing these three traits. We verified that 'Baldo' recruited mostly halotolerant and P-solubilizers endophytes, while the endophytes selected by 'Primadur' were mainly N-fixers. The applied ex-situ plant trapping method allowed to isolate endophytes with potential beneficial traits that could be applied for the improvement of rice and wheat growth under adverse environmental conditions. [ABSTRACT FROM AUTHOR]

Common femoral artery (CFA) transfemoral access (TFA) has been the traditional route for neuroendovascular intervention with flow diversion including the pipeline embolization device (PED) for the treatment of wide-necked aneurysms. Successful deployment requires significant catheter support, thus making alternative access challenging. A 56-year-old-female presented with subarachnoid hemorrhage secondary to a large ruptured posterior communicating artery (PCOM) aneurysm as well as found to have an unruptured left superior cerebellar artery (SCA) aneurysm. Endovascular embolization of PCOM aneurysm via TFA was complicated by a right CFA pseudoaneurysm. The SCA aneurysm was treated 8 weeks later via left TFA with consequent development of a left CFA pseudoaneurysm. Contrasted magnetic resonance angiography revealed recurrence at the neck of the PCOM aneurysm at 4-month follow-up, treated via transradial access (TRA) PED flow diversion to avoid additional groin complications. Anatomic, procedural, and clinical considerations for TRA anterior circulation flow diversion using the PED are reviewed.

Dissecting intracranial pseudoaneurysms (IPs) are associated with a high incidence of rupture and poor neurologic outcomes. Lesions in the posterior circulation are particularly malignant and pose even greater management challenges. Traditional management consists of microsurgical vessel sacrifice with or without bypass. Flow diversion (FD) in the setting of subarachnoid hemorrhage (SAH) represents a reconstructive treatment option and can be paired with coil embolization to promote more rapid thrombosis of the lesion. We report a case of a ruptured dissecting vertebral artery (VA) IP successfully acutely treated with coil-assisted FD. A 53-year-old male presented with a right V4 dissection spanning the origin of the posterior inferior cerebellar artery and associated ruptured V4 IP. The patient was treated with coil-assisted FD. Oral dual-antiplatelet therapy (DAPT) was initiated during the procedure, and intravenous tirofiban was used as a bridging agent. Immediate obliteration of the IP was achieved, with near-complete resolution of the dissection within 48 h. The patient made a complete recovery, and angiography at 6 weeks confirmed total IP obliteration, reconstruction of the VA, and a patent stent. The use of FD and DAPT in the setting of acute SAH remains controversial. We believe that coil-assisted FD in carefully selected patients offers significant advantages over traditional microsurgical and endovascular options. The risks posed by DAPT and potential for delayed thrombosis with FD can be effectively mitigated with planning and the development of protocols. We discuss the current literature in the context of our case and review the challenges associated with treating these often devastating lesions.

Background: Different studies showed that the use of telemedicine is effective in reducing hospital burden, suffering from patients, need of transports, hospital fear, save money and time, and increasing the quality of health care. However, the implementation of telemedicine countenances different challenges in developing countries generally and in Ethiopia, particularly. This review aims to evaluate barriers affecting sustainable telemedicine implementation in Ethiopia. Methods: PubMed (Medline), Google Scholar, Embase, and Scopus databases were searched between July 4, 2020 and July 28, 2020. Studies published between 2005 and June 30, 2020 were considered. Relevant articles were selected by reviewing keywords, titles, and abstracts. Out of 40 articles, 33 articles remained after removing duplicates. We finally analyzed 14 articles from the mentioned databases based on our eligibility criteria and identified different barriers. We followed the preferred reporting items for systematic review and meta-analyses (PRSIMA 2009) checklist for this review. Results: We identified 25 barriers through 14 articles and classified barriers into organizational, users, and staff and programmers' barriers. Accordingly, organizational, users, and staff and programmer barriers were 12 (48%), 7 (28%), and 6 (24%), respectively, with the frequency of occurrence through 14 articles. Cost, awareness, and resistance to change were the most frequently reported barriers among organizational, user, and staff and programmer barriers, respectively. Conclusions: Infrastructure and costs were the most frequently reported barriers, and staff resistance to change was also the critical factor in influencing the sustainable implementation of telemedicine in Ethiopia.

Purpose: Robotic-assisted simple prostatectomy (RASP) is a novel surgical procedure for the management of obstructive symptoms caused by enlarged prostate glands. Before the introduction of minimally invasive techniques, the standard approach was the open simple prostatectomy (OSP). The aim of our study was to compare intraoperative and perioperative outcomes of robotic (RASP) and laparoscopic (LSP) simple prostatectomy. Methods: We retrospectively analyzed data from patients who underwent minimally invasive simple prostatectomy at the Urological Department of Portogruaro Hospital, Portogruaro, and at the Urological Department of “San Bassiano” Hospital, in Bassano del Grappa, from March 2015 to December 2020. Data collected from medical records included age, body mass index, prostate volume, operative time, preoperative International Prostatic Symptoms Score (IPSS), postoperative IPSS, time with drainage, blood transfusion, intraoperative complications, perioperative complications and length of hospital stay. Results: Robotic-assisted (n = 25) and laparoscopic simple prostatectomy (n = 25) were performed with a transvesical approach. No significant differences were observed regarding baseline characteristics, body mass index, prostate volume and IPSS. Operative time was lower in the laparoscopic group (122 min vs 139 min) (p = 0.024), while hospital stay was lower in the robotic group (4 days vs 6 days) (p = 0.047). Conclusions: Robotic-assisted simple prostatectomy is a safe technique with results comparable to laparoscopic simple prostatectomy, encompassing the advantage of a shorter hospitalization. Considering the costs and the limited availability of robotic-assisted simple prostatectomy, laparoscopic simple prostatectomy is a valid and safe alternative for experienced surgeons.