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Abstract Background Juvenile dermatomyositis (JDM) is a systemic vasculopathy associated with metabolic derangements and possible increased risk for premature atherosclerosis. Oxidation of low-density lipoprotein (LDL) in the endothelium is an early step in atherosclerotic plaque formation. It is not known if oxidized LDL is altered in children with untreated JDM. The deposition of oxidized LDL in the vasculature of muscle biopsies (MBx) from patients with untreated JDM and pediatric controls was assessed. Findings Frozen tissue sections of MRI-directed MBx from 20 female children with untreated JDM and 5 female controls were stained with DAPI and fluorescently labeled antibodies against von Willebrand factor (vWF) and LDL oxidized by copper (oxLDL). Blood vessels were identified by positive vWF staining, and total fluorescence of oxLDL within the vessel walls was measured. Children with untreated JDM had increased deposition of oxLDL in the walls of muscle vasculature compared to healthy children (difference in means ± SEM = 19.86 ± 8.195, p = 0.03). Within the JDM cohort, there was a trend towards increased oxLDL deposition with longer duration of untreated disease (r = 0.43, p = 0.06). There was no significant correlation found between oxLDL deposition and markers of acute JDM disease activity including disease activity scores or muscle enzymes. Conclusions This study found increased deposition of oxLDL within blood vessels of children with untreated JDM supporting the concern that these children are at increased risk for premature atherosclerosis from chronic exposure to vascular oxLDL. This study highlights the importance of early diagnosis and treatment initiation to ameliorate cardiovascular damage.

The increase of antibiotic-resistant bacteria has become a global health emergency and the need to explore alternative therapeutic options arises. Phage therapy uses bacteriophages to target specific bacterial strains. Phages are highly specific and can target resistant bacteria. Currently, research in this regard is focused on ensuring reliability and safety to bring this tool into clinical practice. The first step is to conduct comprehensive preclinical research. In this work, we present two novel bacteriophages vB_Kpn_F13 and vB_Kpn_F14 isolated against clinical carbapenem-resistant Klebsiella pneumoniae strains obtained from hospital sewage. Multiple studies in vitro were conducted, such as sequencing, electron microscopy, stability, host range infectivity, planktonic effect and biofilm inhibition in order to discover their ability to be used against carbapenem-resistant K. pneumoniae pathogens causing difficult-to-treat infections.

In the present paper, we prove the algebraic independence of a finite number of real continued fractions which have partial quotients that increase rapidly. We then use a general Liouville criteria to justiy the algebraic independence of limits of some real series. We note that these results extend some work of Bundschuh and we use a new and simple method.

BackgroundHealth misinformation and myths about treatment for opioid use disorder (OUD) are present on social media and contribute to challenges in preventing drug overdose deaths. However, no systematic, quantitative methodology exists to identify what types of misinformation are being shared and discussed. ObjectiveWe developed a multistage analytic pipeline to assess social media posts from Twitter (subsequently rebranded as X), YouTube, Reddit, and Drugs-Forum for the presence of health misinformation about treatment for OUD. MethodsOur approach first used document embeddings to identify potential new statements of misinformation from known myths. These statements were grouped into themes using hierarchical agglomerative clustering, and public health experts then reviewed the results for misinformation. ResultsWe collected a total of 19,953,599 posts discussing opioid-related content across the aforementioned platforms. Our multistage analytic pipeline identified 7 main clusters or discussion themes. Among a high-yield data set of posts (n=303) for further public health expert review, these included discussion about potential treatments for OUD (90/303, 29.8%), the nature of addiction (68/303, 22.5%), pharmacologic properties of substances (52/303, 16.9%), injection drug use (36/303, 11.9%), pain and opioids (28/303, 9.3%), physical dependence of medications (22/303, 7.2%), and tramadol use (7/303, 2.3%). A public health expert review of the content within each cluster identified the presence of misinformation and myths beyond those used as seed myths to initialize the algorithm. ConclusionsIdentifying and addressing misinformation through appropriate communication strategies could be an increasingly important component of preventing overdose deaths. To further this goal, we developed and tested an approach to aid in the identification of myths and misinformation about OUD from large-scale social media content.

