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Marius Nicolae Popescu,1 Mihai Berteanu,1 Cristina Beiu,2 Liliana Gabriela Popa,2 Mara Mădălina Mihai,2 Madalina Gabriela Iliescu,3 Ana Maria Alexandra Stănescu,4 Anca Mirela Ionescu5 1Department of Physical and Rehabilitation Medicine-Elias Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 2Department of Oncologic Dermatology-Elias Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 3Department of Medical Rehabilitation, “Ovidius” University, Constanta, Romania; 4Department of Family Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 5Department of Physical and Rehabilitation Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaCorrespondence: Cristina Beiu, Department of Oncologic Dermatology-Elias Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., Bucharest, 050474, Romania, Tel +40724051346, Email cristina.popescu1990@yahoo.comAbstract: Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of COVID-19, causing major emotional distress among the affected patients. The affected individuals are further exposed to a vast amount of misinformation from the internet and social media and it is important for physicians to be familiar with the phenomenon and provide appropriate counselling to their patients regarding this condition. This article aims to review the evidence-based complementary strategies that can help enhance hair regrowth after post-COVID-19 hair loss, from psychological support and patient education to the importance of optimal nutrition and potential indications and benefits of oral nutritional supplementation, as well as the role of both topical and injectable hair growth stimulators.Keywords: COVID-19, SARS-CoV-2, hair loss, telogen effluvium, hair growth

The development of autonomous, miniaturized pumps remains a problem of much interest, particularly with a view on microfluidics-based devices with increased portability and simplicity of use by nonspecialists. Spatially localized patches of enzyme imprinted on walls have been shown to induce a hydrodynamic flow when supplied with the corresponding enzyme substrate. Thus, such enzymatic micropumps are seen as a possible way of providing the means for nonmechanical, structurally simple, autonomous pumping. Hereby, we extend the current knowledge of enzymatic micropumps in two ways. First, we introduce β-glucosidase as an enzyme that facilitates building micropumps with robust inward flows in the presence of cellobiose (e.g., 2.51 ± 0.56 μm s -1 in the presence of 80 mM cellobiose). Second, we embed β-glucosidase and urease within the same patch and thus obtain a bienzymatic micropump. The latter exhibits the so far missing capability of bidirectional pumping as it produces inward flows in the presence of cellobiose (e.g., 0.95 ± 0.37 μm s -1 in the presence of 20 mM cellobiose) and outward flows in the presence of urea (e.g., 1.46 ± 0.47 μm s -1 in the presence of 20 mM urea). This bienzymatic micropump is a significant step for the development of biocompatible micropumps with versatile, controlled, and on-demand hydrodynamic pumping capabilities.

Many biological microswimmers are capable of chemotaxis, i.e. , they can sense an ambient chemical gradient and adjust their mechanism of motility to move towards or away from the source of the gradient. Synthetic active colloids endowed with chemotactic behavior hold considerable promise for targeted drug delivery and the realization of programmable and reconfigurable materials. Here, we study the chemotactic behavior of a Janus particle, which converts "fuel" molecules, released at an axisymmetric chemical patch located on a planar wall, into "product" molecules at its catalytic cap and moves by self-phoresis induced by the product. The chemotactic behavior is characterized as a function of the interplay between the rates of release (at the patch) and the consumption (at the particle) of fuel, as well as of details of the phoretic response of the particle ( i.e. , its phoretic mobility). Among other results, we find that, under certain conditions, the particle is attracted to a stable "hovering state" in which it aligns its axis normal to the wall and rests (positions itself) at an activity-dependent distance above the center of the patch.

Autoimmune blistering diseases represent a group of chronic severe, disabling, and potentially fatal disorders of the skin and/or mucous membranes, primarily mediated by pathogenic auto-antibodies. Despite their rarity, these diseases are associated with significant morbidity and mortality and profound negative impact on the patient's quality of life and impose a considerable economic burden. Rituximab, an anti-CD-20 monoclonal antibody, represents the first line of therapy for pemphigus, regardless of severity and a valuable off-label therapeutic alternative for subepidermal autoimmune blistering diseases as it ensures high rates of rapid, long-lasting complete remission. Nevertheless, disease recurrence is the rule, all patients requiring maintenance therapy with rituximab eventually. While innate resistance to rituximab in pemphigus patients is exceptional, acquired resistance is frequent and may develop even in patients with initial complete response to rituximab, representing a real challenge for physicians. We discuss the various resistance mechanisms and their complex interplay, as well as the numerous therapeutic alternatives that may be used to circumvent rituximab resistance. As no therapeutic measure is universally efficient, individualization of rituximab treatment regimen and tailored adjuvant therapies in refractory autoimmune blistering diseases are mandatory.

With the increasing use of Botulinum toxin type A (BoNT-A) injections in the masseter muscles for both medical and aesthetic purposes, there is a constant need to continually enhance the efficacy of these treatments and reduce the risk of potential adverse events. This review provides an in-depth analysis of the masseter muscle's anatomical structure and essential landmarks and emphasizes the advantages of ultrasound (US) guidance in improving the precision of BoNT-A injections compared to conventional blind methods. The review is supplemented with comprehensive figures, including graphics, clinical images, and ultrasound visuals, to support the discussion. Potential complications such as paradoxical bulging, inadvertent injections into the risorius muscle or parotid gland, facial paralysis, and the risk of bone resorption are examined. Future research should aim at refining injection techniques and assessing the long-term effects of repeated treatments to ensure optimal patient care and safety.

