Coronavirus disease 2019 (COVID-19), can manifest with ocular symptoms. These symptoms can be divided into isolated events attributed to COVID-19 and those occurring in multisystem inflammatory syndrome in children (MIS-C), a newly diagnosed disease entity associated with COVID-19 infection. Currently, the literature lacks specific guidelines and treatment regimens for COVID-19 ocular symptoms, especially in children.

Stress during a pandemic increased the risk of alcohol consumption, which may require pharmacological management. The characteristics of emergency calls for alcohol-related issues for patients pharmacologically treated, admitted to, or not admitted to the emergency department (ED) were analyzed. An observational single-center retrospective study was conducted from January 1, 2018 to December 31, 2021, and divided into 2-year periods (2018–2019 and 2020–2021). This study focused on calls to one of the EDs of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ES) who were either admitted or not admitted, due to their refusal. A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, a reduced rate of pharmacological treatment for calls coded green (non-critical), and an increase in calls coded yellow (fairly critical) and red (very critical) were recorded. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.

Hydrogen has a leading role in accomplishing a net zero green-house gas emission future. Today’s challenge is producing green hydrogen to cover the fuel demand of transportation and industry, to gain independence from fossil fuels. This review’s goal is to demonstrate critically the existing methods of biomass treatment and assess their ability to scale up. Biomass is an excellent hydrogen carrier and biomass-derived processes are the main target for hydrogen production as it is an innovative pathway to green hydrogen production. Comparing the existing processes, thermochemical treatment is found to be far more evolved than biological or electrochemical treatment especially with regard to scaling prospects.

Abstract: (1) Background and rationale: To validate the reported therapeutic coverage, a lymphatic filariasis post-mass drug administration (MDA) campaign survey was conducted in the Lukonga health zone from 10 June to 15 July 2023. (2) Materials and methods: This was a descriptive, cross-sectional study conducted at the community level in 30 villages in the Lukonga health zone from 10 June to 15 July 2023. The study population included all individuals from the visited com-munities. The study variables included age, sex, drug use (ivermectin + albendazole), adverse events, and adherence to MDA guidelines for supervised drug use. Questionnaires were administered on Android phones using the SurveyCTO platform. Stata version 17 was used for data analysis. (3) Results: Of the 1092 respondents, 54.8% were female and one-third were between the ages of 5 and 14. Two-thirds of the households surveyed, or 64%, had more than six people living in them, and 1031 individuals, or 94%, reported being present during the community mass drug distribution. Notably, 678 individuals, or 66%, reported taking the drugs offered, and 66.4% of those who took the drugs reported doing so in the presence of drug distributors. Thus, the survey coverage was 65.7% [95% CI: 62.9–68.7]. The results of this study show that the survey coverage was above the 65% threshold recommended by the WHO but below the 82.3% reported by the Lukonga health zone. The main reason for non-compliance was a fear of ivermectin-related side effects (47%). Supervised or directly observed treatment was not adhered to (66.4%). (4) Discussion and conclusions: Key challenges to further increase treatment coverage include assessing data quality, building capacity, motivating drug distributors, improving data reporting tools, proper recording by drug distributors, and ac-curate reporting on non-residents who take the drugs during the MDA. In addition, harmonization of the numerator for calculating drug coverage in the health zone is critical.

Background: On Dec 19, 2019, the public health department of China reported that an outbreak of pneumonia was caused by a novel Coronavirus. The virulence of the new virus COVID-19 was much greater than either the SARs and MERSs viruses and on March 11, 2020, the World Health Department (WHO) declared a worldwide pandemic. Understanding the pathophysiology of virulence of the SARS-COV-2 virus is absolutely necessary for understanding the transmission, virulence factors, reduce risk factors, clinical presentation, predict outcomes of the disease and provide guidance for any current or future treatment protocols. Methodology: A comprehensive PubMed search was performed during December 20, 2019 and April 03, 2020, utilizing the words: Wuhan Virus, COVID-19, SARs coronavirus, ACE2, S-protein, virulence, clinical presentation, epidemiology, genome, treatment, structure, MERs, pathogenesis and/or pathology alone and in combination with other terms. Each paper was evaluated by three content experts for quality, reproducibility, credibility and reputation of the journal. Results: The SARS-COV-2 virus is much more virulent than either the SAR’s or MER’s virus and its ability to cause serious disease inversely corresponds to the person’s ability to produce T-cells which declines linearly with age. The ACE2 receptor binding site does not vary among different ethnic groups but do in ACE-2 expression levels. This variance in expression level may explain for different infectivity rates among men and women and predict and explain different susceptibilities to infection by different ethnic groups. Furthermore, by understanding the underlying pathophysiology one can explain and provide guidance to the clinical effectiveness of any treatment. Conclusions: The underlying pathophysiology of COVID-19 explains not only the virulence, and clinical presentation, but, explains at a molecular level the comorbidity risk factors such as hypertension, sex, and age. Ethnic and anatomic expression patterns of ACE-2 and associated pathophysiology suggests that Native Americans and Asians may be particularly susceptible to this disease.

Background The spread of COVID-19 continues, the mutation of SARS-COV-2 is still difficult to control, and the need for antiviral drugs to treat COVID-19 remains urgent. The use of arbidol in the treatment of COVID-19 is limited and controversial. Methods To clarify the efficacy of arbidol on COVID-19, we collected 25 cases and 178 related studies. We analyzed the treatment information of arbidol based on the obtained cases, expanded the scope of the study, and collected current studies on the treatment of COVID-19 in various databases for in-depth analysis. Results History analysis showed that arbidol was effective (76% cure rate) compared with other drugs. However, compared with other antiviral drugs or standard therapy, the arbidol group had no significant advantage in reducing the time to negative virus transformation, length of hospital stays, or improvement in CT (MD=0.22, 95%CI -0.29-0.73; MD = 0.61, 95% CI 1.46 to 2.67; RR=1.15, 95%CI 0.88-1.50); Analysis of adverse events showed no significant difference between the arbidol group and the other groups (RR=0.82, 95%CI 0.25-2.71). Conclusion Our study showed that arbidol had no significant effect on COVID-19, but showed a slight advantage in CT improvement and adverse events. Our study objectively evaluated the efficacy of arbidol in the treatment of COVID-19 and provided some guidance for arbidol in the treatment of COVID-19.

Direct-acting antivirals (DAAs) revolutionized therapeutics of chronic hepatitis C. The emergence and transmission of HCV variants with resistance-associated substitutions (RASs) can undermine HCV treatment. This study aimed to assess the prevalence and temporal trends of RASs in HCV with a particular focus on the clinically-relevant RASs (cr-RASs). Near-complete HCV GenBank sequences archived in the Los Alamos HCV Database were analyzed. The study period was divided into two phases; before 2011 and 2011 onwards. Identification of RASs across three DAA classes; NS3, NS5A, and NS5B inhibitors was based on the 2020 EASL guidelines. The AASLD-IDSA recommendations were used to identify cr-RASs for three HCV genotypes/subtypes (1a, 1b, and 3) for four DAA regimens; ledipasvir/sofosbuvir; elbasvir/grazoprevir; sofosbuvir/velpatasvir; and glecaprevir/pibrentasvir. The final HCV dataset comprised 3443 sequences and the prevalences of RASs were 50.4%, 60.2%, and 25.3% in NS3, NS5A, and NS5B, respectively. In subtype 1a, resistance to ledipasvir/sofosbuvir was 32.8%, while resistance to elbasvir/grazoprevir was 33.0%. For genotype 3, resistance to sofosbuvir/velpatasvir and glecaprevir/pibrentasvir was 4.2% and 24.9%, respectively. Significant increase in cr-RASs was observed across the two study phases as follows: for ledipasvir/sofosbuvir in subtype 1a, cr-RASs increased from 30.2% to 35.8% (p=0.019); for elbasvir/grazoprevir in subtype 1a, cr-RASs increased from 30.4% to 36.1% (p=0.018); In subtype 1b, neither ledipasvir/sofosbuvir nor elbasvir/grazoprevir showed any cr-RASs in the first phase, but both were present at a prevalence of 6.5% in the second phase (p<0.001); for sofosbuvir/velpatasvir in genotype 3, cr-RASs increased from 0.9% to 5.2% (p=0.006); and for glecaprevir/pibrentasvir, cr-RASs increased from 12.0% to 29.1% (p<0.001). Rising prevalence of HCV RASs and cr-RASs was discernible. This highlights the necessity for ongoing surveillance and adaptation of novel therapeutics to manage resistance effectively. Updating of the clinical guidelines and treatment regimens are recommended to counteract the evolving resistance to DAAs.

We present the AI-discovered aetiology of COVID-19, based on a precise disease model of COVID-19 built under five weeks that best matches the epidemiological characteristics, transmission dynamics, clinical features, and biological properties of COVID-19 and consistently explains the rapidly expanding COVID-19 literature. We present that SARS-CoV-2 implements a unique unbiased survival strategy of balancing viral replication with viral spread by increasing its dependence on (i) ACE2-expressing cells for viral entry and spread, (ii) PI3K signaling in ACE2-expressing cells for viral replication and egress, and (iii) viral-non-structural-and-accessory-protein-dependent immunomodulation to balance viral spread and viral replication. We further propose the combination of irinotecan (an in-market topoisomerase I inhibitor) and etoposide (an in-market topoisomerase IIinhibitor) could potentially be an exceptionally effective treatment to protect critically ill patients from death caused by COVID-19-specific cytokine storms triggered by sepsis, ARDS, and other fatal comorbidities.

BACKGROUND: From March to April 2020, Spain was the center of the SARS-CoV-2 pandemic, particularly Madrid with approximately 30% of the cases in Spain. The aim of this study is to report the suspected serious adverse drug reactions (SADRs) in COVID-19 patients versus non-COVID-19 patients detected by the prospective pharmacovigilance program based on automatic laboratory signals (ALSs) in the hospital (PPLSH) during that period. We also compared the results with the suspected SADRs detected during the same period for 2019. METHODS: All ALSs that reflected potential SADRs (including neutropenia, pancytopenia, thrombocytopenia, anemia, eosinophilia, leukocytes in cerebrospinal fluid, hepatitis, pancreatitis, acute kidney injury, rhabdomyolysis and hyponatremia were prospectively monitored in hospitalized patients during the study periods. We analyzed the incidence and the distribution of causative drugs for the COVID-19 patients. RESULTS: The incidence rate of SADRs detected in the COVID-19 patients was 760.63 (95% CI 707.89–816.01) per 10,000 patients, 4.75-fold higher than the SADR rate for non-COVID-19 patients (160.15 per 10,000 patients,95% CI 137.09–186.80), and 5.84-fold higher than the SADR rate detected for the same period in 2019 (130.19 per 10,000 patients, 95% CI 109.53–154.36). The most frequently related drugs were tocilizumab (59.84%), dexketoprofen (13.93%), azithromycin (8.43%), lopinavir-ritonavir (7.35%), dexamethasone (7.62%), and chloroquine/hydroxychloroquine (6.91%). CONCLUSIONS: The incidence rate of SADRs detected by the PPSLH in patients with COVID-19 was 4.75-fold higher than that of the non-COVID-19 patients. Caution is recommended when using medications for COVID-19 patients, especially drugs that are hepatotoxic, myotoxic, and those that induce thromboembolic events.

Globally, an approximate of 380,000 patients succumbed to death due to the pandemic COVID-19 which also infected more than six million people since December 2019. Not sparing anyone, COVID-19 infections are widely reported among healthcare professionals, sanitation workers and researchers too while global leaders and various governments are providing their best in defending their citizens against this airborne and contact spread virus. In order to contain the virus and protect millions of lives from this deadly coronavirus, there is a need to have a combination of advanced engineering technology and medical facilities. Application of applied science, engineering and technology diffuse almost every aspect of contemporary living. Grasping the fundamentals to determine humanity's most imperative and forthcoming challenges is essential. Artificial Intelligence, the technology that learns, adapts and reciprocates the actions according to the situations, finds optimum position in the fight against corona virus and acts as a powerful tool against this pandemic. In this research article, the authors discusses how Artificial Intelligence (AI) can be leveraged to fight the deadly virus. The research paper further discusses the efficient utilization of AI across the globe to help in testing, treating and serving the population in these hard times. This manuscript focuses on the potential impact of the process in which AI can be implemented to prevent, test and treat.

Since the worldwide spread of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), treating taste and saliva secretory disorders associated with coronavirus disease 2019 (COVID-19) has become one of the most critical issues in the COVID-19 era. The aim of the present study was to update information on treatments being applicable to such oral symptoms and discuss their pathogenic mechanisms. Promising treatments include different types of methods using tetracycline, corticosteroid, zinc, stellate ganglion block, phytochemical curcumin, traditional herbal medicine, nutraceutical vitamin D, photobiomodulation, antiviral drug, malic acid sialagogue, chewing gum, acupuncture, and/or moxibustion. At present, however, fully validated treatments are still lacking for COVID-19-associated ageusia/dysgeusia/hypogeusia and xerostomia/dry mouth/hyposalivation. An appropriately selected treatment and oral healthcare should be provided to COVID-19 patients and survivors suffering from taste and saliva secretory disorders. Understanding of currently available treatment options is required for dental profes-sionals because they not only experience patients who were infected with SARS-CoV-2 or recov-ered from COVID-19 but first become aware of their abnormal taste and salivary secretion. By doing so, dentists and dental hygienists can play a crucial role in managing COVID-19-associated oral symptoms and contribute to improving the oral health-related quality of life of the relevant dental patients.