Background: The Mycobacterium avium complex includes the commonest non-tuberculous mycobacteria associated with human infections. These infections have been associated with the production of biofilms in many cases, but there are only a few studies about biofilms produced by the species included in this group. Methods: Three collection strains (M. avium ATCC25291, M. intracellulare ATCC13950, and M. chimaera DSM756), three clinically significant strains (647, 657, and 655), and three clinically non-significant ones (717, 505, and 575) of each species were included. The clinical significance of the clinical isolates was established according to the internationally accepted criteria. The biofilm ultrastructure was studied by Confocal-Laser Scanning Microscopy by using BacLight Live–Dead and Nile Red stains. The viability, covered surface, height, and relative autofluorescence were measured in several images/strain. The effect of clarithromycin was studied by using the technique described by Muñoz-Egea et al. with modifications regarding incubation time. The study included clarithromycin in the culture medium at a concentration achievable in the lungs (11.3 mg/L), using one row of wells as the control without antibiotics. The bacterial viability inside the biofilm is expressed as a percentage of viable cells. The differences between the different parameters of the biofilm ultrastructure were analyzed by using the Kruskal–Wallis test. The correlation between bacterial viability in the biofilm and treatment time was evaluated by using Spearman’s rank correlation coefficient (ρ). Results: The strains showed differences between them with all the studied parameters, but neither a species-specific pattern nor a clinical-significance-specific pattern were detected. For the effect of clarithromycin, the viability of the bacteria contained in the biofilm was inversely proportional to the exposure time of the biofilm (ρ > −0.3; p-value < 0.05), excluding two M. chimaera strains (M. chimaera DSM756 and 575), which showed a weak positive correlation with treatment time (0.2 < ρ < 0.39; p-value < 0.05). Curiously, despite a clarithromycin treatment of 216 h, the percentage of the biofilm viability of the strains evaluated here was not less than 40% at best (M. avium 717). Conclusions: All the M. avium complex strains studied can form biofilm in vitro, but the ultrastructural characteristics between them suggest that these are strain-specific characteristics unrelated to the species or the clinical significance. The clarithromycin effect on MAC species is biofilm-age/time-of-treatment-dependent and appears to be strain-specific while being independent of the clinical significance of the strain.

Diabetes mellitus type 2 is a chronic metabolic condition whose incidence has been continuously growing around the world. As a result of this tendency, it is quickly becoming an epidemic in some parts of the world, with the number of individuals affected anticipated to double in the next decade as the world's population ages, adding to the already existing load on healthcare providers, particularly in poor developing countries. World Health Organization (WHO) guidelines are still used for screening and diagnosis, which include both clinical and laboratory characteristics. There is currently no cure for the disease; however, therapy options include lifestyle changes, obesity management, oral hypoglycemic medications, and insulin sensitizers such as metformin, a biguanide that reduces insulin resistance which is used as first line medication especially for obese patients. The traditional herbal medicine like garlic, neem, bitter gourd, aloe vera, onion, methi, amla, jamun, baheda etc. are also used for the treatment of the diabetes. Other effective medication includes non-sulfonylurea secretagogues, thiazolidinediones, alpha glucoside inhibitors, and insulin. Recent research into the biology of type 2 diabetes has led to the development of new medications such as glucagon-like peptide 1 analogues: dipeptidyl peptidase inhibitors, sodium glucose cotransporter 2 inhibitors, and 11-hydroxysteroid dehydrogenase 1 inhibitors, insulin releasing glucokinase activators. The novel drug delivery improves the treatment of diabetes by the inhaled insulin. Keywords: Type 2 diabetes mellitus, Diabetes complications, Diabetes diagnosis, Diabetes management, Antidiabetic newer drugs, Antidiabetic herbal drugs