As life expectancy continues to increase, improving the quality of life (QoL) for older adults becomes an important issue. This study investigated the impact of a two-week intensive rehabilitation program at the Techirghiol Balneal and Rehabilitation Sanatorium on older adults' QoL, focusing on physical and cognitive function. The study employed a comprehensive geriatric assessment to evaluate the progress of 156 patients over 65 from admission to discharge. We used the Scale for Identifying Fall Risk Factors (STRATIFY) scale to assess the risk of falling, the Visual Analogue Scale (VAS) to assess pain levels, and the Functional Independence Measure (FIM) to assess motor and cognitive abilities. The program included multi-parametric evaluations and personalized treatment plans. Statistical analysis of these data led to the following results: The STRATIFY scale showed a significant improvement in patient functionality and a decrease in the risk of falling during hospitalization, with a mean difference in scores between admission and discharge ranging from 0.141 to 0.372, with a p-value of less than 0.001, confirming the clinical significance of this improvement. The VAS showed a significant reduction in pain or symptom intensity, reflected by a mean decrease of -3.141 between admission and discharge. The FIM recorded a mean increase of 1.436 in patients' motor capacity between admission and discharge, reflecting improved adaptation to daily activities, especially in the areas of self-care, sphincter control, transfer, and locomotion. Social participation and health status were positively influenced, demonstrating the benefits of short-term, intensive rehabilitation. The two-week rehabilitation program significantly improved the QoL of older adult patients. These outcomes suggested that active aging strategies could be effectively integrated into medical and institutional care frameworks, highlighting the necessity for policies that support older adults' involvement in economic and social contexts., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of the Techirghiol Balneal and Rehabilitation Sanatorium (TBRS) issued approval 11022/14.07.2023. This was carried out in strict compliance with EU Regulation No. 679/2016, applicable in Romania since 25.05.2018. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This research received external funding from Ovidius University of Constanta. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Vancea et al.)

Introduction: The COVID-19 pandemic has led to approximately 3.5 million cases in Romania, causing systemic inflammation and over 200 symptoms affecting various body systems. This complexity has challenged rehabilitation systems, necessitating personalized plans tailored to each patient's illness stage and impairment level. The ISPRM-developed ClinFIT COVID-19 instrument, aligned with the ICF categories, assists in assessing patients during acute, post-acute, and long-term phases., Objective: This study aimed to evaluate and assess functional impairments in post-COVID-19 patients in Romania, with a secondary goal of generating rehabilitation directions., Methods: Data were collected from patients at two Bucharest medical centers, including those with persistent symptoms post-acute phase. Participants were assessed using the adapted ClinFIT COVID-19 instrument, and descriptive statistics were applied., Conclusions: Findings revealed diverse functional impairments in physical, psychological, and social domains among post-COVID-19 patients, with severe impairments more common in those with long-term COVID-19. Complete impairment in complex movement and paid work was noted, affecting one-third of salaried employees and forcing some to retire. In the acute phase, the most frequent functional impairments were sleep, attention, pain sensation, and exercise tolerance functions. In contrast, the most severely affected functions were exercise tolerance and mobility joint functions. Age did not positively correlate with any of the analyzed functions. In the post-acute phase, sleep, energy, and drive functions remained the most frequently affected functions, while the most severely affected was, by far, the moving around function. In the post-acute period, respiratory and respiratory muscle functions strongly correlated with all tasks related to physical activity. In the long COVID-19 phase, remunerative employment was the most severely affected function, while attention functions remained the most frequently affected, similar to the acute phase. The ClinFIT COVID-19 instrument effectively captured these impairments, underscoring the need for comprehensive rehabilitation strategies.

Introduction Acute insulin resistance (IR) and hyperglycemia are frequently observed during acute myocardial infarction (AMI), significantly influencing both immediate and long-term patient outcomes, irrespective of diabetic status. Neutrophilia and increased neutrophil activity, which are common in these scenarios, have been associated with poorer prognoses, as demonstrated in our recent findings. While it is well established that neutrophils and stress-induced hyperglycemia exacerbate inflammation and hinder recovery, the complex interplay between these factors and their combined impact on AMI prognosis remains inadequately understood. This study aims to investigate the effects of stress hyperglycemia and IR on AMI patients at the onset of the event and to elucidate the relationship between these metabolic disturbances and inflammatory markers, particularly neutrophils. Methods We conducted a longitudinal prospective study on 219 AMI patients at Elias Emergency Hospital in Bucharest, Romania, from April 2021 to September 2022. Patients were included within 24 hours of AMI with ST-segment elevation and excluded if they had acute infections or chronic inflammatory diseases. Blood samples were collected to study inflammatory biomarkers, including neutrophil extracellular traps (NETs), S100A8/A9, interleukin (IL)-1β, IL-18, and IL-6. Diabetic and pre-diabetic statuses were defined using glycated hemoglobin (HbA1c) and medical history (ADA 2019 criteria). To assess glycemic parameters, we employed the glycemia ratio (GR) and the homeostatic model assessment of insulin resistance (HOMA-IR) index, enabling a precise evaluation of stress hyperglycemia, acute IR, and their prognostic implications. Patients were stratified into groups based on GR calculations, categorized as under-average glycemia, normal glycemia, and stress hyperglycemia. Results The majority of patients in the stress hyperglycemia group exhibited an unfavorable prognosis. This group also demonstrated significantly elevated neutrophil counts and neutrophil-to-lymphocyte ratios (NLR). The GR was significantly and positively correlated with inflammation markers, including neutrophil count (Pearson's R = 0.181, P = 0.008) and NLR (Pearson's R = 0.318, P < 0.001), but showed no significant correlation with other evaluated inflammatory markers. Conclusions Our findings suggest that poor outcomes in AMI patients may be associated with stress hyperglycemia, as indicated by GR. AcuteIR, quantified by GR and HOMA-IR, exhibits a strong correlation with neutrophil count and NLR within the first 24 hours of AMI onset. However, no significant correlation was observed with other inflammatory markers, such as IL-1β, IL-18, and IL-6, underscoring the specific interplay between IR and neutrophil activity in this setting., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of Elias Emergency Hospital, Bucharest, Romania issued approval (3349/06.05.2021). Informed consent was obtained from the participants as per the Declaration of Helsinki guidelines. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This work was supported by Romania’s National Recovery and Resilience Plan, European Union - NextGenerationEU"; PNRR-III-C9-2022-I8, CF 93/15.11.2022, financing contract no. 760063/23.05.2023. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Barbu et al.)