The recent pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread so rapidly and severely affected the people of almost every country in the world. The highly contagious nature of this virus makes it difficult to take control of the present pandemic situation. With no specific treatment available, the coronavirus disease 2019 (COVID-19) presents a threat to people of all ages including the elderly people and people with other medical complications as a vulnerable group to this disease. Better understanding of viral pathogenesis, appropriate preventive measures, early diagnosis and supportive treatments of the infected patients are now the general solutions to fight against this viral transmission. But, as an emerging disease, most about it remains still poorly understood. This article holds an overview on the origin and structure, pathogenesis, diagnosis and possible therapeutic options for the causative agent, SARS-CoV-2 and disease, COVID-19. However, few therapeutic options, laboratory experiments and other strategies proposed here need to be further clinically tested.

Childhood obesity is a public health problem and most of the interventions are focused on healthy habits as reducing energy intake, avoiding a sedentary lifestyle and increasing physical activity. However, usually they are based in individual programs, with few structured interventions in health systems without satisfactory results. PinPo aims to carry out an integral intervention in children with obesity, as well as in their parents and caregivers, to get motivation to change towards healthy lifestyle habits. The program contains 9 educational grupal sessions directed by a multidisciplinary expert team. 10 boys and girls, and another group with 10 family members and/or caregivers participate in sessions during 90 min biweekly. Moreover, there is an individual adaptation depending on the severity and comorbidities. At the beginning and at the end of the program, an integral evaluation for health status is developed including anthropometric, nutritional, physical activity, and psychologist and analytical measurements. Finally, a satisfaction survey is carried out on the participants.In conclusion, the implementation of PinPo could offer to paediatric patients with obesity and their families, an integral intervention to treat obesity and its complications. So, there are expectations of achieving favorable results that also allow to optimize its effectiveness.

Background: Although no specific treatment for COVID 19 has been proven effective yet, some drugs with in vitro potential against SARS-CoV-2 virus have been proposed for clinical use. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness on the outcome of the disease. Methods: We enrolled all 18-85 years old inpatients from Central Defense Hospital, Madrid, Spain, who were hospitalised due to COVID-19 and had a definitive outcome (either dead or discharged). We used a statistical survival analysis. Results: We analysed 220 medical records. 166 patients met the inclusion criteria. 48,8 % of patients not treated with HCQ died, versus 22% in the group of hydroxychloroquine (p=0,002). According to clinical picture at admission, hydroxychloroquine increased the mean cumulative survival in all groups from 1,4 to 1,8 times. This difference was statistically significant in the mild group. Conclusions: in a cohort of 166 patients between 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with an initial loading dose of 800mg improved patient survival when admitted in early stages of the disease. There was a non-statistically significant trend towards survival in all groups, which will need to be clarified in subsequent studies.

In this paper, drug treatment and vaccination are compared healthy and economically. In this comparison, in addition to comparing economic costs, it has paid attention to patients' recovery. To reach the goal, the prevalence of Covid-19 virus in New York is modeled by using the SEIR dynamic model. The SEIR dynamic model is used to model the period of epidemic diseases. Then, three disease control scenarios are evaluated economically. Treatment and vaccination are two important issues in controlling epidemic diseases. To control the disease, each of these two methods has economic costs and benefits. The main purpose of this paper is to compare the two methods of vaccination and treatment economically. Although the results of the study show that vaccination can be effective in preventing the epidemic of the disease than treatment, but due to the high cost and genetic mutation of the virus, vaccination is not the optimal method for both health and the economy in the long term.

Background: Resistant hypertension (HTN) is associated with high risk of cardiovascular complications. Our study aimed to assess prevalence, characteristics and treatment of patients with resistant HTN; Methods: We screened 4340 consecutive cardiovascular patients and identified 3762 with HTN. Of them 128 fulfilled criteria for resistant HTN and were included in our study. We matched these patients to 128 hypertensive patients with controlled HTN; Results: Resistant HTN patients were 3.4% of all hypertensives. Most of these patients (67.2%) were at high or very high cardiovascular risk compared to controlled HTN patients (40.6%), p<0001. Resistant HTN patients had more frequently concomitant chronic kidney disease (CKD) (60.9%), overweight/obesity (52.3%), dyslipidemias (35.2%), smoking (27.3%) and diabetes (21.9%) compared to controlled HTN patients (37.5%, 29.7%, 28.1%, 14.1% and 7.8% respectively), p<0.001. Regression analysis showed strongest association of resistant HTN with CKD (OR 6.64), stage III HTN (OR 3.07) and obesity/overweight (OR 2.60). In contrast, single-pill combinations (SPCs) were associated with lower likelihood of uncontrolled HTN (OR 0.58); Conclusions: Resistant HTN represented a small proportion of all hypertensives in our study, but it was characterized by high/very high cardiovascular risk. Optimized therapy including increased usage of SPCs could improve blood pressure control and long-term prognosis of these patients.

Background: A novel virulent coronavirus is what causes Novel Corona-virus Disease 2019 (nCOVID 19). It results in severe respiratory distress syndrome and potentially fatal infectious pneumonia. On March 12, 2020, the World Health Organization first labeled it a pandemic, which was then followed on the same day by a community health emergency of global concern. Vaccines against this deadly virus are now being created. Many drugs with different uses have been repurposed and tested for the prevention and treatment of the infection. Objective: The purpose of this review is to provide an in-depth analysis of data on possible pharmacological targets and available coronavirus treatments. Methods: Following the review protocol, a literature search was conducted. Results: Chloroquine phosphate and hydroxychloroquine, Remdesivir, and Lopinavir-Ritonavir in combination with or without interferon and convalescent plasma therapy are the main treatment candidates, according to the World Health Organization. This review article has elaborated on the current evidence of prospective pharmacological targets and related ongoing research, including inflammatory chemicals, bioactive peptides, beta cells, platelets, and the Angiotensin I Converting Enzyme 2 Receptor. This information was gathered from published journals. In addition, stories of medications and biological products like interferons and vaccinations that are utilized or could be utilized have been provided. Conclusion: There are a variety of pharmacological targets and therapeutic strategies that need more study.

Superior mesenteric artery (SMA) syndrome or Wilkie’s syndrome is a vascular compression disorder that causes abnormal compression of the third portion of the duodenum by the SMA. It has a low incidence rate, higher in young women, and is rarely associated with the Nutcracker phenomenon: a condition of compression of the left renal vein between the SMA and the aorta, which manifests as pain in the left flank and pelvis. Here we report the case of a 54-year-old woman with a history of repeated episodes of abdominal pain caused by the Nutcracker syndrome and Wilkie's syndrome.

Due to the host immunological disease brought on by infection is sepsis, multiple organ dysfunction syndrome (MODS), which has a high morbidity and mortality rate, could be the result. With advances in pathogen detection technologies, breakthroughs in anti-infection drugs, and the creation of organ function support, the clinical diagnosis and treatment of sepsis have advanced significantly. Pathogen-induced abnormal immunological responses, which can range from excessive inflammation to immunosuppression, are recognized to play a significant role in the high death rate. Unfortunately, no medications that are specifically intended to treat sepsis have been licensed. In order to offer a theoretical foundation for the management of sepsis, we will now discuss current advancements in research on immunological responses in sepsis. The prognosis of sepsis patients may be improved by developing and optimizing a dynamic immune system treatment plan based on anti-infection therapy, fluid replacement, support for organ function, and timely application of immunomodulatory therapies

With the ongoing amendment of the EU legislation on the treatment of urban wastewater, stricter requirements for the removal of pollutants are expected, which calls for the need for innovative wastewater treatment technologies. Biological systems are still the first choice. The survey of typical bioreactors applied in wastewater treatment is presented. Wastewater treatment objective, bio-chemical environment and microbial growth are selected as a main criterion for classification of these bioreactors. Hydraulic and kinetic aspects are considered, advantages and drawbacks of these bioreactors regarding the selection of appropriate type of the reactor as well as regarding operation of reactors are mentioned. The aim of this paper is to provide operators and designers with a brief overview of selected traditional and advanced processes, reactors, and technologies for nutrient removal from municipal wastewater. Another goal is to discuss the possibilities and limitations to comply with more strict effluent standards. From the evaluation of the published papers, it follows that the currently applied traditional methods of nutrients removal have the potential to convey also with the expected stricter limits.

Hip fractures are the most frequently treated fractures in the world. Of these, intertrochanteric fractures (ITFs) account for almost 50%. After surgical fixation of ITFs, nonunion is rare. Nonunions are commonly produced from mal-reduction (in varus) and/or inadequate stability of the bone-implant construct and/or fatigue failure of the implants. Other causes of nonunion include posteromedial comminution and osteoporosis. The published incidence of ITF nonunion is 1%-2%. Mechanical complications of ITFs include cut-out, excessive shortening of the proximal femur, delayed union, nonunion, early implant fracture, nail toggle and cut through/medial migration. That is why a fundamental goal in the treatment of ITFs is to achieve stable fixation in osteoporotic bone, allowing early weight bearing. Intraoperative determination of fracture stability is essential. The American Academy of Orthopedic Surgeons (AAOS) clinical practice guidelines for the management of intertrochanteric fractures (ITF) in patients older than 55 years are the following: 1) In patients with stable ITF, the use of either a sliding hip screw (SHS) or a cephalomedullary nail (CMN) is advised (strong strength of evidence). 2) In patients with reverse obliquity fractures, a CMN is recommended (strong strength of evidence). 3) Patients with unstable ITF should be treated with a CMN (strong strength of evidence). 4) In patients with ITF, a short or long CMN may be considered (limited strength of evidence).

Crystalline silver thin layers were obtained by high-energy pulsed laser ablation without heating of the deposition substrate. The fluid Plateau-Rayleigh (PRI), Rayleigh – Taylor (RTI) and Richtmyer – Meshkov (RMI) instabilities, as well as crown splash induced during pulsed laser deposition (PLD) in high energy regime, resulting in ring and pearl shaped structures, offer the benefit of increased sorption surface. These morphological structures obtained for the silver thin layers make them of interest for catalytic applications. The study presented with this work addresses both the fundamental and applied issues on the morphological structures obtained for the silver thin layer and their catalytic function in organic processes. In this sense, the catalytic action of the thin silver layer was highlighted by modifications of the Reactive Blue 21 dye (C.I.) in aqueous solution with sodium bicarbonate. Specific investigations and analyzes were carried out by electron microscopy and elemental analysis (SEM-EDX), atomic force microscopy (AFM) and profilometry, mass spectrometry, ablation plasma diagnosis, diffractograms (XRD), as well as IR spectroscopy (FTIR). In addition to the experimental investigation and analyzes, simulation of the ionization energy threshold was conducted in COMSOL for complementary evaluation on the involved processes and phenomena.

A drug repositioning effort supported the possible use of the anti-HIV drug etravirine as a treatment for Friedreich Ataxia (FRDA). Etravirine increases frataxin protein and corrects the biochemical defects in cells derived from FRDA patients. Because of these findings, and since etravirine displays a favorable safety profile, we conducted this pilot open-label phase 2 clinical trial assessing the safety and potential efficacy of etravirine in FRDA patients. Thirty-five patients were stratified into 3 severity groups and randomized to etravirine 200 mg/day or 400 mg/day. They were treated for 4 months. Efficacy endpoints were represented by changes in peak oxygen uptake and workload as measured by incremental exercise test, SARA score, cardiac measures, measures of QoL and disability. Data were collected 4 months before the start of the treatment (T-4), at the start (T0), at the end (T4) and 4 months after the termination of the treatment (T+4). Etravirine was well tolerated. Etravirine completely stopped the progression of the SARA score during the 4-months treatment period, compared to the 4 months pre and post treatment. It increased peak workload, while the improvement of peak oxygen uptake was not statistically significant. No changes in the cardiac measures were observed. Health and QoL measures showed a worsening at the suspension of the drug. In this open trial etravirine significantly improved neurological function and was generally safe and reasonably tolerated. This suggests that etravirine represents a potential therapeutic agent in FRDA deserving testing in a randomized placebo controlled clinical trial.

We are proposing, for any interested investigator, a randomized open clinical trial for mild and mild-to-moderate Covid-19 comparing a treatment regimen with standard of care, and eventually with another investigational regimen, if ongoing or will be implemented. The patients could be hospitalized or ambulatory but not requiring admission to intensive care units and mechanical ventilation. The proposed therapeutic regimen consists of doxycycline (an antimicrobial having also anti-inflammatory properties, probable antioxidant and possible some antiviral effects), and pentoxifylline, a hemorheological compound used in occlusive arterial diseases but also having proven anti-inflammatory properties. Doxycycline is included in the WHO’s list of essential medicine being an effective, safe, widely available, and inexpensive medication and widely accessible. It will be administered at a dosage of 100 mg orally twice daily for ten days. Pentoxifylline, in clinical use since 1972, and also widely accessible, will be given at a dosage of 400 mg orally, also twice daily, for ten days. The primary outcome measures are: 1) Progression of disease to a severe form requiring intensive care admission and mechanical ventilation; 2) Fatality rates and 3) Time to clinical recovery.This proposal was presented to the National Directors and Core Leads meeting of the Canadian Trials Network (CTN) on May 6, 2020. The interventional trial template suggested by CTN was used for designing the trial.