Background and objectives: Lesions of the head and neck region are routinely encountered by clinicians, in patients across all age groups. Diagnoses range from reactive inflammatory conditions to malignancies. Cancer is among the leading causes of death in India. Head and neck cancers account for 23% of all cancer incidents in males and 6% of all incidents in females in India,. Fine needle aspiration cytology (FNAC) of cervical masses is an easy, effective, and relatively inexpensive technique. The aim of this study was to determine occurrence of various head and neck swellings and classify them under various categories. Methods: The present study included 100 cases of palpable cervical swellings who had been referred to the AMC MET Medical College, Ahmedabad (India) from June 2018 to October 2020. Results: The majority of cases were lymph node swellings (57%), followed by thyroid swellings (23%), salivary gland swellings (12%), and soft tissue swellings (8%). Among all cervical region swellings, tuberculous lymphadenitis and thyroid lesions were the most prevalent. Conclusion: The findings suggest that lymph node swellings are most commonly observed in the cervical area, and that the majority of them are inflammatory, requiring medical treatment rather than surgery. Moreover, FNAC is a straightforward, quick, and cost-effective way to distinguish between non-neoplastic and metastatic malignant lesions, which could help timely surgical interventions.

K-anonymity is the most widely used approach to privacy preserving microdata which is mainly based on generalization. Although generalization-based k-anonymity approaches can achieve the privacy protection objective, they suffer from information loss. Clustering-based approaches have been successfully adapted for k-anonymization as they enhance the data quality, however, the computational complexity of finding an optimal solution has shown as NP-hard. Nature-inspired optimization algorithms are effective in finding solutions to complex problems. We propose, in this paper, a novel algorithm based on a simple nature-inspired metaheuristic called Black Hole Algorithm (BHA), to address such limitations. Experiments on real data set show that data utility has been improved by our approach compared to k-anonymity, BHA-based k-anonymity and clustering-based k-anonymity approaches.

The increase of antibiotic-resistant bacteria has become a global health emergency and the need to explore alternative therapeutic options arises. Phage therapy uses bacteriophages to target specific bacterial strains. Phages are highly specific and can target resistant bacteria. Currently, research in this regard is focused on ensuring reliability and safety to bring this tool into clinical practice. The first step is to conduct comprehensive preclinical research. In this work, we present two novel bacteriophages vB_Kpn_F13 and vB_Kpn_F14 isolated against clinical carbapenem-resistant Klebsiella pneumoniae strains obtained from hospital sewage. Multiple studies in vitro were conducted, such as sequencing, electron microscopy, stability, host range infectivity, planktonic effect and biofilm inhibition in order to discover their ability to be used against carbapenem-resistant K. pneumoniae pathogens causing difficult-to-treat infections. [ABSTRACT FROM AUTHOR]

Introduction: Laryngoscopy and intubation cause lots of haemodynamic changes which adversely affects the patient during the perioperative period. Various methods have been applied to reduce stress response in high risk patients. Ivabradine is a unique cardiotonic drug which reduces the heart rate without compromising blood pressure, specially in debilitating and severely ill patients. Aim: To evaluate role of oral ivabradine in attenuating the haemodynamic stress response to laryngoscopy, intubation and extubation in patients undergoing surgical procedure under General Anaesthesia (GA) and to note the side-effects and its complications, if any. Materials and Methods: A randomised controlled multicentric study was conducted in 200 American Society of Anaesthesiologists’ (ASA)-I and II patients undergoing various surgery under general anaesthesia. The patients were randomly divided into two groups: group A (Test group, n=100) received 5 mg oral ivabradine one hour before intubation, group B (Control group, n=100) received placebo. The pulse rate, Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) were recorded at intubation and 10 minutes postintubation along with at extubation and postintubation period till 10 minutes. Patients were monitored for haemodynamic changes as per the protocol. Statistics analysis was done using Statistical Package of Social Science (SPSS) software version 21.0. Results: Demographic findings were comparable in both groups. Heart rate (84.36±4.11 versus 114.19±12.4), SBP (120±10.5 versus 150±17.5), DBP (76.08±4.29 versus 113.2±10.6), MAP (91.3±6.7 versus 124.4±12.8) at 10 minutes postintubation decreased more in test group as compared to control group from baseline (p-value