The pathogenesis of chronic wounds (CW) involves a multifaceted interplay of biochemical, immunological, hematological, and microbiological interactions. Biofilm development is a significant virulence trait which enhances microbial survival and pathogenicity and has various implications on the development and management of CW. Biofilms induce a prolonged suboptimal inflammation in the wound microenvironment, associated with delayed healing. The composition of wound fluid (WF) adds more complexity to the subject, with proven pro-inflammatory properties and an intricate crosstalk among cytokines, chemokines, microRNAs, proteases, growth factors, and ECM components. One approach to achieve information on the mechanisms of disease progression and therapeutic response is the use of multiple high-throughput 'OMIC' modalities (genomic, proteomic, lipidomic, metabolomic assays), facilitating the discovery of potential biomarkers for wound healing, which may represent a breakthrough in this field and a major help in addressing delayed wound healing. In this review article, we aim to summarize the current progress achieved in host-microbiome crosstalk in the spectrum of CW healing and highlight future innovative strategies to boost the host immune response against infections, focusing on the interaction between pathogens and their hosts (for instance, by harnessing microorganisms like probiotics), which may serve as the prospective advancement of vaccines and treatments against infections.

Ultrasonography is a well-tolerated procedure that aids in the targeted esthetic therapies of special cutaneous regions, as well as in the prevention (vascular mapping, identification of previous filler, and others) and management of potential complications (vascular occlusion, external vascular compression, product misplacement or migration, inflammatory reactions, and others). It has lately been promoted as the first-line imaging tool to address injectables. In this article, we aim to review the evolving role of ultrasonography in cosmetic filler procedures, from the fundamental ultrasound characterization of cosmetic fillers to the ultrasound-enhanced detection and management of cosmetic filler complications, including ultrasound's role in hyaluronidase-guided injections for cosmetic filler dissolution. Furthermore, the paper explores the integral role played by ultrasound in enhancing the precision, efficacy, and safety of additional minimally invasive aesthetic techniques such as mesotherapy, radiofrequency, cryolipolysis, and polydioxanone procedures.

Efficient exploration of space is a paramount motive for active colloids in practical applications. Yet, introducing activity may lead to surface-bound states, hindering efficient space exploration. Here, we show that the interplay between self-motility and fuel-dependent affinity for surfaces affects how efficiently catalytically-active Janus microswimmers explore both liquid-solid and liquid-fluid interfaces decorated with arrays of similarly-sized obstacles. In a regime of constant velocity vs. fuel concentration, we find that microswimmer-obstacle interactions strongly depend on fuel concentration, leading to a counter-intuitive decrease in space exploration efficiency with increased available fuel for all interfaces. Using experiments and theoretical predictions, we attribute this phenomenon to a largely overlooked change in the surface properties of the microswimmers' catalytic cap upon H 2 O 2 exposure. Our findings have implications in the interpretation of experimental studies of catalytically active colloids, as well as in providing new handles to control their dynamics in complex environments.

Background: AMD (age-related macular degeneration) is the main cause of central vision loss in the population over 60 years old. AMD does not affect peripheral vision and complete blindness does not occur, instead, central vision is affected both for distance and for near. The purpose of this study is to evaluate the neovascular form of AMD treatment and compare ocular and systemic effects after intravitreal injection of aflibercept, respectively after bevacizumab when administered in comparable dosages and regimens. We conducted a retrospective, single-center study from June 2021 to December 2022 and enrolled 20 patients with neovascular AMD who had not received any prior treatment for this condition. We randomly assigned them to two groups of 10: group one received aflibercept and group two received bevacizumab as intravitreal injections under aseptic conditions. We excluded 2 patients who did not meet the criteria and ended up with two groups of 9 patients who received monocular treatment. We gave the patients 3 monthly injections of anti-VEGF agent and followed them up at 1 month, 3 months, and 9 months after the treatment. We assessed their visual acuity, intraocular pressure and OCT appearance at each follow-up visit. The primary outcome was visual acuity. All 18 patients included in the study reported an improvement in visual acuity after the intervention. When comparing the two anti-VEGF agents, data revealed the effect of aflibercept was prompter and more long-lasting. Areas of retinal ischemia appeared in both cases. However, they were observed faster in the case of patients treated with aflibercept. Thus, neovascular AMD is a disease that occurs with age, it can be early detected by OCT and slowed the progression to central blindness with intravitreal treatment., Competing Interests: None to declare., (Copyright © 2023, Medical University Publishing House Craiova.)