Microgreens (young, edible plantlets) are a remarkable opportunity for both consumers, to benefit from health promoting compounds and for applied research, as such organisms have a very high plasticity related to environmental cues, allowing biotechnology development with low costs. Ocimum basilicum species naturally synthesize valuable, phenolic compounds, among which rosmarinic acid is most prominent. Basil plantlets were grown for 10 days under either full spectrum light (white light) or modulated blue:red:far-red:UV spectrum with an additional factorization, by applying fertilisation. Biomass accumulation reached up to 0.8 g/20 plantlets, while chlorophyll fluorescence was in the 0.75 – 0.78 range and remained uniform across treatments, indicating that no significant stress was exerted under modified light treatment. However, total phenolic contents and, in particular, rosmarinic acid contents were markedly enhanced (up to 7.5 mg/g in the red cultivar) under modulated light treatment and fertilization, compared to full spectrum light. Moreover, gene expression was enhanced, 1.3-6.3 fold for genes coding for enzymes involved in phenylpropanoid synthesis patwhays, such as phenylalanine ammonia lyase (PAL), Catechol-O-methyltransferase (COMT) and renin-angiotensin system (RAS). Overall, light modulation coupled with fertilization led to the production of basil microgreens with up to 10% more total phenolics and up to 25% more rosmarinic acid.

The spread of micro- (MPs) and nanoplastics (NPs) in the environment has become a significant environmental concern, necessitating effective removal strategies. In this comprehensive scientific review, we examine the use of magnetic nanoparticles (MNPs) as a promising technology for the removal of MPs and NPs from water. We first describe the issue of MPs and NPs and their impact on the environment and human health. Then the fundamental principles of using MNPs for the removal of these pollutants will be presented, emphasizing that MNPs enable selective binding and separation of MPs and NPs from water sources. Furthermore, we provide a short summary of various types of MNPs that have proven effective in the removal of MPs and NPs. These include ferromagnetic nanoparticles, MNPs coated with organic polymers, as well as nanocomposites and magnetic nanostructures. We also review their properties, such as magnetic saturation, size, shape, surface functionalization and stability, and their influence on removal efficiency. Next, we describe different methods of utilizing MNPs for the removal of MPs and NPs. We discuss their advantages, limitations, and potential for further development in detail. In the final part of the review, we provide an overview of existing studies and results demonstrating the effectiveness of using MNPs for the removal of MPs and NPs from water. We also address challenges that need to be overcome, such as nanoparticle optimization, process scalability, and the removal and recycling of nanoparticles after the completion of the process. This comprehensive scientific review offers an extensive insight into the use of MNPs for the removal of MPs and NPs from water. With improved understanding and the development of advanced materials and methods, this technology can play a crucial role in addressing the issue of MPs and NPs and preserving a clean and healthy environment.

This study explored the effects of cryogenic treatment on the microstructure, hardness, and wear-resistance of diamond-like carbon (DLC) by cryogenically treating NAK 80 mold steel coated with DLC. Raman spectroscopy analyzed the structure of the DLC film. Nanoindenter analyzed the hardness and Young’s modulus of the film, and their relationship determined the wear resistance. Wear test assessed the wear rate and friction coefficient of the DLC film. The results showed that cryogenic treatment increased the rate of carbide precipitation and refined the grain structure. Raman spectroscopy indicated that the Raman intensity rate (I_D/I_G) of treated DLC films was smaller than those without cryogenic treatment. When the sp3 bond increased, the hardness and wear-resistance of the DLC film also increased.

Background: Despite advances in the treatment of hepatocellular carcinoma (HCC) over the last few decades, treatment opportunities for patients with HCC remain limited. HCC is the most common form of liver cancer, accounting for approximately 90% of all cases worldwide. Moreover, apart from the current pharmacological interventions, hepatic resection and liver transplantation are the mainstay curative approaches for patients with HCC. Methods: This systematic review included phase I, II, III, and IV clinical trials (CTs) and randomized controlled trials (RCTs) on current treatments for patients with HCC in an Asian population (2013–2023). A total of 427 articles were screened, and 184 non-duplicate publications were identified. After screening titles and abstracts, 96 publications were excluded, and another 28 were excluded after full-text screening. The remaining 60 eligible RCTs/CTs were finally included. Results: Sixty clinical trials fulfilled our inclusion criteria and screened 36 drugs as monotherapy or combination therapy for HCC. Most studies used sorafenib alone or in combination with any of the treatment regimens. Lenvatinib or atezolizumab with bevacizumab was used for HCC after initial sorafenib treatment. Eighteen studies compared the efficacy of sorafenib with that of other drugs, including lenvatinib, cabozantinib, tepotinib, tigatuzumab, linifanib, erlotinib, resminostat, brivanib, tislelizumab, selumetinib, and refametinib. Conclusion: This study provides comprehensive insights into effective treatment interventions for HCC in Asian populations. The overall assessment indicated that sorafenib alone or in combination with atezolizumab and bevacizumab has been the first treatment choice in the past decade to achieve better outcomes in patients with HCC in an Asian population

Background and Objectives: The COVID-19 pandemic influenced the management of patients with immune mediated rheumatic and musculoskeletal diseases (imRMDs) in various ways. The goal of our systematic review was to determine the influence of the first period of the COVID-19 pandemic on the management of imRMDs. Materials and Methods: Systematic literature search of PubMed, Cochrane and Embase databases, including studies with adult patients on the influence of the COVID-19 pandemic on management of imRMDs. There were no restrictions regarding to study-design except for systematic reviews and case reports that were excluded as well as articles on the disease outcomes in case of SARS-CoV-2 infection. Two reviewers screened the studies for inclusion, and, in case of disagreement, consensus was reached after discussion. Results: A total of 5969 potentially relevant studies were found, and, after title, abstract and full-text screening, 35 studies were included with data from 182’746 patients and 2018 rheumatologists. Non-availability of drugs, e.g., hydroxychloroquine and tocilizuab, was frequent (16–69% of patients). Further, medication non-adherence was reported among patients with different RMDs and between different drugs in 4–46% of patients. Changes to preexisting medication were reported in up to 33% of patients (e.g. reducing dose of steroids or cessation of biological disease-modifying antirheumatic drugs). Physical in-office consultations and laboratory testing decreased and as a consequence newly implemented remote consultations increased greatly with an increase of up to 80%. Conclusion: The COVID-19 pandemic influenced the management of imRMDs, especially at the beginning. Influences were wide-ranging, affecting availability of pharmacies, adherence to medication or medication changes, doctor visits and laboratory testing. New systems of care were set up, including virtual clinics and video consultations. These new forms of health care delivery should be spread and implemented worldwide to routine clinical practice to be ready for future pandemics.

Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported even in specialized centers. Mobile health technologies have been used in research settings to overcome these limits with contrasting results. This study aims to evaluate the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up. Methods: Patients were randomly assigned to standard care or standard care plus mobile app (2:1). The mobile app delivered high-intensity lifestyle counseling for diet and physical activity. Results: Seventy-five subjects were prospectively enrolled. At six months of follow-up, the m-app group showed significantly lower dropout rates compared to standard care(p=0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86,95%C.I. 1.39-10.42,p=0.01). After one year of follow-up, we observed lower albeit non statistically significant dropout rates in the m-app compared to the standard care group(p=0.24). No differences were observed in terms of z-score BMI and percentage of BMI reduction between the two groups. Conclusion: our findings suggest that mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction.

According to current literature and preliminary data, hydroxychloroquine (HCQ) seems potentially effective in the treatment of patients with Covid-19 pneumonia. The concentrations of HCQ in lungs might be well above that of plasma. Most likely, this property of HCQ provides effective drug concentrations in lungs. HCQ has a gradual onset of action in the treatment of rheumatic diseases. This could be valid for the treatment of Covid-19 pneumonia. It was suggested that regular HCQ administration in animals for a certain time might result in gradual accumulation of HCQ in tissues. Reduced perfusion, somewhat distorted architecture of lung tissue, edema and, suggested gradual accumulation of HCQ in lung tissue might cause reduced HCQ concentrations in pneumonic areas of the lungs in Covid-19 pneumonia. Patients with Covid-19 pneumonia and extensive lung involvement might have less HCQ concentrations in their lungs than patients having limited lung involvement. Furthermore, patients with Covid-19 pneumonia and extensive lung involvement might have more viral load than patients having limited lung involvement. That’s why treatment of patients with advanced Covid-19 pneumonia using HCQ might result in treatment failure, however HCQ might be effective in the treatment of patients with mild and moderate Covid-19 pneumonia. Using HCQ in Covid-19 pneumonia prophylaxis seems logical since providing enough accumulation of HCQ in the healthy lungs, before the arrival of the SARS-CoV-2 virus, might prevent Covid-19 pneumonia. However, the purpose of this paper is not to recommend using or not using HCQ for the treatment or for the prophylaxis of Covid-19 pneumonia. The purpose of this paper is only to try to bring a new perspective on the role of HCQ in the treatment or in the prophylaxis of Covid-19 pneumonia. This paper proposes only hypotheses, which need further researches to be confirmed.

Lyme disease is a highly prevalent tick-borne infection caused by Borrelia burgdorferi spirochetes in North America and Eurasia. Diagnosis of the early disease remains difficult with the currently approved serological tests in the absence of noticeable tick bite or erythema migrans due to presentation of non-specific symptoms and the absence of antibodies early in infection. Furthermore, it is difficult to distinguish persistence of disease and reinfection in the endemic regions. If not treated early, infection spreads throughout the body and affects most organs with disease manifestations including arthritis, musculoskeletal pain, neuroborreliosis and acrodermatitis chronicum atrophicans. Although most patients recover after antibiotic treatment, ~10-12% of show recurrence of symptoms known as post-treatment Lyme disease syndrome (PTLDS). Various causes of PTLDS are not well-defined; however, the spirochete persisters, antigenic debris, dysregulation of immunological response in individuals or a combination of these factors are proposed to result in continuation of Lyme disease manifestations. Based on these considerations, this review highlights currently employed treatment approaches with antimicrobials and vaccines being tried for prevention of B. burgdorferi infection. We also summarize combinatorial approaches that could be employed to alleviate symptoms to improve the quality of life of the individuals suffering from long Lyme disease.

Background: The Corona Virus Disease 2019 (COVID-19) is spreading globally now. However, the clinical presentation that predict prognosis of the patients are still largely unknow. Methods: We enrolled 393 patients infected with COVID-19 and 30 patients with common pulmonary bulla and reviewed their clinical features to evaluate the potential prognostic value of pulmonary vesicles, especially in the patients with severe symptoms. One COVID-19 patient with vesicles was treated by bullectomy for last resort, and its characteristics of the patient’s perioperative laboratory tests was analyzed. The pathological findings of bullectomy were described and compared with those of common bulla cases. Results: Patients infected with COVID-19 showed more dependence on ventilator, occurrence of super resistant bacteria, and prone to vesicle formation than common bulla (p<0.05). Disease severity is associated with age, sex, and usage of ventilator, ECMO and antibiotics, super resistance bacteria and vesicle formation (p<0.05). The average mortality rate of COVID-19 patients was 4.10% (25.4% in severe patients, 0.00% in mild patients). Interestingly, the mortality rate further increased in severe patients with pulmonary vesicles than those without pulmonary vesicles (35.7% vs 22.4%, p=0.0442). One COVID-19 patient with vesicles underwent bullectomy and had a poor prognosis, who showed diffuse alveolar damage and extensive necrosis in bullectomy specimen. Conclusions: Patients infected with COVID-19 are more prone to form pulmonary vesicles showed on chest CT scans, as an important poor prognosis factor, especially in the severe patients.

The mechanical pre-treatment constitutes an unavoidable pre-step prior to biofuels conversion. As the cost of this step is often underestimated, recently researchers have striven to identify and characterize the mechanical pre-treatment effects in terms of post-treatment physical characterization, derived improvement of enzymatic digestibility, and output yields. The status of existing mechanical pre-treatment techniques is reviewed by substrate’s typology for lignocellulose biomass, focusing on comminution techniques. Emphasis has been dedicated to the particle size achieved after treatment, crystallinity breakage and eventual inhibitory phenomena deriving from the application of particle size reduction, which are analysed and discussed.

Monkeypox virus belongs to the Orthopoxvirus genus, which belongs to the Poxviridae family. The Monkeypox virus is responsible to cause monkeypox, a developing zoonotic disease that has been identified as the most common orthopoxvirus infection in humans in the post-eradication era of smallpox. The virus can be transmitted by a variety of animals, including monkeys and rodents as well as person-to-person. Monkeypox has a clinical presentation that is quite similar to smallpox but mortality is low, in that the febrile prodrome is followed by a period of skin eruption. Monkeypox cases have extended outside the forests of central Africa, where they were first discovered, to other regions of the globe, where they have been imported. This pattern of transmission is most likely related to a global reduction in orthopoxvirus immunity following the discontinuation of smallpox vaccination in 1980, when smallpox was proclaimed eliminated. As a result, monkeypox might become the very common orthopoxvirus infection that affect humans. The emergence of epidemics outside of Africa emphasizes the disease's global significance. Increased monitoring and identification of monkeypox cases are critical tools for gaining a better knowledge of the disease's ever-changing epidemiology.

Acne Vulgaris is a multifactorial skin disorder affecting many adolescents involving a complex array of factors. Previous extensive research has delved into the correlation between acne outbreaks and specific diet consumption, and while there have been a variety of treatment indications for decreasing acne in patients, many do not involve the significant impact a holistic approach can take. This case reports on the relationship between cystic acne and dietary habits, presenting a possible treatment approach for acne vulgaris by eliminating dairy consumption.

The fundamental goal of modern medicine is to increase human life expectancy. Currently, most of the patients in hospitals with different clinical profiles are elderly and senile subjects, with a high incidence of comorbidities, as well as concomitant age-related changes in peripheral tissues. One such change is sarcopenia, a progressive loss of muscle mass, strength, and muscle function that is associated with a high risk of adverse outcomes, leading to an increased risk of disability and death among older adults. The mechanisms of development of sarcopenia are currently being actively studied. This narrative review presents the issues of epidemiology, pathophysiology, and diagnostic criteria for sarcopenia. The relationships between sarcopenia and metabolic dysfunction-associated steatotic liver disease (MASLD) with possible promising directions for the treatment of this comorbid pathology are considered.

