Search Results (230,930)

Background: Immunosuppressive therapy (methotrexate and biological agents) for juvenile idiopathic arthritis (JIA) is associated with an increased risk of severe infections, higher infection rates, treatment interruptions, failure to achieve disease remission, and recurrent disease flares. Our study aimed to evaluate the safety and efficacy of simultaneous immunization with 13-valent polysaccharide conjugate vaccines (PCV13) against S. pneumoniae (SP) and Hemophilus influanzae type b infections (HibV) in children with JIA without systemic manifestations. Methods: A total of 371 non-systemic JIA patients who received 13PCV and HibV were included in this prospective cohort study. In every patient, we evaluated clinical, laboratory, anti-SP, and anti-Hib IgG antibodies before vaccination, three weeks after, and six months after, and all adverse events (AEs) were collected during the study. The number and duration of acute respiratory infection (ARI) episodes and requirements for antibacterial treatment and AE six months before and after the baseline were collected. Results: The levels of the Ig G anti-SP and anti-Hib antibodies increased in the 3 weeks after vaccination; then, anti-SP antibodies slightly decreased and anti-Hib antibodies remained increased during the whole study, as well as in a part of the patients with a protective titer. During the study, there were no patients with significant flares, and the main JIA outcomes gradually decreased during the trial. The number of patients with uveitis remained equal, as well as the part of the patients with active, low-active, and inactive uveitis. There was no significant rise in the hs-CRP or S100 protein after the vaccination. Previous or ongoing treatment with non-biological (p = 0.072) and biological (p = 0.019) disease-modified anti-rheumatic drugs affected the Hib and did not affect the anti-SP protective titer at the end of the study. Within 6 months following vaccination, the number of ARI episodes (p < 0.001) and the number of courses of antibacterial treatment (p < 0.0001) decreased twice. The median duration of ARI episodes decreased four times (p < 0.0001). Mild AEs (injection site reactions and short-term fever episodes) were found in 58 (15.6%) patients with JIA, and 1 patient (0.2%) developed an SAE. Conclusions: Simultaneous vaccination against pneumococcal and Hib infections reduces the frequency and duration of episodes of ARI, as well as the number of courses of antibacterial drugs, and does not lead to significant JIA flares. The number of reported AEs is consistent with what was expected. Full article

Background: Despite the ongoing innovations and the availability of numerous effective inhaled treatment options, achieving optimal disease control in most patients frequently remains disappointing. Unfortunately, although inhaled therapy is the cornerstone of respiratory disease management, the selection of the most appropriate inhaler is still overlooked or underestimated by some healthcare professionals, and inhaler misuse remains a significant challenge in managing chronic respiratory diseases which directly influences patients’ quality of life, clinical outcomes, and risk of disease progression. Materials and Methods: This is a unicentric, observational, cross-sectional study designed to evaluate the inhaled therapy prescribed in hospitalized patients and to analyze device changes after hospitalization, as well as the factors associated with these changes. A single face-to-face visit was performed during the patient’s hospitalization, where the inhaled therapy used prior to hospitalization was evaluated: technique (critical errors), compliance (TAI questionnaire), maximum peak inspiratory flow [PIF (L/min)], and level of inhaler handling-related knowledge. A binary logistic regression model was used to explore the association between changing device at discharge and the other independent variables Results: The inhaler most used during hospitalization was the metered-dose inhaler (MDI) with a chamber (51.9% of patients), with the dry powdered inhalers (DPI) being the inhalers used in 43% of maintenance inhaled therapies in the community setting prior to hospitalization. In addition, 90% of patients showed a maximum PIF ≥ 30 L/min, and 35.6% performed critical inhaler errors. These patients had statistically significantly lower maximum PIF values (52.1 L/min in patients with critical inhaler errors vs. 60.8 L/min without critical inhaler errors; p > 0.001) and were more likely to exhibit poor inhaler compliance compared to those without critical errors (50.5% vs. 31.0%, respectively). More than half of the patients who used MDI with spacer chamber made critical inhaler errors; 69.9% showed regular or poor treatment adherence, although 75.6% demonstrated good knowledge about inhaler handling. Only in 27% of the patients did the healthcare professional change the type of inhaler after hospitalization within clinical practice. The medical and nursing staff responsible for the patient’s hospitalization were not informed of the assessment carried out in the study. The probability of not performing a device change at discharge was lower in patients with previous at-home treatment with combined inhaled therapy with LABA + ICS (OR 0.3 [0.18–0.83], p = 0.016) and in patients under triple inhaled therapy (OR 0.3 [0.17–0.76], p = 0.007). No significant differences were observed in inhaler changes when considering the frequency of critical inhaler errors, inhaler handling-related knowledge or maximum PIF values. Conclusions: Our study highlights the urgent need for a more personalized inhaler selection and consistent monitoring by healthcare professionals to minimize inhaler misuse, increase treatment compliance and adherence, and improve disease management outcomes. It is essential to provide training and promote the role of nursing in the evaluation and education of inhaled therapy. Additionally, the use of standardized approaches and tools, such as the CHECK DIAL, is crucial to facilitate the adaptation of devices to patients’ needs. Full article