The vitreous body is an anatomically and biochemically complex structure. Because of its proximity and firm adherence to the retina, researchers have examined the link between these two structures and how their individual pathologies might be connected. Several experimental and clinical studies have already demonstrated the important role of vitreous in the pathogenesis of retinal disorders. This narrative review highlights the role of the vitreous in retinal diseases and the improvements that have been made since the introduction of optical coherence tomography. This leads to a better understanding of vitreoretinal diseases and demonstrates its determinant role in other retinal pathologies, such as diabetic retinopathy or age-related macular degeneration. As we deepen our knowledge of the vitreous's structure, function, and abnormal conditions, we can better link the changes in diseases and identify effective treatments., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Popescu et al.)

One of the fields of medicine in which artificial intelligence techniques have made progress is ophthalmology. Artificial intelligence (A.I.) applications for preventing vision loss in eye illnesses have developed quickly. Artificial intelligence uses computer programs to execute various activities while mimicking human thought. Machine learning techniques are frequently utilized in the field of ophthalmology. Ophthalmology holds great promise for advancing artificial intelligence, thanks to various digital methods like optical coherence tomography (OCT) and visual field testing. Artificial intelligence has been used in ophthalmology to treat eye conditions impairing vision, including macular holes (M.H.), age-related macular degeneration (AMD), diabetic retinopathy, glaucoma, and cataracts. The more common occurrence of these diseases has led to artificial intelligence development. It is important to get annual screenings to detect eye diseases such as glaucoma, diabetic retinopathy, and age-related macular degeneration. These conditions can cause decreased visual acuity, and it is necessary to identify any changes or progression in the disease to receive appropriate treatment. Numerous studies have been conducted based on artificial intelligence using different algorithms to improve and simplify current medical practice and for early detection of eye diseases to prevent vision loss. Abbreviations: AI = artificial intelligence, AMD = age-related macular degeneration, ANN = artificial neural networks, AAO = American Academy of Ophthalmology, CNN = convolutional neural network, DL = deep learning, DVP = deep vascular plexus, FDA = Food and Drug Administration, GCL = ganglion cell layer, IDP = Iowa Detection Program, ML = Machine learning techniques, MH = macular holes, MTANN = massive training of the artificial neural network, NLP = natural language processing methods, OCT = optical coherence tomography, RBS = Radial Basis Function, RNFL = nerve fiber layer, ROP = Retinopathy of Prematurity, SAP = standard automated perimetry, SVP = Superficial vascular plexus, U.S. = United States, VEGF = vascular endothelial growth factor., (#x00A9; The Authors.Romanian Society of Ophthalmology.)

Separation of particles by size, morphology, or material identity is of paramount importance in fields such as filtration or bioanalytics. Up to now separation of particles distinguished solely by surface properties or bulk/surface morphology remains a very challenging process. Here a combination of pressure-driven microfluidic flow and local self-phoresis/osmosis are proposed via the light-induced chemical activity of a photoactive azobenzene-surfactant solution. This process induces a vertical displacement of the sedimented particles, which depends on their size and surface properties . Consequently, different colloidal components experience different regions of the ambient microfluidic shear flow. Accordingly, a simple, versatile method for the separation of such can be achieved by elution times in a sense of particle chromatography. The concepts are illustrated via experimental studies, complemented by theoretical analysis, which include the separation of bulk-porous from bulk-compact colloidal particles and the separation of particles distinguished solely by slight differences in their surface physico-chemical properties., (© 2023 The Authors. Advanced Materials published by Wiley-VCH GmbH.)

Chronic wounds encompass a myriad of lesions, including venous and arterial leg ulcers, diabetic foot ulcers (DFUs), pressure ulcers, non-healing surgical wounds and others. Despite the etiological differences, chronic wounds share several features at a molecular level. The wound bed is a convenient environment for microbial adherence, colonization and infection, with the initiation of a complex host-microbiome interplay. Chronic wound infections with mono- or poly-microbial biofilms are frequent and their management is challenging due to tolerance and resistance to antimicrobial therapy (systemic antibiotic or antifungal therapy or antiseptic topicals) and to the host's immune defense mechanisms. The ideal dressing should maintain moisture, allow water and gas permeability, absorb wound exudates, protect against bacteria and other infectious agents, be biocompatible, be non-allergenic, be non-toxic and biodegradable, be easy to use and remove and, last but not least, it should be cost-efficient. Although many wound dressings possess intrinsic antimicrobial properties acting as a barrier to pathogen invasion, adding anti-infectious targeted agents to the wound dressing may increase their efficiency. Antimicrobial biomaterials may represent a potential substitute for systemic treatment of chronic wound infections. In this review, we aim to describe the available types of antimicrobial biomaterials for chronic wound care and discuss the host response and the spectrum of pathophysiologic changes resulting from the contact between biomaterials and host tissues.

Intermittent oxygen therapy (IHT), initially used in the hypoxic administration variant, has been shown to be effective in various pathologies studied, from cardiopulmonary to vascular and metabolic pathologies and more. IHT used to prevent and treat various diseases has thus gained more and more attention as the years have passed. The mechanisms underlying the beneficial effects have been investigated at multiple biological levels, from systemic physiological reactions to genomic regulation. In the last decade, a new method of intermittent oxygen therapy has been developed that combines hypoxic and hyperoxic periods. They can be applied both at rest and during physical exercise, hence the specific indications in sports medicine. It has been hypothesized that replacing normoxia with moderate hyperoxia may increase the adaptive response to the intermittent hypoxic stimulus by upregulating reactive oxygen species and hypoxia-inducible genes. This systematic literature review is based on the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis"-"PRISMA"-methodology, the widely internationally accepted method.

