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Relapsing-remitting (RR) Multiple Sclerosis (MS) is the most common form of the disease; RRMS patients can maintain their clinical phenotype throughout life or can develop a secondary progressive (SP) course over time. We investigated whether circulating miRNAs can predict RR-to-SPMS conversion. A serum miRNAs profile was initially analyzed in a cross-sectional study by qPCR in 16 patients (8 RRMS and 8 SPMS) (Discovery cohort). Three miRNAs, i.e. miR-34a-5p, miR-103a-3p and miR-376a-3p, were significantly up-regulated in SPMS compared to RRMS patients (p

This data article describes the collection process of two sub-datasets comprehending images of Apis mellifera captured inside a commercial beehive (“Frame” sub-dataset, 2057 images) and at the bottom of it (“Bottom” sub-dataset, 1494 images). The data was collected in spring of 2023 (April–May) for the “Frame” sub-dataset, in September 2023 for the “Bottom” sub-dataset. Acquisitions were carried out using an instrumented beehive developed for the purpose of monitoring the colony's health status during long periods of time. The color cameras used were equipped with different lenses accordingly (liquid lenses for the internal one, standard lens of 8 mm focal length) and actuated by an embedded board, alongside red LED strips to illuminate the inside of the beehive. Images captured by the internal camera were mostly out-of-focus, thus a filtering procedure based on the adoption of focus measure operators was developed to keep only the in-focus ones. All images were manually labelled by experts using 2-class bounding boxes annotations representing full visible bees (class “bee”) and blurred or occluded bees according to the sub-dataset (“blurred_bee” or “occluded_bee” class). Annotations are provided in YOLO v8 format. The dataset can be useful for entomology research empowered by computer vision, especially for counting tasks, behavior monitoring, and pest management, since a few occurrences of Varroa destructor mites could be present in the “Frame” sub-dataset.

PurposeDespite the increase in socio-health conditions and, in general, the focus on health worldwide, many diseases still adversely affect the quality of life (QoL), including those causing vision loss. The main purpose of this study was to evaluate the QoL of people with visual impairments through a questionnaire and identify issues concerning everyday life in the urban and extra-urban areas of Turin.Patients and methodsA personalized questionnaire including 25 questions was distributed to 100 enrolled patients. It was designed by integrating the most widely used questionnaires related to the QoL of people with visual impairment with questions concerning the city of Turin. The inclusion criteria were any degree of visual impairment (from mild defect to complete blindness), according to Law n. 138/2001 classification. The exclusion criteria were mental disability and residence in care homes. Finally, statistical analysis was performed. Pearson’s Chi-Square test was used to evaluate the strength of the association between two qualitative variables in different sections of the questionnaire. The results were classified as statistically significant with a p-value of ≤0.05 or borderline (0.05

The management of multiple dilemmas became a norm overnight for Catholic school superintendents navigating the COVID-19 pandemic as they quickly moved to making decisions that would have long-term effects on the system of schools they led. This paper attempts to make sense of the new educational dilemmas that have confronted Catholic school superintendents during these past several months. Utilizing the 2019 framework for navigating and managing professional dilemmas in educational leadership (Spillane & Lowenhaupt), we explore educational dilemmas Catholic school superintendents face during this pandemic. We show in this paper that Catholic school superintendents have drawn on their professional expertise and tailored their responses to these COVID-19 dilemmas in illustrative and instructive ways for considering how the U.S. Catholic school system may better respond as the pandemic continues.

Background:. This study aimed to measure the impact of insurance type on access to pediatric surgical care, clinical and surgical scheduling decisions, provider-driven cancelations, and missed care opportunities (MCOs). We hypothesize that patients with public health insurance experience longer scheduling delays and more frequently canceled surgical appointments compared with patients with private health insurance. Methods:. This retrospective study reviewed the demographics and clinical characteristics of patients who underwent a surgical procedure within the plastic and oral surgery department at our institution in 2019. Propensity score matching and linear regressions were used to estimate the effect of insurance type on hospital scheduling and patient access outcomes while controlling for procedure type and sex. Results:. A total of 457 patients were included in the demographic and clinical characteristics analyses; 354 were included in propensity score matching analyses. No significant differences in the number of days between scheduling and occurrence of initial consultation or number of clinic cancelations were observed between insurance groups (P > 0.05). However, patients with public insurance had a 7.4 times higher hospital MCO rate (95% CI [5.2–9.7]; P < 0.001) and 4.7 times the number of clinic MCOs (P = 0.007). Conclusions:. No significant differences were found between insurance groups in timely access to surgical treatment or cancelations. Patients with public insurance had more MCOs than patients with private insurance. Future research should investigate how to remove barriers that impact access to care for marginalized patients.