This paper presents multidisciplinary and innovative research concerning fighting against coronavirus through wastewater collection and treatment. Studies suggest that coronavirus exists in the wastewaters. Untreated wastewater is proved to spread the virus. Coronavirus is attacking people globally and shrinking the economy. This paper highlights the idea that the coronavirus shall be defeated with the help of wastewater collection and treatment as well. The question addressed by this paper is will communities defeat the coronavirus without well-collected and treated wastewaters? This research aims to display the role of wastewaters in the spread of coronavirus in cities and to require their collection. The methods to achieve the goals are theoretical surveys, case study strategy, mathematical modeling, statistical procedures, forecasting of future, and dialectical discussions. The findings of this research demonstrate the need for carefully collected and treated wastewaters to overcome the coronavirus. This paper gives suitable techniques to collect and treat wastewater such as wastewater stabilization ponds, bacterial reactors, and anaerobic ponds. The innovative idea of this paper, its suggested indicators to select a certain wastewater treatment technique in every city, and its outcome will assist the global community to fight the coronavirus more effectively.

(1) Background: Intravesical Chemotherapy is standard of care in intermediate risk non-muscle-invasive bladder cancer (NMIBC). Different agents are used across the world based on availability, cost and practice patterns. Epirubicin (EPI), one of these agents is used by many centers over many decades. However, its true differential efficacy compared to other agents and its tolerability is still poorly reported. We aimed to assess the differential efficacy and safety of intravesical EPI in NMIBC patients. (2) Methods: A systematic search of PUBMED, Webofscience, clinicaltrials.gov, and Google Scholar databases was performed on December 31, 2023. We reviewed 28 studies that included patients treated EPI after TURBT (transurethral resection of bladder tumors) for NMIBC and who compared oncological outcomes such as recurrence and progression to other adjuvant treatment such as Mitomycin C (MMC), Gemcitabine (GEM) and BCG. Further, we looked at the safety profile of EPI at room temperature under hyperthermia intravesically and at the oncological outcomes when administrated with hyperthermia; (3) Results: When compared to other chemotherapeutics (MMC/GEM), EPI seemed to be equally effective; however, EPI seems less effective in preventing disease management recurrence compared to BCG intravesical. The most common adverse events of EPI include cystitis, dysuria, and pollakiuria. (4) Conclusions: EPI exhibits similar oncological performances to Gemcitabine and Mitomycin C currently used for adjuvant therapy in NMIBC. Novel delivery mechanisms such as hyperthermia are promising newcomers.

SIBO is a pathology of the small intestine and may predispose individuals to a range of nutritional deficiencies. Very little is known whether specific subtypes of SIBO, such as hydrogen-dominant (H+), methane-dominant (M+), or hydrogen/methane –dominant (H+/M+), impact nutritional status and dietary intake in SIBO patients. The aim of this study was to investigate possible correlations between biochemical parameters, dietary nutrient intake, and distinct SIBO subtypes. This observational study included 67 patients who were newly diagnosed with SIBO. Biochemical parameters and diet were studied utilizing laboratory tests and food records, respectively. The H+/M+ group was associated with low serum vitamin D (p&lt;0.001), low serum ferritin (p=0.001) and low fiber intake (p=0.001). The M+ group was correlated with high serum folic acid (p=0.002) and low intakes of fiber (p=0.001) and lactose (p=0.002). The H+ group was associated with low lactose intake (p=0.027). These results suggest that the subtype of SIBO may have varying effects on dietary intake, leading to a range of deficiencies in the body. Conversely, specific dietary patterns may predispose to the development of a SIBO subtype. The assessment of nutritional status and diet, along with diagnosis of SIBO substype, are believed to be key components of SIBO therapy.

For some persistent pollutants, such as recalcitrant pesticides, the polluted water (urban, agricultural and/or industrial) treated by conventional wastewater treatment plants is in some cases insufficient to achieve the legally required level of purity. This issue is of particular concern in areas where low rainfall does not provide sufficient water resources to meet the needs of agriculture, requiring increased reuse of water from wastewater treatment plants. In this context, Advanced Oxidation Processes (AOPs) hold great promise for the removal of organic pollutants. This study first evaluates the effectiveness of UV/S2O8= compared to heterogeneous photocatalysis using UV/TiO2 processes on the degradation of two commonly used herbicides (terbutylazine and isoproturon) in aqueous solutions using a photoreactor. In addition. the effect of UV wavelength on the degradation efficiency of both herbicides was investigated. Although degradation rate was higher under UV-254/S2O8= nm than under UV-365/S2O8= nm, complete degradation of the herbicides (0.2 mg L-1) was achieved within 30 min under UV-366 nm using a Na2S2O8 dosage of 250 mg L-1 in the absence of inorganic anions. To assess the impact of water matrix, the individual and combined effects of sulphate, bicarbonate and chloride were evaluated. They can react with hydroxyl and sulphate radicals formed during AOPs to form new radicals with a lower redox potential. The results showed negligible effects of sulphate, while the combination of bicarbonate and chloride seemed to be the key for the decrease in herbicide removal efficiency found when working with complex matrices. Finally, the main intermediates detected during the photodegradation process were identified and the likely pathways are proposed and discussed.

Introduction: Parkinson’s disease (PD) patients harboring recessive gene variants exhibit a distinct clinical phenotype with an early disease onset and relatively mild symptoms. Data concerning individualized therapy for autosomal recessive PD forms are still scarce. Methods: Demographic and treatment data of a cohort of PD carriers of recessive genes (9 homozygous or compound heterozygous PRKN carriers, 4 Heterozygous PRKN carriers and 3 biallelic PINK1 carriers) were evaluated. Results: The average Levodopa Equivalent daily dose (LEDD) was 806.8±453.5 (range 152-1810) in PRKN carriers and 765±96.6 (range 660-850) in PINK1 carriers. The majority responded to low/moderate doses of Levodopa. The response to Dopamine Agonists (DA) was often favorable both as initial and longitudinal therapy. 8/13 PRKN and 1/3 PINK1 carriers were treated with amantadine successfully, and this also applied to patients who could not tolerate Levodopa or DA. Conclusions: In the era of personalized treatment, the therapeutic approach in recessive PD gene carriers might differ as compared to idiopathic PD. Lower LEDD doses were efficient even in patients with a very long disease duration, while a few patients were doing well without any Levodopa treatment decades after disease initiation. DA or amantadine could be used as a first and main line treatment regimen if well tolerated. Literature data on therapeutic strategies in carriers of pathogenic mutations in recessive PD genes, including device-aided treatments will be further discussed.

The emergence of novel SARS-CoV-2 virus in China in December 2019 has turned into a global pandemic through continued spread beyond borders. This review was aimed to extract up-to-date information on the evolution, transmission, clinical manifestations, diagnosis, treatment and prevention of COVID-19 to fight against this common enemy. PubMed, Scopus and Google Scholar were the sources of literature; whereas CDC, WHO and Worldometer provided updated information. Bats served as the reservoirs of this virus while pangolin is believed as an intermediate host to transmit the virus to humans. Direct human-to-human and indirect transmissions were involved. Major clinical manifestations included fever, cough, fatigue, sputum production and shortness of breath. Chest radiographs mostly showed bilateral ground-glass opacities. Aged patients and patients with comorbidities had higher case fatality ratios. Critical cases were vulnerable to develop pneumonia, multi-organ failure and deaths. Overall situation in China has improved substantially. The European region and region of the Americas were the worst hit out of six WHO global regions. PCR based methods are used for the diagnosis of COVID-19. Severe/critical cases essentially require supportive or intensive cares. Avoiding exposure to COVID-19 is the best way to prevent the disease. Thus, this review provides a snapshot on COVID-19.

A new two-step method for developing a nanocomposite of polypropylene (PP) decorated with photocatalytically active TiO2 nanoparticles (nTiO2) is proposed. This method involves low-temperature plasma functionalization of polypropylene followed by ultrasound-assisted anchoring of nTiO2. The nanoparticles, polymeric substrate, and resultant nanocomposite were thoroughly characterized using nanoparticle tracking analysis (NTA), microscopic observations (SEM, TEM, EDX), spectroscopic investigations (XPS, FTIR), thermogravimetric analysis (TG/DTA), and water contact angle (WCA) measurements. The photocatalytic activity of the nanocomposites was evaluated through the degradation of methyl orange. The individual TiO2 nanoparticles ranged from 2-6 nm in size. Oxygen plasma treatment of PP generated surface functional groups (mainly -OH and -C=O), transforming the surface from hydrophobic to hydrophilic, which facilitated efficient deposition of nTiO2. Optimized plasma treatment and sonochemical deposition parameters resulted in an active photocatalytic nTiO2/PP system, degrading 80% of methyl orange under UVA irradiation in 200 minutes. The proposed approach is considered versatile for the functionalization of polymeric materials with photoactive nanoparticles and, in a broader perspective, can be utilized for the fabrication of self-cleaning surfaces.

Estrogen receptor-positive (ER+) breast cancer is common among postmenopausal women and is frequently treated with Letrozole. Letrozole inhibits aromatase from synthesizing estrogen from androgens. Decreased estrogen slows the growth of tumors and can be an effective treatment. Letrozole resistance is increasingly being observed, which poses a unique problem for patients. We reanalyzed transcriptomic data comparing individuals who responded to Letrozole therapy (responders) to those who were resistant to treatment (non-responders). We identified SOX11 and S100A9 as two genes that significantly differed between these patients; with “PLK1 signaling events” being the most significant signaling pathway. We also identified PRDX4 and E2F8 as the top transcriptional biomarkers for ER+ treatment resistance. Many of the other significant gene products play a known role in ER+ breast cancer or other types of cancer, which partially validate our results. Several of the gene products we identified do not have a characterized role in ER+ breast cancer. Our analysis identified a set of genes that warrant further research to elucidate the molecular mechanism of Letrozole resistance in this patient population, as well as novel high-performing biomarkers. We anticipate that these findings could contribute to improved therapeutic outcomes in human patients.

The management of brain tumors presents numerous challenges, despite the employment of multimodal therapies including surgical intervention, radiotherapy, chemotherapy, and immunotherapy. Owing to the distinct location of brain tumors and the presence of the blood-brain barrier (BBB), these tumors exhibit considerable heterogeneity and invasiveness at a histological level. Recent advancements in hydrogel research for the local treatment of brain tumors have sought to overcome the primary challenge of delivering therapeutics past the BBB, thereby ensuring efficient accumulation within brain tumor tissues. This article elaborates on various hydrogel-based delivery vectors, examining their efficacy in the local treatment of brain tumors. Additionally, it reviews the fundamental principles involved in designing intelligent hydrogels that can circumvent the BBB and penetrate larger tumor areas, thereby facilitating precise, controlled drug release. Hydrogel-based drug delivery systems (DDSs) are posited to offer a groundbreaking approach in addressing the challenges and limitations inherent in traditional oncological therapies, which are significantly impeded by the unique structural and pathological characteristics of brain tumors.

Cartilage degeneration is a characteristic of osteoarthritis (OA) which is often observed in aging populations. This degeneration is due to the breakdown of articular cartilage (AC) mechanical and tribological properties, primarily attributed to lubrication failure. Understanding the reasons behind these failures and identifying potential solutions could have significant economic and societal implications, ultimately enhancing the quality of life. This review provides an overview of developments in the field of AC, focusing on its mechanical and tribological properties. The emphasis is on the role of lubrication in degraded AC, offering insights into its structure and function relationship. Further it explores the fundamental connection between AC mechano-tribological properties and the advancement of its degradation and puts forth recommendations for strategies to boost its lubrication efficiency.

Hadhramout Initiative Against Corona (HIAC ) formed a working group of clinicians relevant to the management of COVID-19 to formulate clinical practice guidelines (CPG) for clinicians caring for the patients infected with COVID-19 in Yemen. The regional guidelines on the management of COVID-19 were thoroughly reviewed and its applicability was assessed for Yemen. HIAC’s recommendations covered (2) sections: the first one is the diagnosis, including case definition, risk stratification of the affected cases, investigations (prioritization of reverse transcription-polymerase chain reaction (RT-PCR) testing, D-dimer, chest x-ray, and chest computed tomography, while the second part covers the treatments (mainly Favipiravir, Remdesivir, Hydroxychloroquine, and Glucocorticoid, Anticoagulants, and Supportive measures). In conclusion, the adoption of cost-effective and evidence-based guidelines in Yemen will standardize the management of the patients infected with COVID-19 and protect both the patients and the health care workers from malpractice.

Background and Objective: Patients with spinal muscular atrophy (SMA) treated with a dis-ease-modifying therapy (DMT) are often classified as responders or non-responders based on at-tainment of a specific improvement threshold on validated functional scales. This categorization may significantly impact treatment reimbursement in some countries. The aim of this research is to evaluate the perception of treatment benefit by patients considered as responder or non-responder. Methods: In this non-commercial multicenter study, 99 post-symptomatically treated SMA type I-III patients with a median age of 11.2 (0.39-57.4) years at treatment initiation were stratified into three groups based on their treatment outcomes, i.e. those exhibiting clinically significant improvement (N=41), those with non-clinically significant improvement (N=18), or those show-ing no improvement (N=40). Fifteen months after treatment initiation patients or patients’ care-givers were assessed using a patient-rated scoring system based on the Patient Global Impression of Change (PGIC) scale, comprising 22 questions targeting important aspects and tasks in the daily life of patients with SMA. Results: We found no statistical difference in patient perception of treatment benefit in 17 out of 22 domains across patient groups. Conclusion: Our results suggest that functional motor scales do not recapitulate patients and pa-tients’ caregivers experience about the effect of nusinersen treatment in SMA.