Catalytic micromotors can be used to detect molecules of interest in several ways. The straightforward approach is to use such motors as sensors of their "fuel" (i.e., of the species consumed for self-propulsion). Another way is in the detection of species which are not fuel but still modulate the catalytic processes facilitating self-propulsion. Both of these require analysis of the motion of the micromotors because the speed (or the diffusion coefficient) of the micromotors is the analytical signal. Alternatively, catalytic micromotors can be used as the means to enhance mass transport, and thus increase the probability of specific recognition events in the sample. This latter approach is based on "classic" (e.g., electrochemical) analytical signals and does not require an analysis of the motion of the micromotors. Together with a discussion of the current limitations faced by sensing concepts based on the speed (or diffusion coefficient) of catalytic micromotors, we review the findings of the studies devoted to the analytical performances of catalytic micromotor sensors. We conclude that the qualitative (rather than quantitative) analysis of small samples, in resource poor environments, is the most promising niche for the catalytic micromotors in analytical chemistry.

Purpose: The study wants to evaluate the incidence, the clinical evolution, and treatment of common peroneal nerve (CPN) palsy after primary total hip arthroplasty., Methods: Our clinical prospective study was made between January 2016 and December 2020. The study group comprised 1240 total hip replacements over a period of five years. Six cases were diagnosed with CPN palsy (0.48%). Five were women and one man, aged from 52 to 71 years old. The common peroneal nerve lesion was diagnosed clinically and by electromyography., Results: The follow-up period was at least 24 months post-operatively. In all six cases, there was a complete common peroneal nerve palsy, documented by electromyography. The poorest results were obtained in the older patients and those who had the highest body mass index, which at two years post-operatively achieved only a partial sensory rehabilitation, with complete motor deficit. All patients can walk unassisted, without support, with one case having complete rehabilitation achieved 18 months postoperatively and three with partial rehabilitation., Conclusion: CPN palsy after primary THA is a very serious complication with poor functional outcome. There is no consensus regarding the treatment. The age and the intensity of the rehabilitation program are the only significant factors for the medical rehabilitation after this debilitating post-operative complication., (© 2022. The Author(s) under exclusive licence to SICOT aisbl.)

Introduction: The complexity of spasticity requires a continuous effort in terms of more adapted treatments for patients, and accurate management. Through this systematic review, we aimed to evaluate and compare the effectiveness of extracorporeal shock wave therapy (ESWT) with botulinum toxin type A (BoNT-A) on reducing spasticity both in children and adults., Evidence Acquisition: An electronic search of PubMed/Medline, Scopus, Ovid Medline(R), and search engine of Google Scholar was performed. Publications ranging from January 2010 to January 2021, published in the English language and available as full-texts were eligible for inclusion and they were searched without any country restriction. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines., Evidence Synthesis: A total of five studies were included in the present systematic review. Screening of the references, data extraction, and risk of bias assessment were performed by two independent authors. The methodological quality and risk of bias were conducted using the Physiotherapy Evidence Database (PEDro) Scale. The primary outcome was spasticity grade assessed by the Modified Ashworth Scale (MAS) and/or Modified Tardieu Scale (MTS). Additional outcomes were active range of motion (AROM), passive range of motion (PROM), upper extremity Fugl-Meyer Assessment (UE-FMA), pain intensity assessed through Visual Analogue Scale (VAS), spasm frequency scale (SFS), sonographic parameters, between-group comparison, and treatment response rate., Conclusions: A beneficial effect on spasticity was found for both treatments: evidence showed that ESWT and BoNT-A can ameliorate spasticity considering parameters such as MAS, MTS, AROM, PROM, UE-FMA, VAS and SFS in post-stroke, multiple sclerosis, and cerebral palsy patients. Further research is required to strengthen the evidence, and more suitable study protocols are highly needed.

Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest within the scientific communities worldwide, with new therapeutic targets being constantly identified and tested. Despite the numerous topical and systemic medications available for the treatment of psoriasis, alternative therapies are still needed for the optimal management of some patients who present with localized, resistant lesions. Novel insights into the contribution of cutaneous neurogenic inflammation in the pathogenesis of psoriasis have yielded exciting new potential roles of nerve-targeting treatments, namely botulinum toxin type A (BoNT-A), for the management of this disease. This paper aims to review the existing literature on knowledge regarding the potential role of BoNT-A in psoriasis treatment, with a focus on its ability to interfere with the immunopathogenetic aspects of psoriatic disease. Furthermore, in our paper, we are also including the first report of psoriatic lesions remission following local BoNT-A injections that were administered for treating upper limb spasticity, in a patient that concomitantly suffered from psoriasis and post-stroke spasticity.