Traditional consolidants commonly used for waterlogged wood conservation often present long-term drawbacks, prompting research into new and reliable alternatives. Reducing reliance on fossil-based chemicals that are harmful to people, the environment, and the climate is a growing trend, and sustainable materials are now being explored as alternative consolidants for conserving waterlogged archaeological wood. Among these bio-based products, sodium alginate, a natural polysaccharide, has shown promising potential. This study aimed to evaluate its effectiveness in stabilising dimensions of severely degraded archaeological elm wood during drying. Various treatments were tested, and dimensional stabilisation (ASE), weight percent gain (WPG), and volumetric shrinkage (Vs) were assessed. Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) were used to evaluate alginate penetration and interactions with residual wood components. Results indicated that the effectiveness of sodium alginate depends on the treatment method, with the soaking approach and slow drying providing the highest WPG and the best stabilisation without altering the natural wood colour. Although the best achieved anti-shrink efficiency of 40% is insufficient from the conservation perspective, sodium alginate has proven to be a promising consolidant for the conservation of waterlogged wood. Further studies will focus on enhancing its penetration and interactions with residual wood components. Full article

Electrochemical glucose sensors are vital for clinical diagnostics and the food industry, where accurate detection is essential. However, the limitations of glucose oxidase (GOx)-based sensors, such as complex preparation, high cost, and environmental sensitivity, highlight the need for non-enzymatic sensors that directly oxidize glucose at the electrode surface. In this study, a self-supporting hierarchical Cu/Fe₃O₄ nanosheet electrode was successfully fabricated by in situ growth on Ni Foam using a hydrothermal method, followed by annealing treatment. The Cu/Fe₃O₄ hierarchical nanosheet structure, with its large surface area, provides abundant active sites for electrocatalysis, while the strong interactions between Cu/Fe₃O₄ and Ni Foam enhance electron transfer efficiency. This novel electrode structure demonstrates exceptional electrochemical performance for non-enzymatic glucose sensing, with an ultrahigh sensitivity of 12.85 μA·μM⁻¹·cm⁻², a low detection limit of 0.71 μM, and a linear range extending up to 1 mM. Moreover, the Cu/Fe₃O₄/NF electrode exhibits excellent stability, a rapid response (~3 s), and good selectivity against interfering substances such as uric acid, ascorbic acid, H₂O₂, urea, and KCl. It also shows strong reliability in analyzing human serum samples. Therefore, Cu/Fe₃O₄/NF holds great promise as a non-enzymatic glucose sensor, and this work offers a valuable strategy for the design of advanced electrochemical electrodes. Full article

We aimed to identify the characteristic functional components of pigeon eggs and the differences among pigeon, chicken, and quail eggs. We analyzed the metabolite profiles of three kinds of eggs using an untargeted metabolomics-based approach to better understand the differences in metabolites among pigeon, chicken, and quail eggs. Then, we quantitatively validated the differences in abundance of partial metabolites through a targeted metabolomics-based approach. A total of 692 metabolites were identified in the three types of eggs. A total of 263 significantly differentially abundant metabolites were found between pigeon eggs and chicken eggs, and 263 significantly differentially abundant metabolites were found between pigeon eggs and quail eggs. The metabolites that were significantly more abundant in pigeon eggs than in other eggs were mainly lipids, lipid-like molecules, nucleosides, nucleotides, and their analogues. We identified the eight metabolites that were significantly greater in abundance in pigeon eggs than in chicken eggs and quail eggs and quantitatively validated the differences in abundance of these metabolites. Our study demonstrates that there are more functional components in pigeon eggs than chicken eggs and quail eggs, especially for the prevention and treatment of various disordered glucose and lipid metabolism-related diseases. The discovery of these differentially abundant metabolites paves the way for further research on the unique nutritional functions of pigeon eggs and the further utilization of pigeon egg products. Full article

Background/Objectives: Artificial intelligence (AI) is transforming neuroimaging by enhancing diagnostic precision and treatment planning. However, its applications in pediatric cancer neuroimaging remain limited. This review assesses the current state, potential applications, and challenges of AI in pediatric neuroimaging for cancer, emphasizing the unique needs of the pediatric population. Methods: A comprehensive literature review was conducted, focusing on AI’s impact on pediatric neuroimaging through accelerated image acquisition, reduced radiation, and improved tumor detection. Key methods include convolutional neural networks for tumor segmentation, radiomics for tumor characterization, and several tools for functional imaging. Challenges such as limited pediatric datasets, developmental variability, ethical concerns, and the need for explainable models were analyzed. Results: AI has shown significant potential to improve imaging quality, reduce scan times, and enhance diagnostic accuracy in pediatric neuroimaging, resulting in improved accuracy in tumor segmentation and outcome prediction for treatment. However, progress is hindered by the scarcity of pediatric datasets, issues with data sharing, and the ethical implications of applying AI in vulnerable populations. Conclusions: To overcome current limitations, future research should focus on building robust pediatric datasets, fostering multi-institutional collaborations for data sharing, and developing interpretable AI models that align with clinical practice and ethical standards. These efforts are essential in harnessing the full potential of AI in pediatric neuroimaging and improving outcomes for children with cancer. Full article