Invasive Candida infections represent a significant cause of morbidity and mortality in the neonatal intensive care unit (NICU), particularly among preterm and low birth weight neonates. The nonspecific clinical presentation of invasive candidiasis, resembling that of bacterial sepsis with multiorgan involvement, makes the diagnosis challenging. Given the atypical clinical presentation and the potential detrimental effects of delayed treatment, empirical treatment is often initiated in cases with high clinical suspicion. This underscores the need to develop alternative laboratory methods other than cultures, which are known to have low sensitivity and a prolonged detection time, to optimize therapeutic strategies. Serum biomarkers, including mannan antigen/anti-mannan antibody and 1,3-β-D-glucan (BDG), both components of the yeast cell wall, a nano-diagnostic method utilizing T2 magnetic resonance and Candida DNA detection by PCR-based techniques have been investigated as adjuncts to body fluid cultures and have shown promising results in improving diagnostic efficacy and shortening detection time in neonatal populations. This review aims to provide an overview of the diagnostic tools and the current management strategies for invasive candidiasis in neonates. Timely and accurate diagnosis followed by targeted antifungal treatment can significantly improve the survival and outcome of neonates affected by Candida species.

The UN Sustainable Development Goal 7 Report 2022 is about ensuring access to clean and affordable energy, which is key to the development of agriculture, business, communications, education, healthcare, and transportation. The lack of access to energy hinders economic and human development. Nevertheless, the current pace of progress is insufficient to achieve Goal 7 by 2030. Huge disparities in access to modern sustainable energy persist. Rising commodity, energy and shipping prices have increased the cost of producing and transporting solar photovoltaics modules, wind turbines and biofuels worldwide, adding uncertainty to a development trajectory that is already far below Goal 7 ambitions. Achieving energy and climate goals will require continued policy support and a massive mobilization of public and private capital for clean and renewable energy such as methane from biomass. An important factor in improving methane yield from biomass waste is pre-treatment of the biomass prior to anaerobic digestion. Size reduction of lignocellulose biomass is important for changing and increasing digestibility thus increasing methane yield. A Hollander beater was used as the mechanical pre-treatment machine throughout this study. Results indicate that methane yield is directly proportional to feedstock/Inoculum (F/I) ratio as higher F/I ratio led to higher methane yield. It was observed at an F/I ratio of 0.5 that 5 minutes pre-treatment time produced highest methane yield, while the lowest methane yield was observed at an F/I ratio of 0.2 with 1 minute of pre-treatment time. Methane yield decreased by 30% from 140 mL gTS-1 at F/I ratio 0.5 with 5 minutes pre-treatment time to 98 mL gTS-1 at F/I 0.2 with 5 minutes pre-treatment time. The optimum methane yield was attained at high F/I ratio allowing sufficient nutrient essential for complete degradation of biomass. Overall, this research shows the Hollander beater is not efficient in optimizing methane yield for cardboard.

Coronavirus that is also known as COVID-19 disease is produced by SARSCoV-2. This causative agent is highly contagious and can cause potentially fatal pneumonia worldwide with serious public health concerns. In the beginning among infected individuals, most of them were those who were mainly shown to the wet animal market in a big city of China known as Wuhan. So, it was suggested that this was almost certainly the zoonotic source of COVID-19illness. The transitional source of origin and their mode of transmission to humans were not known obviously. Conversely, from human to human rapidly transformation have been confirmed generally. Currently, there is no availability of FDA approved clinically antiviral drugs and/or vaccines to be used against the COVID-19. Afterward, SARS-CoV and MERS-CoV, the occurrence of SARS-CoV-2 has been manifested as the third sketch of an enormously pathogenic coronavirus into human population globally. In this review, we provide a brief overview of the history of COVID-19 in Pakistan up-to 18^th weeks after beginning, current situation, epidemiology, and its impact on the human population. Moreover, we focused on physiological variation during the incubation period, genome analysis of SARS-CoV2, supportive treatment approaches, and safety measures in the Pakistani population, which may be supportive for combating the risk of COVID-19 epidemic. We also reviewed the future approaches for the development of therapeutic interventions and vaccines to cope with the COVID-19 epidemic.

Cancers, a large and heterogeneous group of malignancies, are becoming an increasingly important cause of premature mortality worldwide. 2% of these are primary CNS tumors, of which 24% are gliomas. These tumors are diverse, but what they have in common is one of the most unfavorable prognoses among all cancers. A patient's future varies depending on the grade of the diagnosed glioma. To date, however, no standard treatment for grade IV has been established. All glioblastomas eventually undergo progression or recurrence. The current standard of treatment, which includes surgical intervention, radiation therapy and chemotherapy, is therefore far from sufficient. Work is constantly underway to discover a new, effective form of glioma therapy. Photodynamic therapy (PDT) may be one of them. It involves the local or systemic application of a photosensitive compound - a photosensitizer (PS), which accumulates in the affected tissues. Photosensitizer molecules absorb light of the appropriate wavelength, initiating activation processes leading to the formation of reactive oxygen species and selective destruction of inappropriate cells. Currently, this method has been approved for the treatment of several cancers. Research focusing on the effective use of PDT in glioma therapy is already underway, with promising results. In our work, we present molecular insights into PDT of glioma. Based on the available literature, we analyze and systematize the impact of various molecules, proteins, transporters and transmitters on the efficacy of PDT and the effect of PDT on their expression. In addition, we highlight gaps in current knowledge and point out directions for future research that may contribute to the efficacy of PDT glioma.

This retrospective study aimed to evaluate the performance of the hormone treatment protocols, determine the factors associated with pregnancy success after hormone treatment, and compare the cost-efficiencies of two types of hormone treatment among cyclic and noncyclic anestrous dairy cows. The clinical records of 279 anestrous cows who received hormone treatment for artificial insemination (AI) from 64 herds in the western region of Thailand were obtained from Kasetsart University Veterinary Teaching Hospital from January to August 2017. The performance of the hormone treatment protocols, fixed-time AI (TAI) and estrus detection before AI (EAI), showed that the pregnancy risk for the TAI protocol was higher than for the EAI protocol, but pregnancy per AI did not differ significantly between the two protocols in cyclic and noncyclic cows. Multivariate logistic regression analysis showed that cows receiving the TAI protocol were more likely to be pregnant compared to those treated with the EAI protocol. Cows with a 3.00 body condition score (BCS) &lt;3.75 after treatment and loose-housing cows were more likely to become pregnant. Treatment during winter showed higher pregnancy success than in the summer and rainy seasons. The cost-efficiency analysis showed that the TAI protocol was the most cost-efficient option for noncyclic cows, whereas the EAI protocol was the most cost-efficient option for cyclic cows.

Human T-cell lymphotropic virus (HTLV) infection lacks effective treatment. This review describes the virological, immunological and clinical outcomes of antiretroviral therapy (ART) in people with HTLV infection. This systematic review followed PRISMA reporting guidelines and was registered in PROSPERO: CRD42022350076. The Newcastle-Ottawa Scales, adapted for cross-sectional studies, and Rob-2 were employed to assess the methodological quality of studies. A systematic search was conducted in Medline (PubMed), Scopus (Elsevier), Cochrane Library, and Web of Science (Clarivate Analytics) databases. We retrieved data from 08 methodologically diverse articles, on treatment of patients infected by HTLV-1 or HTLV-2 alone, or coinfected by HIV-1 with Raltegravir, Tenofovir, Lamivudine and Zidovudine. Proviral load decreased in 3 of 7 studies, during 4 to 48 weeks of antiretrovirals use. Cellular immune response (CD4, CD8, CD25, CD69 and CD71 cells) were evaluated in six studies. There was no significant clinical improvement in the studies but all of them detected clinical stability during treatment. Despite the demonstrated antiviral activity of ART, in vitro, clinical improvement was not proven. Most studies showed disease stability during ART use, suggesting potential clinical benefits. There is a need of larger, well-controlled trials, to define the role of ART for treatment of HTLV infection.

Our first modern global pandemic is caused by a nanosized lipid vesicle, called SARS-CoV-2. Its molecular structure and biogenesis have remarkable similarities with Extracellular Vesicles (EVs, most notably exosomes) that are constantly shed by all cells during their life. Their resemblance may not be a coincidence. Growing body of evidence has shown that EVs have significant roles in various biological processes, including viral infection, transmission and anti-viral response. Drawing comparison with the virus might shed light on how we could fight the COVID-19 disease. This may include novel EV research and diagnostics technologies as well as novel EV-based treatments.

Keywords: Endodontic microsurgery; Root canal treatment; Isthmus preparation; Short-term outcomes

Cocoa (Theobroma Cacao, L.) represents an important market that gained relevance and became an esteemed commodity thanks to cocoa powder, chocolate, and other related products. This work has analyzed 59 cocoa powder samples from the European market. Three distinct subgroups were identified: organic or conventional, alkalized or not alkalized, and raw or roasted processing. The impact of the technological process was evaluated on the pH, color, and compositional traits, as content of biogenic amines and salsolinol. The phenolic fraction was also investigated trough both common and emerging methods. Results depict that the influence of the agronomical practices (organic/conventional) did not affect significatively (p&lt;0.05) the composition of cocoa powders; similarly, the roasting process was not discriminative for the compounds traced. On the other hand, the alkalinization process greatly impacted on color, and pH, no matter of cocoa provenience, obtention, or other processes, also resulting reducing the phenolic fraction of treated samples. Principal components analysis confirmed that the alkali process acts on pH, color, and phenolic composition, but not on other bioactives molecules (BAs and salsolinol). All samples resulted safe while alkalized powders have a great reduction in beneficial biocompounds. A novel strategy could be to emphasize non-alkalized powders in the label, to meet the demand for more beneficial products.

Researchers are increasingly concerned about microplastics (MPs) since they have proven to be detrimental to the environment and humans. They not only contribute to the accumulation of plastics in the environment, but they can also help spread micropollutants through absorption. MPs have entered the environment through a variety of channels, including direct discharge through human activities, the textile industry, and wastewater treatment systems. Wastewater treatment plants (WWTPs) are seen as the final line of defense, forming a barrier between MPs and the environment. The most common MPs found in wastewater are polyethylene terephthalate (PET), polyethylene (PE), polypropylene (PP), and polystyrene. The purpose of this study is to investigate and measure the efficacy of conventional and advanced technologies in removing microplastic. The fate of MPs in WWTPs and their impact on various wastewater treatment processes will be thoroughly examined. Both conventional and advanced methods of treatment will be discussed. Conventional methods include coagulation/flocculation, sedimentation, and filtration. Advanced treatment methods that will be discussed include membrane bioreactors, rapid sand filtration, electrocoagulation, and photocatalytic degradation. Despite the high removal of MPs, WWTPs remain an important entry point into aquatic and terrestrial systems due to the large volumes involved and the quantity of sludge reused through land application. Also, the complex interactions between MPs and other environmental pollutants may broaden MPs' effects on wastewater treatment processes, which have yet to be fully researched. Furthermore, potential issues with MP removal from treatment procedures and microplastic remediation techniques in drinking water was discussed.

Arsenic is naturally present in many geological formations around the world and is a major source of groundwater contamination. Bolivia is not exempt from this problem. Physical-chemical studies of water quality in deep and shallow wells have determined the presence of arsenic in some areas of the Bolivian Altiplano, valleys, and plains. In the Lake Poopó basin, water from shallow wells (up to 30 m) has arsenic concentrations that exceed the Bolivian drinking water standard and the WHO recommendation of 10 μg-As/l by up to 25 times. In peri-urban areas of Cochabamba, the arsenic content in groundwater is up to 113 μg-As/l. chronic exposure to arsenic is associated with neurological and dermatological problems and carcinogenic effects. To date, no measures have been taken to mitigate the arsenic problem for the rural population, who often rely on arsenic-contaminated water as their only source of drinking water. This contamination represents a serious threat to the health and economic well-being of the inhabitants and ecosystem in these areas. In this work, for arsenic removal, iron and iron oxide nanoparticles obtained from recycling metal chips by top-down and bottom-up technology have been used for arsenic adsorption in an experimental filter combined with other artisanal filtering materials in the form of layers. The results have shown that water contaminated with arsenic after passing through the filter reduces the concentration of total arsenic filtered from 83, 52 ppb to less than 5 ppb, less than the Bolivian standard 512 of 10 ppb for drinking water.

Oil and gas refineries are highly water-intensive industrial settings, with effluent containing a significant level of pollution stemming from diverse organic and inorganic compounds. Besides adhering to discharge standards for industrial effluent, incorporating treated oil refinery effluent (ORE) into the production cycle can play a pivotal role in curbing water consumption. In recent years, there has been research into different approaches to reclaiming ORE. Yet, selecting treatment methods that are technically, economically, and environmentally effective is crucial to preventing resource waste. Therefore, this study aimed to examine the last two decades of literature on methods and technologies used for ORE treatment. Based on the inclusion criteria, the final screening included 82 studies, with acceptable agreement assessed using Cohen's inter-examiner kappa equal to 0.86. The included studies were of biological treatment (n = 27), physicochemical processes (n = 12), advanced purification processes (n = 16), membrane-based technologies (n = 15), and green technologies (n = 13). This comprehensive review showed that the advanced membrane-based techniques are effective in the removal of pollutants from ORE for several reasons, such as reducing the consumption of chemicals, high efficiency, and ease of setup and maintenance. However, combined methods with a focus on membrane-based processes (e.g. UF-RO) are the most promising options for the reclamation of ORE. Since some effluent treatment methods require the use of chemicals and energy to run, future research should focus on environmentally friendly methods and the use of renewable energy.