In time, osteoarthritis (OA) generates the misalignment of the affected joint structures. However, due to the nature of bipedal gait, OA in the lower limb can also cause pathological gait patterns, which can generate instability and falls, with great consequence, especially in the aged population. With goniometry used to evaluate the range of motion (ROM) of joints, we wanted to evaluate how gender impacts gait dynamics in OA patients. For this study, we have compared 106 OA patients (74 females and 32 males) to age matched controls. All participants had their right leg as dominant. Video recording of normal gait was analyzed with a digital goniometry tool phone application, and the knee's ROM was measured in midstance and midswing moment of the gait. During midstance, significant extension and flexion of the knee excursion have been observed in both males and females. During midswing, knee OA presents more differences, whereas subjects with hip and knee OA present changes on the dominant knee. Midstance changes suggest that the knee's joint degenerative changes, such as synovitis, can be linked to hip OA secondary changes. Midswing changes in lower limb OA suggest a connection to the activities of daily life. Gender differences generated by OA must furthermore be studied in both lower limbs so that the best therapeutic approach can be chosen.

Lately, easier and shorter tests have been used in the functional evaluation of cardiac patients. Among these, walking speed (WS) and Timed Up and Go (TUG) tests are associated with all-cause mortality, mainly cardiovascular and the rate of re-hospitalization, especially in the elderly population. We prospectively analyzed a group of 38 patients admitted to the Cardiology Clinic from Elias Hospital, Romania, with chronic coronary syndrome (CCS) (n=22) and STEMI (n=16). We assessed the patients immediately after admission and before discharge with G-WALK between the 1 st and 30 th of September 2019. Our study group had a mean age of 62.7±12.1 years. Patients with a low WS were older (69.90±12.84 vs. 59.90±10.32 years, p=0.02) and had a lower serum hemoglobin (12.38±1.20 vs. 13.72±2.07 g/dl, p=0.02). The WS significantly improved during hospitalization (p=0.03) after optimal treatment. The TUG test performed at the time of admission had a longer duration in patients with heart failure (14.05 vs. 10.80 sec, p=0.02) and was influenced by patients' age (r=0.567, p=0.02), serum creatinine (r=0.409, p=0.03) and dilation of right heart chambers (r=0.399, p=0.03). WS and TUG tests can be used in patients with CCS and STEMI, and are mainly influenced by age, thus having a greater value among the elderly., (©2022 JOURNAL of MEDICINE and LIFE.)

Platelet-rich plasma (PRP) has emerged as a significant regenerative therapy used alone or combined mainly with stem cells, autologous fat grafts, hyaluronic acid, and biomaterials in a variety of medical fields, especially in hair regrowth, wound healing, and sports and rehabilitation medicine. However, the results obtained with this biologic therapy are heterogeneous and conflicting. The observed disparities in the effectiveness of PRP therapies may be due to a lack of standardization in blood processing and preparation. This article is aimed at reviewing the main biological parameters that need to be documented for a thorough reporting of quantitative and qualitative characteristics of the PRP injected, to allow a comparison between the quality of samples and the clinically obtained results and advance the efforts towards treatment standardization., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Marius Nicolae Popescu et al.)

Electrochemotherapy (ECT) is an effective bioelectrochemical procedure that uses controlled electrical pulses to facilitate the increase of intracellular concentration of certain substances (electropermeabilization/ reversible electroporation). ECT using antitumor drugs such as bleomycin and cisplatin is a minimally invasive targeted therapy that can be used as an alternative for oncologic patients not eligible for surgery or other standard therapies. Even though ECT is mainly applied as palliative care for metastases, it may also be used for primary tumors that are unresectable due to size and location. Skin neoplasms are the main clinical indication of ECT, the procedure reporting good curative results and high efficiency across all tumor types, including melanoma. In daily practice, there are many cases in which the patient's quality of life can be significantly improved by a safe procedure such as ECT. Its popularity must be increased because it has a safe profile and minor local adverse reactions. The method can be used by dermatologists, oncologists, and surgeons. The aim of this paper is to review recent literature concerning electrochemotherapy and other clinical applications of electroporation for the targeted therapy of metastatic melanoma.

Chemically active Janus particles sustain non-equilibrium spatial variations in the chemical composition of the suspending solution; these induce hydrodynamic flow and (self-)motility of the particles. Direct mapping of these fields has so far proven to be too challenging. Therefore, indirect methods are needed, e.g., deconvolving the response of "tracer" particles to the activity-induced fields. Here, we study experimentally the response of silica particles, sedimented at a wall, to active Pt/silica Janus particles. The latter are either immobilized at the wall, with the symmetry axis perpendicular or parallel to the wall, or motile. The experiments reveal complex effective interactions that are dependent on the configuration and on the state of motion of the active particle. Within the framework of a coarse-grained model, the behavior of tracers near an immobilized Janus particle can be captured qualitatively once activity-induced osmotic flows on the wall are considered., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)

We study how crowding affects the activity and catalysis-enhanced diffusion of enzymes and passive tracers by employing a fluctuating-dumbbell model of conformation-changing enzymes. Our Brownian dynamics simulations reveal that the diffusion of enzymes depends qualitatively on the type of crowding. If only enzymes are present in the system, the catalysis-induced enhancement of the enzyme diffusion - somewhat counter-intuitively - increases with crowding, while it decreases if crowding is due to inert particles. For the tracers, the diffusion enhancement increases with increasing the enzyme concentration. We also show how the enzyme activity is reduced by crowding and propose a simple expression to describe this reduction. Our results highlight subtle effects at play concerning enzymatic activity and macromolecular transport in crowded systems, such as, e.g., the interior of living cells.