Background:. The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to pediatric surgical care. Although surgical capacity has returned to the prepandemic state, barriers to surgical access may still exist for children who are medically underserved. We assessed pediatric plastic and oral and maxillofacial surgical volumes by sociodemographic characteristics before and during the COVID-19 pandemic. Methods:. A 72-month retrospective cohort analysis of 10,681 pediatric plastic and oral and maxillofacial procedures between 2016 and 2021 was conducted. Multivariable logistic regression and interrupted time series analyses were used to analyze surgical volume trends by sociodemographic groups and Child Opportunity Index (COI). Results:. Compared with prepandemic, patients undergoing procedures were more likely to be older than 18 years (P < 0.001) and Hispanic/Latino (adjusted odds ratio 1.38; 95% confidence interval, 1.14–1.68; P < 0.01). Surgical volume trends among patients from the lowest COI levels were lower than where they were estimated to have been if the pandemic did not occur (P = 0.040). Patients who spoke a primary language other than English or Spanish (P = 0.02) and patients with the lowest COI levels (P = 0.04) continued to have unrecovered surgical volumes. Conclusions:. There were differences in the sociodemographic case-mix of patients undergoing plastic and oral and maxillofacial surgical procedures before and during the pandemic, and surgical volumes did not recover at the same rate for all patients. Further research can determine why certain sociodemographic groups and patients with low COI levels had decreased surgical access compared with prepandemic trends, and develop interventions focused on equitable pediatric surgical access.

Vitamin D (VitD) is a vitamin essential for human life. In addition to its well-known activities on phospho-calcium metabolism and bone mineralization, we start to know its actions at extraskeletal levels, due to the presence of its receptor and the 1α-hydroxylase enzyme in many cells of the body, especially on the cells of the immune system. The controversy on the indications for the use of VitD is extremely debated, perhaps a little less so in pediatric age, where in addition to the undoubted musculoskeletal effects there is much evidence on the immune system effects. In this review, we will examine the actions of VitD and the correlation between its deficit and the development of some pathologies.

Winter is the season of main concern for beekeepers since the temperature, humidity, and potential infection from mites and other diseases may lead the colony to death. As a consequence, beekeepers perform invasive checks on the colonies, exposing them to further harm. This paper proposes a novel design of an instrumented beehive involving color cameras placed inside the beehive and at the bottom of it, paving the way for new frontiers in beehive monitoring. The overall acquisition system is described focusing on design choices towards an effective solution for internal, contactless, and stress-free beehive monitoring. To validate our approach, we conducted an experimental campaign in 2023 and analyzed the collected images with YOLOv8 to understand if the proposed solution can be useful for beekeepers and what kind of information can be derived from this kind of monitoring, including the presence of Varroa destructor mites inside the beehive. We experimentally found that the observation point inside the beehive is the most challenging due to the frequent movements of the bees and the difficulties related to obtaining in-focus images. However, from these images, it is possible to find Varroa destructor mites. On the other hand, the observation point at the bottom of the beehive showed great potential for understanding the overall activity of the colony.

Abstract Background Intrahepatic cholestasis of pregnancy (ICP) in the first trimester occurring after ovarian hyperstimulation syndrome (OHSS) is a rare condition and few cases are reported in the literature. Hyperestrogenism may explain this problem in genetically predisposed women. The objective of this article is to report one of these rare cases and offer an overview of the other published cases. Case presentation We report a case of severe OHSS followed by ICP in the first trimester. The patient was admitted to the intensive care unit and was treated according to the guidelines for the management of OHSS. Moreover, the patient also received ursodeoxycholic acid for ICP, which brought to an improvement of her clinical conditions. The pregnancy continued without other complications until the 36th week of gestation, when the patient developed ICP in the third trimester and underwent cesarean section for increased bile acid levels and cardiotocographic (CTG) pathologic alterations. The newborn was a healthy baby weighing 2500 gr. We also reviewed other case reports published by other authors about this clinical condition. We present what is, to our knowledge, the first case of ICP developed in the first trimester of pregnancy after OHSS in which genetic polymorphisms of ABCB4 (MDR3) have been investigated. Conclusions ICP in the first trimester might be induced by elevated serum estrogen levels after OHSS in genetically predisposed women. In these women, it might be useful to check for genetic polymorphisms to know if they have a predisposition for ICP recurrence in the third trimester of pregnancy.