Abstract Kidney transplant recipients, because of a weak immune response due to the assumption of immunosuppressant are exposed to the risk of COVID-19 infection. This fact realize the problem on how to treat the severe infection without carrying the risk of acute rejection due to the reduction of the immunosuppressive drugs. The best are the prophylactic measures to be taken before transplantation as vaccination. If the patient is already transplanted, three measures may be undertaken: Vaccination, use of monoclonal antibodies, use of therapeutic antiviral small molecules. Concerning vaccination is still debated which one is the best and how many doses should be given. The surge of new virus variant is the major problem and invites to find new active vaccines. In addition, not all the transplanted patients develop antibodies. The other measure is the use of monoclonal antibodies. They may be used as prophylaxis or in the early stage of the disease. Finally, the antiviral small molecules may be used again as prophylaxis or treatment. Their major drawback are the interference with the immunosuppressive drugs and the fact that some of them cannot be administered to patients with low eGFR.

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker, whereas methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing a diagnosis. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency and the treatment goals govern decisions regarding the route and dose of B12 therapy.

Solar pasteurization, as a means of treating milk in remote rural areas without electrical power, is based on using solar energy to thermally inactivate pathogenic microorganisms at temperatures below the boiling point to maintain or improve milk quality. A solar milk pasteurizer of flat‐plate water‐heating glass acting as the solar collector, connected to a stainless-steel cylindrical milk vat, was constructed and evaluated in Navrongo, in the tropical savanna zone of Ghana, West Africa. The novel approach taken in this project is to integrate the solar collection and heat exchanger into a single unit using materials and fabrication techniques readily available in the developing world. The vat comprises a 1.5 mm thick stainless steel cylindrical tank, a 2.2 cm wide hot water jacket, and an outer layer of 5.0 mm thick aluminium foil insulation. Hot water produced by the collector was used for pasteurizing milk. The optimum quantity of milk that this device could pasteurize under the study conditions was 8 L. The device could pasteurize raw milk to a maximum temperature of 74 °C at 14:00 h GMT. The ambient temperature during the pasteurization ranged from 30 °C to 43 °C. The microbial analysis before and after the pasteurization was done, and the result shows that the total bacteria count before pasteurization was 6.6x10⁶ log CFU/mL per unit volume, and the total bacteria count after pasteurization was 1.0x10² log CFU/mL. By acceptable standards, the total bacteria count after pasteurization is within a safe range for consumption, and coliform counts were negative. The solar milk pasteurization system is cost-effective. Hence, it is appropriate for milk producers in arid pastoral areas without electricity to adopt the solar pasteurizer as an alternative to firewood as a fuel source for milk pasteurization. This approach can potentially create a cottage industry that may also play a crucial role as a water treatment technology that will improve the health of rural populations.

Background: Leishmaniasis is a significant global public health issue that is caused by parasites from Leishmania genus. With limited treatment options and rising drug resistance, there is a pressing need for new therapeutic approaches. Molecular chaperones, particularly Hsp90, play a crucial role in parasite biology and are emerging as promising targets for drug development. Objective: This study evaluates the efficacy of 17-DMAG in treating BALB/c mice from cutane-ous leishmaniasis through in vitro and in vivo approaches. Materials and Methods: We assessed 17-DMAG cytotoxic effect on bone marrow-derived mac-rophages (BMMΦ) and its effects against L. braziliensis promastigotes and intracellular amastigotes. Additionally, we tested the compound's efficacy in BALB/c mice infected with L. braziliensis via intraperitoneal administration to evaluate the reduction of lesion size and de-crease of parasite load in the ears and lymph nodes of infected animals. Results: 17-DMAG showed selective toxicity [selective index=432) towards Leishmania amastigotes, causing minimal damage to host cells. The treatment significantly reduced lesion sizes in mice and results in parasite clearance from ears and lymph nodes. It also diminished in-flammatory responses and reduced the release of pro-inflammatory cytokines (IL-6, IFN-g, TNF) and the regulatory cytokine, IL-10, underscoring its dual leishmanicidal and anti-inflammatory properties. Conclusion: Our findings confirm the potential of 17-DMAG as a viable treatment for cutaneous leishmaniasis and support further research into its mechanisms and potential applications against other infectious diseases.

Medication non-adherence remains a substantial obstacle in asthma care, prompting the exploration of novel therapeutic modalities that prioritize rapid symptom relief, anti-inflammatory activity and facilitate patients’ compliance. This task is well served by a new form of therapy - inhaled triple-combination medications ICS/LABA/LAMA (inhaled glucocorticosteroid/long-acting beta2-agonist/long-acting muscarinic antagonist). The integration of three medications within a singular inhalation device culminates in the reduction of the effective dose of the principal therapeutic agent for asthma management, namely, ICS. This consolidation yields a dual benefit of minimizing the likelihood of adverse effects typically linked with ICS while concurrently optimizing bronchodilator efficacy. The accumulated evidence suggests that adding LAMA to a medium- or high-dose ICS/LABA results in a decrease of asthma exacerbations compared to medium- or high-dose ICS/LABA alone, accompanied by sustained enhancements in lung function parameters. We propose in adult patients experiencing suboptimal asthma control despite medium/high-dose ICS/LABA treatment - regardless of adherence to GINA-recommended strategies, such as MART therapy as a first-line approach or alternative second-line strategies - the preferred course for intensifying asthma therapy involves the addition of a LAMA, ideally in the form of SITT.

Recent advances in organoid technology have revolutionized cancer biology and thera-peutic interventions, offering personalized immunotherapy treatment. Organoids, three-dimensional cell cultures derived from patient tumors, accurately replicate the tumor microenvi-ronment, providing unprecedented insights into tumor-immune interactions and therapeutic re-sponses. In this literature-based study, we discuss various culture methods for the diverse appli-cations of organoids in cancer immunotherapy, including drug screening, personalized treatment strategies, and mechanistic studies. Additionally, we address the technological challenges asso-ciated with these methods and propose potential future solutions to accelerate the development of novel immunotherapeutic approaches. This review highlights the transformative potential of or-ganoid models in advancing preclinical cancer immunotherapy modeling, screening, and evalua-tion, paving the way for more effective and personalized cancer treatments.

Many studies on flexible strain and pressure sensors have been reported due to growing interest in wearable devices for healthcare. However, most are fabricated with multiple ingredients and complicated methods even though commercial textiles, such as cotton, nylon, polyester, and silk were used. Here we present flexible pressure and strain (motion) sensors prepared with only graphene oxide (GO) and commercial silk fabrics and yarns. The pressure sensors were fabricated by simply dipping the silk fabric into GO solution followed by thermal treatment at 400 °C for reduction of GO (rGO). The pressure sensors were made from rGO-coated fabrics, which were stacked in 3-, 5-, and 7-layers. The super-sensitivity of 2.58 ×103 kPa-1 at low pressure was observed in the 7-layer pressure sensor. The strain sensors were obtained from rGO-coated twisted silk yarns whose gauge factor was 0.307. Although this value is small or comparable to other sensors, it is appropriate for motion sensing. The results of this study show a cost-effective and simple method for the fabrication of pressure and motion sensors with commercial silk and GO.

Vitiligo is a chronic autoimmune disease characterized by progressive depigmentation of the skin caused by the selective destruction of melanocytes. Although its etiopathogenesis remains unclear, multiple factors are believed to be involved, including genetic and metabolic factors linked to cellular oxidative stress, melanocyte adhesion defects, innate and adaptive immunity. The aim of this review is to provide an overview of the current state of knowledge regarding the role of different cellular mechanisms, including cytokines and chemokines interactions in the pathogenesis of vitiligo. Although there is no definitive cure for vitiligo, excessive progress has been made and several treatments have shown favourable results. A thorough understanding of the basis of the disease, uncover promising drug targets for future research, providing clinical researchers with valuable insights for developing improved treatment options.

Introduction: The aim is to investigate the possibility of altering the delusional perceptions of psychotic patients by exposing them to a cognitively flexible virtual environment. A flexible vir-tual reality (VR) environment could challenge and enhance the ability to adapt to changing situa-tions and generate novel solutions to core psychotic symptoms. Materials and methods: A systematic review was conducted using different combinations of keywords in different databases. This study was conducted using the PRISMA statement. Results: There is a growing literature on the use of VR to manipulate and normalise perceptual distortions in psychosis. Over the last decade, the number of published studies on VR in mental health has increased 14-fold. Conclusions: A cognitive flexibility virtual environment can alter delusional perception by ex-posing the person to different scenarios that require them to question their assumptions, test their hypotheses, and revise their beliefs. Commonly used biosensors measure heart rate, skin con-ductance and body temperature in relation to different emotional states. Recently, there has been a major shift towards the use of neuroimaging techniques to better understand the pathophysiology of mental disorders. This is where the new wave of biosensor-integrated virtual reality (VR) sys-tems comes in.

The scratch test consists in pushing a tool across the surface of a material at a given penetration depth or applied load. It has several applications in Science and Engineering including strength testing, damage and quality control of thin films and coatings. Despite numerous attempts in scientific literature, the application of scratch test to characterizations of fracture properties remains a heavily controversial topic. Therefore, this investigation arises as an experimental study in order to assess the fracture toughness using scratch test. A study on the effect of cryogenic treatment, performed after tempering, on fracture toughness, via scratch test experiments, of different tool steels has been made. A laboratory investigation on AISI D2, AISI M2 and X105CrCoMo18 steel confirms the possibility of increasing the fracture toughness by carrying out the cryogenic treatment after the usual heat treatment

The main purpose of this work was to tests of form and size of fatigue wear of the top layer of oil gear pump wheel (3PW-BPF-24). The object of tests was operated during a determined number of hours at strictly controlled operational and environmental parameters. A microscope of focal differentiation by Alicona InfiniteFocus G4 (with Focus-Variation optical measuring technology) was used for an identification, measurement and description of noticed superficial defects, which resulted from the fatigue process of the top layer and an earlier thermochemical treatment. The work was finished with an analysis of obtained results (based on the analysis of 3D scans) and conclusions concerning about optimization of the thermal treatment. Taking into consideration the presented results (suggestions) in the technology of improving strength properties of gear wheels (of this type oil pumps) may render it possible to obtain an appropriate fatigue endurance of the top layer, i.e. a minimization of observed superficial defects.

This study examines the effects of the δ phase and annealing twins on the hardness, Charpy impact toughness, and tensile properties of Inconel 718 fabricated using L-PBF. Two heat treatment methods, involving solid solution and precipitation hardening, were utilized. The δ phase was formed through solid solution heat treatment at 980C for 1 hour while annealing twins were generated at 1100C for 3 hours. After precipitation hardening, specimens with a higher concentration of  precipitates exhibited increased ultimate tensile strength (13%), yield strength (27%), and hardness (12%) compared to those with annealing twins. This can be attributed to the smaller grain size, subgrains, and δ precipitates, which contribute to the differences in mechanical strength. On the contrary, specimens with annealing twins showed significantly higher impact toughness (4 times) and ductility (twice) than those with δ precipitates. This is caused by the formation of  precipitates, which serve as sites for void formation and crack propagation, leading to a decrease in plasticity due to lattice mismatches with the matrix. Microstructural, compositional, phase, crystallographic, and fractographic analyzes were performed using OM, SEM, TEM and XRD techniques to identify the factors responsible for the variations in the measurements. The results demonstrate that the heat treatment method involving annealing twins significantly improves the ductility of Inconel 718 while maintaining the required mechanical strength.

Micropollutants belongs to various groups of chemicals. One of the most diverse and large group of them are pharmaceuticals. The presence of pharmaceutical residues in wastewater poses a significant challenge to water quality and environmental health. This paper provides an overview of recent advancements in the removal of pharmaceuticals from water, focusing on various treatment processes and their effectiveness in eliminating micropollutants. Through a review of literature, including studies on ozonation, UV irradiation, sulphate radical-based tech-nologies, and photocatalytic processes, insights into degradation mechanisms and optimal con-ditions for their removal are synthesized. Additionally, with new legislation mandating the monitoring of selected micropollutants and the implementation of quaternary treatment in wastewater treatment plants, the paper discusses prospects for future research and recommen-dations for effective pharmaceuticals removal. Key actions include conducting comprehensive laboratory and pilot trials, implementing quaternary treatment of wastewaters, continuously monitoring of water quality, investing in research and development, and promoting collabora-tion and knowledge sharing among stakeholders. By embracing these strategies, we can work towards safeguarding water resources and protecting public health from the adverse effects of pharmaceutical contamination.

In machining, there is a constant effort to achieve the expected roughness of the machined surface while maintaining the life of the cutting tool during its operation. The methods used for extending machinability characteristics can be applied due to cooling and lubrication. One of the latest, but not new, targeted cooling techniques have become cryogenic treatment, which uses substances that exhibit extremely low-temperature values of about 123 K. This is a very environmentally friendly technique compared to the current standardized cooling and lubricating fluids. The main task of such cooling is to change the properties of the workpiece so that it exhibits the properties of a brittle material. Bringing the workpiece structure in this way can result in easier material separation through the chip. In the article, the obtained test results can approximate the behavior of various materials during cryogenic cooling.