Lipofuscin is an intracellular aging pigment with fluorescent properties, found in retinal pigment epithelium cells of the eye. It is the main fluorophore used in fundus autofluorescence imaging techniques to diagnose, describe, and follow retinal disease. Lipofuscin forms by incomplete lysosomal degradation of cellular material previously subjected to oxidative changes. A2E is the most studied fluorescent component of lipofuscin, but most of its composition remains unknown. Lipofuscin is photoreactive, generating reactive oxygen species, which may explain its role in disease development. Further knowledge is needed concerning lipofuscin genesis, biochemical composition, fluorescent compounds, and role in pathogenesis of retinal degenerative disease., (© The Authors.Romanian Society of Ophthalmology.)

For monolayers of chemically active particles at a fluid interface, collective dynamics is predicted to arise owing to activity-induced Marangoni flow even if the particles are not self-propelled. Here, we test this prediction by employing a monolayer of spherically symmetric active [Formula: see text] particles located at an oil-water interface with or without addition of a nonionic surfactant. Due to the spherical symmetry, an individual particle does not self-propel. However, the gradients produced by the photochemical fuel degradation give rise to long-ranged Marangoni flows. For the case in which surfactant is added to the system, we indeed observe the emergence of collective motion, with dynamics dependent on the particle coverage of the monolayer. The experimental observations are discussed within the framework of a simple theoretical mean-field model.

Background/aim: Lumbar radiculopathy refers to the disruption of one or more lumbosacral nerve root functions, usually causing radiating pain and functional impairments., Patients and Methods: We aimed to analyze the role of repetitive peripheral magnetic stimulation (rPMS) alone or in association with physiokinesiotherapy (PKT) in treating lumbar radiculopathy. A total of 41 patients diagnosed with lumbar radiculopathy were randomly allocated to the rPMS group and the rPMS plus PKT group. Subjects were then administered a total of 10 treatment sessions., Results: A statistically significant improvement was highlighted in both groups in terms of pain score, and electromyography (EMG) analysis depicted a far superior functional recovery in the rPMS plus PKT group., Conclusion: rPMS can constitute an effective treatment for subjects with lumbar radiculopathy and its association with a complex physical rehabilitation program could improve the outcome in these patients., (Copyright© 2021, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Current models of phoretic transport rely on molecular forces creating a "diffuse" particle-fluid interface. We investigate theoretically an alternative mechanism, in which a diffuse interface emerges solely due to a nonvanishing correlation length of the surrounding solution. This mechanism can drive self-motility of a chemically active particle. Numerical estimates indicate that the velocity can reach micrometers per second. The predicted phenomenology includes a bilinear dependence of the velocity on the activity and a possible double velocity reversal upon varying the correlation length.

The COVID-19 pandemic had a great negative impact on nursing homes, with massive outbreaks being reported in care facilities all over the world, affecting not only the residents but also the care workers and visitors. Due to their advanced age and numerous underlying diseases, the inhabitants of long-term care facilities represent a vulnerable population that should benefit from additional protective measures against contamination. Recently, multiple countries such as France, Spain, Belgium, Canada, and the United States of America reported that an important fraction from the total number of deaths due to the SARS-CoV-2 infection emerged from nursing homes. The scope of this paper was to present the latest data regarding the COVID-19 spread in care homes worldwide, identifying causes and possible solutions that would limit the outbreaks in this overlooked category of population. It is the authors' hope that raising awareness on this matter would encourage more studies to be conducted, considering the fact that there is little information available on the impact of the SARS-CoV-2 pandemic on nursing homes. Establishing national databases that would register all nursing home residents and their health status would be of great help in the future not only for managing the ongoing pandemic but also for assessing the level of care that is needed in this particularly fragile setting., Competing Interests: The author declares that there is no conflict of interest regarding the publication of this paper., (Copyright © 2020 Dana-Claudia Thompson et al.)

When asymmetric Janus micromotors are immobilized on a surface, they act as chemically powered micropumps, turning chemical energy from the fluid into a bulk flow. However, such pumps have previously produced only localized recirculating flows, which cannot be used to pump fluid in one direction. Here, we demonstrate that an array of three-dimensional, photochemically active Au/TiO 2 Janus pillars can pump water. Upon UV illumination, a water-splitting reaction rapidly creates a directional bulk flow above the active surface. By lining a 2D microchannel with such active surfaces, various flow profiles are created within the channels. Analytical and numerical models of a channel with active surfaces predict flow profiles that agree very well with the experimental results. The light-driven active surfaces provide a way to wirelessly pump fluids at small scales and could be used for real-time, localized flow control in complex microfluidic networks.

Chemically active particles achieve motility without external forces and torques ("self-propulsion") due to catalytic chemical reactions at their surfaces, which change the chemical composition of the surrounding solution (called "chemical field") and induce hydrodynamic flow of the solution. By coupling the distortions of these fields back to its motion, a chemically active particle experiences an effective interaction with confining surfaces. This coupling can lead to a rich behavior, such as the occurrence of wall-bound steady states of "sliding". Most active particles are density mismatched with the solution and, thus, tend to sediment. Moreover, the often employed Janus spheres, which consist of an inert core material decorated with a cap-like, thin layer of a catalyst, are gyrotactic (i.e., "bottom-heavy"). Whether or not they may exhibit sliding states at horizontal walls depends on the interplay between the active motion and the gravity-driven sedimentation and alignment, such as the gyrotactic tendency to align the axis along the gravity direction being overcome by a competing, activity-driven alignment with a different orientation. It is therefore important to understand and quantify the influence of these gravity-induced effects on the behavior of model chemically active particles moving in the vicinity of walls. For model gyrotactic, self-phoretic Janus particles, here we study theoretically the occurrence of sliding states at horizontal planar walls that are either below ("floor") or above ("ceiling") the particle. We construct "state diagrams" characterizing the occurrence of such states as a function of the sedimentation velocity and of the gyrotactic response of the particle, as well as of the phoretic mobility of the particle. We show that in certain cases sliding states may emerge simultaneously at both the ceiling and the floor, while the larger part of the experimentally relevant parameter space corresponds to particles that would exhibit sliding states only either at the floor or at the ceiling-or there are no sliding states at all. These predictions are critically compared with the results of previous experimental studies, as well as with our dedicated experiments carried out with Pt-coated, polystyrene-core, or silica-core Janus spheres immersed in aqueous hydrogen peroxide solutions.