Background:. Tuberous breast deformity is a nondiagnostic, descriptive term for a congenital breast difference that becomes apparent at puberty. Although the negative physical and psychosocial effects of macromastia and breast asymmetry are established, no studies to date have explored the impact of tuberous breasts on health-related quality of life (HRQoL) outcomes using a robust sample size. Methods:. In this cross-sectional study, HRQoL surveys were administered to adolescent women with tuberous breasts and healthy female controls, aged 12–21 years. Surveys included the Short-Form 36v2, Rosenberg Self-Esteem Scale, and Eating Attitudes Test-26. Demographics were compared, and linear regressions were fit to determine the effect of tuberous breast deformity on survey scores, with body mass index (BMI) category as a covariate. Results:. Thirty-four patients with tuberous breasts and 264 controls participated. Patients with tuberous breasts had higher mean BMI than controls (P

The Toffoli gate is the essential ingredient for reversible computing, an energy-efficient classical computational paradigm that evades the energy dissipation resulting from Landauer's principle. In this paper, we analyze different setups to realize a magnetic implementation of the Toffoli gate using three interacting classical spins, each one embodying one of the three bits needed for the Toffoli gate. In our scheme, different control-spin configurations produce an effective field capable of conditionally flipping the target spin. We study what the experimental requirements are for the realization of our scheme, focusing on the degree of local control, the ability to dynamically switch the spin-spin interactions, and the required single-spin anisotropies to make the classical spin stable, showing that these are compatible with current technology.

Carbon monoxide (CO) poisoning during pregnancy is a rare occurrence, associated with high maternal and fetal mortality rates. As CO can cross the placenta, leading to intrauterine hypoxia, CO intoxication can result in neurological sequelae and neurologic complications in fetuses who survive. We report a case of a preterm newborn acutely exposed to CO in-utero and delivered by emergent cesarean section at the 31st week of gestation due to the severe burns suffered by the mother following an indoor boiler explosion. As CO has serious adverse effects both on the mother and fetus, it is important to recognize and treat poisoning in a timely manner. Despite maternal blood CO levels, CO intoxication at critical stage of central nervous system development can lead to hypoxic-ischemic lesions, thus interdisciplinary care and follow up for these patients are mandatory.

Abstract Background Huntington’s disease is a complex neurodegenerative hereditary disease with symptoms in all domains of a person’s functioning. It begins after a healthy start in life and leads through the relentless progression over many years to complete care dependency and finally death. To date, the disease is incurable. The long progressive complex nature of the disease demands multiple disciplines for treatment and care of patient and family. These health care providers need inter- and multidisciplinary collaboration to persevere and be efficacious in this devastating disease trajectory. Discussion The position paper outlines current knowledge and experience alongside the experience and consensus of a recognised group of HD multidisciplinary experts. Additionally the patient’s voice is clear and calls for health care providers with a holistic view on patient and family. Building long-term trust is a cornerstone of the network around the patient. This paper describes a managed care network comprising all the needed professionals and services. In the health care system, the role of a central coordinator or case manager is of key importance but lacks an appropriate guideline. Other disciplines currently without guidelines are general practitioners, nurses, psychologists, and social workers. Guidelines for neurologists, psychiatrists, geneticists, occupational therapists, speech and language therapists, physiotherapists, dieticians, and dentists are being discussed. Apart from all these profession-specific guidelines, distinctive inter- and multidisciplinary collaboration requirements must be met. Conclusions and recommendations The complex nature of Huntington's disease demands multidisciplinary treatment and care endorsed by international regulations and the lay association. Available guidelines as reviewed in this paper should be used, made available by a central body, and updated every 3–5 years. Time needs to be invested in developing missing guidelines but the lack of this ‘proof’ should not prevent the ‘doing’ of good care.