Traditional Medicine (TM) is a culturally-rooted healthcare practice, and its use, including for treating illnesses among children, has been reported in many countries. Despite the cultural significance of TM in managing children’s illnesses, evidence suggests that child mortality remains high in many settings. This indicates that the sole use of TM within families and communities might act as a barrier to using biomedical services, contributing to avoidable deaths. Globally, Indonesia is in the top 10 countries with the highest child mortality rates. In addition, Belu is a district in East Nusa Tenggara province, Indonesia that exhibits a high number of child deaths within the last three years. However, the use of TM for the treatment of illnesses among children in Indonesia has received minimal academic attention. This study aimed to understand parental beliefs, knowledge, views, and perceptions of TM and the impact on the use of TM and biomedical services in the treatment of illnesses among their children in Belu district, Indonesia. The participants (n=25) were parents with the real-life experiences of using TM for treating their children’s illnesses. They were recruited using the snowballing sampling technique. Data were collected using in-depth qualitative interviews. A thematic data analysis was performed and guided by a qualitative data analysis framework. The findings were grouped into four main themes: (i) parental beliefs, knowledge, views, and perceptions of TM, (ii) the influence of these factors on parental use of TM and biomedical services for the treatment of children’s illnesses, (iii) social and cultural influences on the use of TM and biomedical services among their children, and (iv) the impact of the sole use of TM or late medical diagnosis on the health condition and the death of children. The findings show that the use of TM is a common practice within families and communities in Belu, however evidence suggests that child mortality remains high in the setting, indicating less effectiveness of the sole use of TM. Thus, there is a need for the development of collaborative models of healthcare programs and service delivery fostering mutual respect and understanding between traditional healers and healthcare professionals, which could significantly contribute to improving parental use of biomedical services for the treatment of their children’s illnesses.

This study investigates the effects of Zinc (4wt.%) and severe plastic deformation on the mechanical properties of AZ61 magnesium alloy through the stir-casting process. The severe plastic deformation (equal channel angular pressing (ECAP)) has been done followed by T4 heat treatment. The microstructural examinations revealed that the addition of 4wt.%Zn enhances the uniform distribution of β-phase, contributing to a more uniformly corroded surface in corrosive environments. Additionally, dynamic recrystallization (DRX) significantly reduces the grain size of as-cast alloys after undergoing ECAP. The attained mechanical properties demonstrate that after a single ECAP pass, AZ61 + 4wt.%Zn alloy exhibits optimal yield strength (YS), ultimate compression strength (UCS), and hardness. This research highlights the promising potential of AZ61 + 4wt.%Zn alloy for enhanced mechanical and corrosion-resistant properties, offering valuable insights for applications in diverse engineering fields.

The emergence of new SARSCoV-2 variants can affect vaccine efficacy, laboratory diagnosis and therapies already available, triggering interest in the search for antiviral agents for SARSCoV-2 infections. Ribavirin (RBV) is a broad-spectrum antiviral with demonstrated in vitro activity against multiple viruses, including SARSCoV-2. Methods. This retrospective study evaluated the dynamic and viral clearance of SARSCoV-2 in hospitalized adult participants (PTs) with COVID-19 pneumonia who received RBV aerosol within a compassionate use study. Was also assessed the impact of RBV on the clinical outcome and the mutational profile of SARSCoV-2. Results. The median RNA values measured in nine PTs included in the study de-creased from baseline to discharge (at BL, threshold cycle (Ct)=22.4, IQR 19.84-5.07; at discharge, Ct=27.92, IQR 26.43-36.11). Seven/9 PTs experienced a clinical improvement, while two PTs deceased during hos-pitalization. In PTs with a favorable outcome the virus clearance rate at discharge was 28.6%. The cumulative clearance rate was 71.4% within day 14th from discharge. A mutational pattern after RBV was detected in 3/5 PTs in whom was available whole genome sequencing. Conclusions. RBV may limit SARSCOV-2 replication resulting in a favorable clinical outcome. Ribavirin may also contribute to the mutational spectrum of SARSCoV-2.

The only solution to avoid pollution due to sewage is to treat the effluent and reuse water and sludge at the wastewater production site. This makes it necessary to install treatment plants distributed along the sewer system to prevent the movement of effluents with the consequent losses to the aquifer. This new management is called decentralized wastewater treatment. To make this change possible, it is necessary to develop treatment plants that do not represent a health hazard for citizens, eliminating the nuisance caused by traditional plants. These plants need to be robust, operate autonomously, have reduced maintenance and exhaustive control of each process, where each cubic meter of effluent is perfectly controlled, avoiding losses to the aquifer or discharges that may occur due to deficiencies in their purification capacity; constantly producing water and sludge, which are directly reusable with all the health and environmental guarantees regardless of variations in inlet effluent or environmental conditions. This article presents a paradigmatic case of a decentralized solution with conditions of maximum complexity that has been solved efficiently, saving around 98% of the initial investment, completely avoiding wastewater discharges into the environment and reusing 100% of the treated water, in 14 years of operation.

In recent decade water pollution by micropollutants is an increasing environmental concern. Since 2019, due to COVID-19 pandemic, increased stormwater pollution by chlorine based disinfectants has been determined. Research aimed to treat of chlorine contaminated stormwater after outdoors spaces disinfection are very limited. Runoff from disinfected areas and residual chlorine present in stormwater are transported to surface water bodies. Residual chlorine reacts with dissolved organic compounds in water and results the formation of environmentally toxic disinfection by-products. Studies present event low residual chlorine concentrations may pose a risk to aquatic flora and fauna. In this study the efficiency of different filter materials, including peat, wood chips, sawdust (column tests) and ceramzites Leca, Pollytag, Polski, Ceski (batch tests), in retaining residual chlorine were tested in laboratory scale batch and flow through experiment. The best efficiency to retain chlorine presented sawdust (96 %) and ceramzite Leca (76 %). The plants abilities to reduce pollution by chlorine was analyzed in raised garden bed. Research results will contribute to future studies aimed to retain various micropollutants in stormwater using remediation technologies.

Research indicates that painful experiences can significantly affect the fear of cancer recurrence among cancer survivors, which is a distressing concern that influences both physiological and psychological recovery. Yet, the role of potential factors and mechanisms in these relationships is not fully known. This cross-sectional study aimed to advance our comprehension of the associa-tions between total pain and the fear of recurrence in post-treatment cancer patients by examining two potential mediators: psychological flexibility and mentalization. Three hundred and thirty-five participants (aged 22 to 88, 49.1% female) who had finished their cancer treatment completed self-report assessments of total pain, fear of recurrence, psychological flexibility, and mentalization. The serial mediation analysis showed that all dimensions of total pain were positively related to the fear of recurrence indirectly through psychological flexibility and mentalization, in serial. Additionally, gender moderated these serial mediational effects. In line with the psychological flexibility model, personal capacities to face difficult internal/external problems and interpret one’s behaviour in motivational terms can counterbalance patients’ negative emotions and feelings related to the illness.

Objective: Evaluation of patients with prosthetic valves who developed infective endocarditis by comparing treatment outcomes in both early- and late-onset IE episodes following prosthetic valve replacement surgery. This study sought to conduct a comprehensive assessment of the efficacy of these methodologies. The insights derived from this assessment will be utilized to enhance the quality of care for individuals with infective endocarditis who have received prosthetic valve replacement surgery. Results: During the period of investigation (January 2018 - December 2022), 78 patients diagnosed with infective endocarditis (IE) on prosthetic valve were admitted to the Infectious Diseases Department of the "Dr. Carol Davila" Central Military Emergency University Hospital in Bucharest. In 28 cases (35.8%), the onset of PVE occurred within 12 months of surgery (early onset), whereas in 50 patients (64.2%), the onset occurred more than 12 months after surgery (late onset). The mortality rate was 35.9% (53.6% among the early onset patients and 26% among the late-onset patients). Among patients who received surgical and medical therapy, the mortality rate was 29.6%, whereas among those who underwent only medical therapy, a 39.2% mortality rate was reported. According to the extracted data, antibiotic therapy was successful in 72.6% of patients. In contrast, a combination of surgical and drug-based approaches resulted in a cure in 76.1% of the patients. The most common etiological agent was Staphylococcus aureus (38.5%), followed by Enterococcus faecalis (26.9%), and Streptococcus mitis (10.3%). The mortality rate of patients with S. aureus was 29.2%, indicating the severity of this infectious agent. Conclusions: Prosthetic valve endocarditis (PVE) is a serious condition associated with a high mortality rate both in the short and long term. Regardless of the therapy used, the risk of death remains high. All patients with PVE who survived received effective early treatment, highlighting the need for prophylactic measures.

Climate change, increasing global food needs, and decreasing global resources brought a new era to human every-day live with a strong turn to circular economy and sustainability. Food packaging and preservation is an important global sector where enchanced research is carried out. New methods such as active packaging and chemical preservatives replacement are of major interest. Many researchers were published studies about active packaging films, replacement of chemical preservatives with natural originated extracts, and novel incorporation procedures. Sequentially to our and other scientists’ previous work, in this paper we present the results of the improvement which was achieved by incorporating the developed nanohybrid of natural-halloysite/carvacrol-extract, the pure natural carvacrol extract and the commonly used low-density-polyethylene. The well known corona-treatment procedure was employed to produced the optimum final film and the results shown that the low-density-polyethylene incorporated with natural-halloysite/carvacrol-extract nanohybrid and coated external with extra carvacrol extract exhibited aproximatelly 100% higher Young-Modulus values, slightly decreased ultimate strength by 20%, and almost stable elonation at break properties. The water-vapor and oxygen barrier increased by 40%. Finally, the antioxidant activity of the corrona-treated film increased by 28% compared to the similar but untreated product because of the lower release rate of the carvacrol.

Abstract: Ovarian cancer (OC) ranks as the fifth most common cancer among women in the United States and globally, posing a significant health threat. Reactive oxygen species (ROS) have emerged as critical factors in the pathophysiology of this malignancy. ROS, characterized by their instability due to an unpaired electron, are involved in essential cellular functions and play a crucial role in the immune response under normal physiological conditions. However, an imbalance in ROS homeostasis, leading to excessive ROS production, results in oxidative stress (OS), which can cause indiscriminate damage to cellular structures and contribute to the pathogenesis of specific diseases, including OC. OC is primarily classified based on the originating cell type into epithelial, stromal, and germinal tumors, with epithelial tumors being the most prevalent. Despite advancements in medical technology, early detection of OC remains challenging, often leading to delayed treatment initiation. Current therapeutic approaches include surgical excision of tumor tissue, radiotherapy and chemotherapy. While these treatments are effective in early-stage OC, high mortality rates and frequent relapse underscore the urgent need for novel diagnostic and therapeutic strategies. This review aims to elucidate the role of ROS in OC, emphasizing the potential for developing innovative diagnostic tools and treatments that target ROS-mediated pathways. Given the critical impact of early detection and effective treatment, advancing our understanding of ROS in the context of OC could significantly enhance patient outcomes.

Background/Objectives: This study aims to investigate the influence of root canal morphology and various treatment variables on the outcomes of root canal treatments (RCT) in mandibular second molars, assessed through cone-beam computed tomography (CBCT) imaging. Methods: A total of 150 CBCT images were examined, comprising 100 cases of persistent endodontic infections and 50 from previously treated root canals with normal apices in mandibular second molars. CBCT was utilized to evaluate root canal configuration, the radiographic quality of coronal restorations and treated canal systems, and the presence of periapical lesions. Statistical analyses were performed to explore correlations between these factors. Results: The presence of a C-shaped root canal configuration did not demonstrate a significant correlation with periapical lesions (p=0.05). Factors influencing endodontic treatment outcomes included the presence of missing canals (p=0.018), underfilling or overfilling (p=0.045), and inadequate coronal restoration (p=0.006). The presence of a missing canal was identified as the variable most significantly associated with periapical lesions (OR=3.103). Leaky canals were more commonly observed in C-shaped root canals (p&lt;0.001). Conclusions: Regardless of the root canal morphology of mandibular second molars, successful RCT depends on thorough disinfection to eliminate any untreated canals, precise three-dimensional filling of the canals at the correct working length, and a securely sealed coronal restoration to prevent leakage.

This study explores the development and characterization of ceramic rod reinforced TWIP (Twinning Induced Plasticity) steel matrix composites, fabricated using a lost foam casting process. The incorporation of ceramic rods aims to enhance the mechanical properties of TWIP steel, which is known for its excellent plasticity. Mechanical testing demonstrated a significant improvement in flexural strength and ductility, with the composite exhibiting over double the strength of the unreinforced TWIP steel. Heat treatment at 500°C for 60 minutes further enhanced these properties, increasing the composite's flexural strength to 1023 MPa and improving its ductility. The observed improvements are attributed to the synergistic effects of the hard ceramic reinforcement and the ductile matrix, as well as the microstructural modification conferred by heat treatment. These findings suggest that ceramic rod reinforced TWIP steel composites are promising materials for applications requiring a combination of high strength and ductility.

This paper explores the feasibility of applying Bayesian statistical methods to study the distortion patterns induced by carburizing heat treatment. By establishing posterior and predictive distribution models for torsion bar dimensions, we aim to accurately understand and predict the expansion behavior, thus enhancing control over carburizing-induced dimensional changes. Bayesian methods allow for the integration of prior knowledge and real-time data, providing a more comprehensive understanding of the distortion phenomena. This approach not only improves the precision of dimensional predictions but also contributes to optimizing the overall manufacturing process, ensuring that the torsion bars meet the rigorous standards required for high-performance applications in demanding industrial environments.

Molecular analysis of growing teratoma syndrome has not been extensively studied. Here, we report a 14-year-old boy with a growing mass during treatment for a mixed germ cell tumor of the pineal region. Tumor markers were negative; thus, growing teratoma syndrome was suspected. A radical resection via the occipital transtentorial approach was performed, and histopathological examination revealed a teratoma with malignant features. Methylation classifier analysis confirmed the diagnosis of teratoma, and DMRT1 loss and 12p gain were identified by copy number variation analysis, potentially elucidating the cause of growth and malignant transformation of the teratoma. The patient remains in remission after intense chemoradiation treatment as a high-risk germ cell tumor.