Chemically active particles suspended in a liquid solution can achieve self-motility by locally changing the chemical composition of the solution via catalytic reactions at their surfaces. They operate intrinsically out of equilibrium, continuously extracting free energy from the environment to power the dissipative self-motility. The effective interactions involving active particles are, in general, nonreciprocal and anisotropic, even if the particles have simple shapes (e.g., Janus spheres). Accordingly, for chemically active particles a very rich behavior of collective motion and self-assembly may be expected to emerge, including phenomena such as microphase separation in the form of kinetically stable, finite-sized aggregates. Here, I succinctly review a number of recent experimental studies that demonstrate the self-assembly of structures, involving chemically active Janus particles, which exhibit various patterns of motion. These examples illustrate concepts such as "motors made out of motors" (as suggestively named by Fischer [Fischer, P. Nat. Phys . 2018 , 14 , 1072]). The dynamics of assembly and structure formation observed in these systems can provide benchmark, in-depth testing of the current understanding of motion and effective interactions produced by chemical activity. Finally, one notes that these significant achievements are likely just the beginning of the field. Recently reported particles endowed with time-dependent chemical activity or switchable reaction mechanisms open the way for exciting developments, such as periodic reshaping of self-assembled structures based on man-made internal clocks.

Symmetry breaking and the emergence of self-organized patterns is the hallmark of complexity. Here, we demonstrate that a sessile drop, containing titania powder particles with negligible self-propulsion, exhibits a transition to collective motion leading to self-organized flow patterns. This phenomenology emerges through a novel mechanism involving the interplay between the chemical activity of the photocatalytic particles, which induces Marangoni stresses at the liquid-liquid interface, and the geometrical confinement provided by the drop. The response of the interface to the chemical activity of the particles is the source of a significantly amplified hydrodynamic flow within the drop, which moves the particles. Furthermore, in ensembles of such active drops long-ranged ordering of the flow patterns within the drops is observed. We show that the ordering is dictated by a chemical communication between drops, i.e., an alignment of the flow patterns is induced by the gradients of the chemicals emanating from the active particles, rather than by hydrodynamic interactions.

We study, by means of an exact analytical solution, the motion of a spheroidal, axisymmetric squirmer in an unbounded fluid, as well as the low Reynolds number hydrodynamic flow associated to it. In contrast to the case of a spherical squirmer-for which, e.g. the velocity of the squirmer and the magnitude of the stresslet associated with the flow induced by the squirmer are respectively determined by the amplitudes of the first two slip ('squirming') modes-for the spheroidal squirmer each squirming mode either contributes to the velocity, or contributes to the stresslet. The results are straightforwardly extended to the self-phoresis of axisymmetric, spheroidal, chemically active particles in the case when the phoretic slip approximation holds.

Coronavirus disease 2019 (COVID-19) continues to spread globally, outpacing the capacity and resources of health systems worldwide. A therapeutic vaccine is not yet on the rise, and preventive measures are the current approach to restraint the transmission of cases. As the virus is highly contagious via respiratory route (droplets from infected persons, widely spread by coughing or sneezing) and via contact with contaminated surfaces, community transmission and spread can be decreased through the practice of regular and diligent hand hygiene. Frequent hand washing implies a prolonged exposure to water and other chemical or physical agents and may induce several pathophysiologic changes, such as epidermal barrier disruption, impairment of keratinocytes, the subsequent release of proinflammatory cytokines, activation of the skin immune system, and delayed-type hypersensitivity reactions. Adverse dermatologic effects, such as excessive skin dryness or even contact dermatitis (particularly the irritant subtype and, to a lesser extent, the allergic subtype), can occur, especially in individuals with a history of atopic dermatitis. These skin conditions are perfectly manageable, and applying a moisturizer immediately after washing hands or after using a portable hand sanitizer is the cornerstone in preventing the development of eczematous changes in the hands. In the current global context, the potential occurrence of these dermatological adverse events should in no way cause people to deviate from strict hand hygiene rules., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Beiu et al.)

Recent experiments have reported that diffusion of enzymes can be enhanced in the presence of their substrates. Using a fluctuating dumbbell model of enzymes, it has been argued that such an enhancement can be rationalized by the reduction of the enzyme size and by the suppression of the hydrodynamically coupled conformational fluctuations, induced by binding a substrate or an inhibitor to the enzyme [Nano Lett. 2017, 17, 4415]. Herein, we critically examine these expectations via extensive Brownian dynamics simulations of a similar model. The numerical results show that neither of the two mechanisms can cause an enhancement comparable to that reported experimentally, unless very large, physically counter-intuitive, enzyme deformations are invoked.