Background/Objectives Bowel endometriosis (BE) is defined as the presence of endometrial-like tissue in the muscular layer of the bowel wall. When BE does not cause severe obstruction to fecal transit, not leading to (sub)occlusive symptoms, the decision to operate becomes challenging as intestinal surgery is associated with higher complication rates and long-term bowel dysfunction. The aim of this cross-sectional study is to evaluate the quality of life (QoL) in patients with BE undergoing medical therapy or expectant management, investigating the impact of characteristics of BE nodules on QoL and intestinal function. Methods A retrospective cross-sectional analysis was conducted on 580 patients with BE who did not undergo surgery but were treated conservatively by medical therapy or expectant management between January 2017 and August 2022. The diagnosis of BE was done by transvaginal ultrasound and confirmed at double contrast barium enema. After at least one year of follow-up, QoL and intestinal function of patients were evaluated by the Endometriosis Health Profile-5 (EHP-5) questionnaire and Bowel Endometriosis Symptom score (BENS), whereas pain symptoms were assessed by the Visual Analogic Scale (VAS 0-10). Statistical analysis was performed to investigate possible associations between QoL and characteristics of bowel nodules (dimension, location, and evidence of stenosis) as well as type and length of eventual medical therapy. Results Patients with BE had a satisfying overall QoL with a mean EHP-5 score of 105.42 ± 99.98 points and VAS lower than 3 for all pain domains; additionally, they did not show a significant impartment of bowel function with mean BENS score of 4.89 ± 5.28 points. Notably, patients under medical therapy had a better QoL than patients without therapy (p

Objective: To describe outcomes of patients with coronavirus disease 2019 (COVID-19) in the outpatient setting after early treatment with zinc, low dose hydroxychloroquine, and azithromycin (the triple therapy) dependent on risk stratification. Design: Retrospective case series study. Setting: General practice. Participants: 141 COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the year 2020. Main Outcome Measures: Risk-stratified treatment decision, rate of hospitalization and all-cause death. Results: Of 335 positively PCR-tested COVID-19 patients, 127 were treated with the triple therapy. 104 of 127 met the defined risk stratification criteria and were included in the analysis. In addition, 37 treated and eligible patients who were confirmed by IgG tests were included in the treatment group (total N=141). 208 of the 335 patients did not meet the risk stratification criteria and were not treated. After 4 days (median, IQR 3-6, available for N=66/141) of onset of symptoms, 141 patients (median age 58 years, IQR 40-67; 73% male) got a prescription for the triple therapy for 5 days. Independent public reference data from 377 confirmed COVID-19 patients of the same community were used as untreated control. 4 of 141 treated patients (2.8%) were hospitalized, which was significantly less (p<0.001) compared with 58 of 377 untreated patients (15.4%) (odds ratio 0.16, 95% CI 0.06-0.5). Therefore, the odds of hospitalization of treated patients were 84% less than in the untreated group. One patient (0.7%) died in the treatment group versus 13 patients (3.5%) in the untreated group (odds ratio 0.2, 95% CI 0.03-1.5; p=0.16). There were no cardiac side effects. Conclusions: Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset with the used triple therapy, including the combination of zinc with low dose hydroxychloroquine, was associated with significantly less hospitalizations and 5 times less all-cause deaths.

Short-cycle therapy has proven to be a safe and effective alternative to standard everyday antiretroviral treatment for virally suppressed people living with HIV. Here we report a favorable long-term virological and immunological outcome in 12 virally suppressed people on short cycle therapy with bictegravir/emtricitabine/tenofovir alafenamide administered five days a week (Monday to Friday).

Abstract: Steamed ginseng water (SGW), the by-product generated from the heated processing of red ginseng, with high content of active substances, better skincare activities, and large amount output ineffective utilization, resulted in environmental pollution and resource waste. In current study, UHPLC-Q-Exactive-MS/MS liquid chromatography-mass spectrometry and multivariate statistical analysis were conducted to characterize the compositional features of the repeated thermal-treated SGW. The total sugar content, total sugar content, total reducing sugar content, total non-reducing sugar content, DPPH, ABTS+, Fe3+ reducing capacity, and the hydroxyl radical scavenging abilities were employed to evaluate the gross contents variation connect with anti-oxidant activities during heat processes. The result revealed the SGW content and antioxidant activity were highly correlated, the 7th SGW sample showed the highest content and the strongest ability on anti-aging capacities. 38 significant common differential markers were screened, by the four compared SGW groups (1- and 3-, 1- and 5-, 1- and 7-, and 1- and 9) through OPLS-DA analysis. The current study showed that the thermal proceeding times could be a vital index value during the recycling operation quality control of SGW, which has a huge potential in anti-aging cosmetic raw materials, In the meanwhile, our results provided a green, sustainable, low-cost thinking of rational application on ginseng resource.

Chronic conditions like type 2 diabetes mellitus (T2DM), arterial hypertension (HTN), and obesity are major global health issues, causing significant morbidity and mortality. In Latin America, these conditions contribute to millions of premature deaths annually, posing challenges exacerbated by limited healthcare access and poor primary care quality, particularly in Mexico. Complementary medicine presents a potential solution, offering minimally invasive techniques to improve physical, mental, and spiritual well-being. Effective treatment adherence, crucial for positive outcomes, is influenced by self-efficacy, the ability to manage one's behavior in response to medical conditions. However, treatment adherence rates remain low, indicating a pressing public health concern. This study aimed to explore how perception of complementary medicine and treatment adherence predict self-efficacy among individuals with chronic conditions in Mexico. Analyzing data from 113 participants revealed significant correlations between variables, with treatment adherence positively associated with self-efficacy and perception of holistic medicine negatively correlated with self-efficacy. Regression analysis showed that incorporating perception of complementary medicine and treatment adherence significantly explained self-efficacy levels, suggesting the potential of complementary therapies in holistic healthcare approaches. However, collinearity between variables highlights the need for further research to better understand these relationships and their implications for improving healthcare outcomes in Mexico. Integrating complementary therapies with conventional treatments could enhance overall well-being and treatment adherence, offering promising avenues for addressing chronic conditions in the region. These findings underscore the importance of comprehensive healthcare approaches that integrate both conventional and complementary modalities to optimize health outcomes and quality of life for individuals with chronic conditions in Mexico and beyond.

Anxiety disorders significantly reduce patients' quality of life. Current pharmacological treatments, primarily benzodiazepines and antidepressants, are associated with numerous side effects. Consequently, there is a continual search for alternative methods to traditional therapies that are less burdensome for patients and broaden their therapeutic options. In this review, we examined recent evidence on alternative treatments for anxiety disorders, including physical activity, mindfulness, VR technology, biofeedback, herbal remedies, and transcranial magnetic stimulation (TMS), cryotherapy, hyperbaric therapy, vagus nerve stimulation, MDMA, electroconvulsive therapy (ECT), and eye movement desensitization and reprocessing (EMDR) therapy. Our objective was to determine the role of these selected alternative methods in the treatment of anxiety disorders. Alternative treatments significantly expand the options available to patients and clinicians, with many serving as adjuncts to traditional therapies. Among the methods presented, mindfulness has the most significant therapeutic potential.

With the outbreak of coronavirus disease 2019 (COVID-19), there is a need for efficient management of patients with mild or no symptoms, which account for the majority. The aim of this study is to introduce the structure and operation protocol of a living and treatment support centre (LTSC) operated by Seoul National University Hospital in South Korea. The existing accommodation facility was converted into a 'patient centre' where patients was isolated. A few Medical staff here performed medical tests and responded to emergencies. Another part of the LTSC was 'remote monitoring centre'. In this center, patients’ self-measured vital signs and symptoms were monitored twice a day, and the medical staff staying here provided video-consultation via a smartphone. During the 3 weeks from March 5 to March 26, 2020, 113 patients were admitted and treated. LTSC could be an efficient alternative to hospital admission in pandemic situation like COVID-19.

Out of a worldwide annual incidence of ~150 million cases for urinary tract infection (UTI), >25% of outpatient prescriptions of oral antimicrobial treatment (OAT) are for cystitis not complicated by sepsis. OAT aids the immune cells infiltrating urothelium to eliminate uropathogens attaching and invading urothelium amidst hyperosmotic urine. This adaptability of uropathogens and the short interval between Penicillin sale and the first antimicrobial resistance (AMR) report suggests that AMR is a 3.8 billion years old evolutionary conserved heritable trait of surviving environmental threats through exponential proliferation of mutant strains selected by Darwinian principle. Therefore, OAT success with minimal AMR can be ensured by antimicrobial stewardship (AMS) following the principle of 5Ds -drug, dose, duration, drug-route, and de-escalation. While convenient to administer, the onset of minimum inhibitory concentration (MIC) for OAT in urine is a window of opportunity for uropathogens to survive the first contact with OAT and the descendant colonies armed with AMR are likely to survive subsequent higher urine OAT levels. Meanwhile, intravesical antimicrobial treatment (IAT) delivers the first strike well above MIC. The root cause analysis of AMR dovetails with the strengths, weaknesses, opportunity, and threat (SWOT) analysis of OAT in this interdisciplinary review.

Background Endometrial cancer is the fourth most common type of cancer in the world. Due to the prevalence and high morbidity, it is of key importance to make a quick and accurate diagnosis and effective therapy. The use of photodynamic therapy (PDT) in the treatment of endometrial cancer is a significant challenge in conducting clinical trials. PDT is non-invasive, with few side effects, damaging only neoplastic tissue, leaving healthy adjacent structures intact. Thanks to numerous experiments (also in vitro), PDT is gaining more and more recognition as a potential tool in endometrium cancer treatment. Objective The aim of the study was to analyze the effectiveness of photodynamic therapy on endometrial cancer tissue samples Methods In the in vitro experiment of PDT, sections of endometrial cancer tissue taken from female patients were subjected to. Rose Bengal was used as a photosensitizer in order to assess the usefulness of the applied PDT and to introduce these solutions into the in vivo test procedure. Results Changes on the cellular substrate, such as: chromatin condensation, disturbed structure and shape of cell nuclei were observed in all tissues subjected to PDT. Conclusions The PDT experiment in vitro offers opportunities and hopes for using the chosen procedure also in vivo. Keywords endometrial cancer; photodynamic therapy; in vitro; treatment; rose bengal

Aim: To evaluate the panmacular subthreshold micropulse laser treatment results among patients with central serous chorioretinopathy (CSC) and their correlation with functional and morphological parameters. Material and methods: The examined group included 10 non-treated and 41 treated patients with acute, recurrent, and chronic CSC (13 F, 38 M, mean age 44.11±6.5) and 14 healthy controls (6 F, 8 M, mean age 45±9.3). The BCVA examination, ophthalmoscopy, microp-erimetry, angio-OCT and OCT were performed. The medical history regarding chronic general disorders and known risk factors were recorded. Results: Complete resorption of SRF was obtained in 100% aCSC, 86.66% cCSC, and 63.63% r CSC. BCVA and RetSens significantly improved most of the patients treated in aCSC. The lowest BCVA and RetSens, but the largest pachyvessel and disease duration, were found in rCSC. A strong negative correlation between final BCVA and disease duration was found. No patient demonstrated laser lesions following treatment. Conclusions: The panmacular MPLT therapy leads to long-term enhancement of functional and morphological parameters in all CSC patients. The acute CSC patients showed the most significant improvement. The procedure is safe and could be considered a preferred treatment option for all active CSC cases. Timely treatment is crucial for beneficial outcomes.

Since association between myocardial infarction (MI) and respiratory infections has been described for influenza-viruses and other respiratory viral agents, understanding possible physiopathological links between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and acute coronary syndromes (ACS) is of the greatest importance. First data suggest an underestimation of ACS cases all over the world, but acute MI still represents a major cause of morbidity and mortality worldwide and should not be overshadowed during the coronavirus disease (Covid-19) pandemic. No common consensus regarding the most adequate healthcare management policy for ACS is currently available. Indeed, important differences have been reported between the measures employed to treat ACS in China during the first disease outbreak and what currently represents clinical practice across Europe and the USA. This review aims to discuss: pathophysiological links between MI, respiratory infections, and Covid-19; epidemiological data related to ACS at the time of the Covid-19 pandemic; what emerged so far from several catheterization labs and coronary care units all over the world, in order to shed some light on the current strategies for optimal management of ACS patients with confirmed or suspected SARS-CoV-2 infection.

Human infection caused by the SARS-CoV-2 virus, called COVID-19, is a new pandemic with devastating effects worldwide. Science seeks the rational and systematic explanation of phenomena. In pandemics, decisions on prevention and treatment of people should be consistently taken, supported by scientific knowledge and ethical principles to produce more good than harm. At first, prospective observational studies to systematically collect patient data, correlating protective or therapeutic interventions with outcomes to assess effectiveness and safety, should be prioritized as the most appropriate type of study. The proposed protocol in this article aims to provide doctors with information on the reduction of harm in early COVID-19 patients by applying individualized interventionist or expectant therapeutic strategies, respecting the autonomy and preferences of physicians and patients in clinical decision-making. The evaluation of the clinical status, besides laboratory confirmation of COVID-19, comprises an individualized symptom score for each patient, a global self-perception scale of the severity of the disease, a clinical progression scale developed by the WHO for clinical studies in COVID-19 and, at the first consultation, doctors´ overall impression on the clinical prognosis. The analysis of anonymized data should preferably use descriptive and inferential statistical resources. The case report form is available for free use in the protocol, along with examples of patient informed consent forms for the prescription of off-label medications and authorization to use the data. Their results may be useful to indicate interventions that are candidates for efficacy trials, in randomized controlled trials, with a higher chance of success. It respects the autonomy and preferences of doctors and patients to decide the best options for treatment in uncertain situations. It also allows the gathering of useful information for future more rigorous clinical trials, trying to link science, ethics, and personal clinical experience.