Abstract: Guhong injection (GH) is a compound preparation widely utilized in the treatment of cerebrovascular diseases. Accumulating evidence indicates that the gut microbiota is implicated in the development of ischemic stroke (IS). However, although the therapeutic potential of GH in IS may be mediated through the gut microbiota, the intricate relationships among the gut–brain axis, biomarkers, and target proteins remain to be completely explained. A rat model of middle cerebral artery occlusion (MCAO) was utilized to investigate the impact of GH on IS. Our 16S rRNA sequence analysis revealed that GH markedly enhanced the α-diversity of the intestinal microbiome and rectified the imbalance of short-chain fatty acids (SCFAs). Metabolomic analysis indicated that GH reversed 45 biomarkers and 6 disordered metabolic pathways in MCAO rats. Among these, the metabolic pathways of arachidonic acid, α-linolenic acid, fructose, and mannose were closely associated with gut microbiota comprising Lactobacillus modulated by GH. Furthermore, IS-related signaling pathways, including inflammation, autophagy, oxidative stress, and apoptosis, were significantly associated with three gut microbial species influenced by GH. The potential efficacy of GH in the context of IS is mediated through multiple pathways, involving the gut microbiota, SCFAs, biomarkers, and target proteins. This process partly relies on the gut–brain axis. Full article

Background: The operative indication for posterior malleolar fracture (PMF) remains controversial. This study aimed to assess the midterm outcomes of PMF treatment for developing a treatment strategy for each morphological type. Methods: In this retrospective analysis, patients undergoing operative treatment for an unstable ankle fracture involving PMF were included after at least 3 years of follow-up. PMFs were classified by fracture morphology according to the Haraguchi classification. This study divided the entire cohort into three independent populations based on the types of PMF. For each population, patients were further categorized into two groups depending on whether PMF was surgically fixed or not, and comparisons were made between these two groups. Demographic data, functional and radiographical outcomes were compared between two groups in each of the three populations. Results: With a total of 472 patients, the mean patient age was 45.8 years, and the mean follow-up was 51 months. For type 1 fracture, a total of 237 cases were found. Quality of reduction by CT (QRC) was mostly good in both groups (83.6% vs. 83.3% in the non-fixation vs. fixation group, respectively, p = 0.269). Functional and radiological outcomes between both groups showed no significant difference. For type 2 PMFs, a total of 199 cases were found, and QRC was significantly different between the two groups (good grade, 5.4% vs. 60.7% in the non-fixation vs. fixation group, respectively, p < 0.001). The radiological and clinical outcomes of the PMF fixation group were statistically superior to those of the non-fixation group (both p < 0.001). For type 3 fractures, a total of 36 cases were found. In all the cases in this group, surgical fixation of PMF was not performed. Only the syndesmosis instability was analyzed as a viable factor to be considered for achieving favorable surgical outcomes. PMF fixation group showed significantly more postoperative complications (24.4% vs. 40.4%, non-fixation vs. fixation, respectively, p < 0.001). Major complications in the fixation group were deep wound infection (6.8%), superficial peroneal nerve injury (6.8%), and hallux flexion deficit (5.0%). Conclusions: Different treatment strategies seem to be required for each PMF morphological subtype. Further studies with more detailed designs for each PMFs are warranted for more clinically related results that are helpful for making practical surgical decisions. Full article

The densification of yellow poplar (Liriodendron tulipifera) has emerged as a critical area of research, driven by its desirable properties and broad potential applications. This study investigated the effects of four densification parameters using a 2⁴ full factorial design to evaluate their impact on physical and mechanical properties. Analysis of variance (ANOVA) and Pareto analyses identified the compression ratio as the most influential factor, significantly affecting bending strength, compression strength, hardness, and spring-back behavior. Pressing temperature was the second most significant factor, with higher levels positively impacting mechanical properties. However, increasing the pre-steaming treatment duration from 30 to 60 min at 130 °C had a detrimental effect on strength and spring-back performance, particularly at a 50% compression ratio. Pressing time showed no significant effect on strength properties but contributed positively to hardness and spring-back behavior at higher levels. Several significant factor interactions were observed, further influencing the outcomes. Differences in density profiles were notable across compression ratios, with higher ratios producing more uniform distributions. Under optimal parameters, densification increased compression strength by 117%, bending strength by 60%, and hardness by 154% compared to undensified control samples, demonstrating the potential of densified yellow poplar (Liriodendron tulipifera) for high-performance applications. Full article

Malaria is a tropical disease caused by the Plasmodium parasite, which was responsible for 249 million cases worldwide in 2022. Malaria is currently diagnosed using RDTs, PCR-based methods, or blood smear microscopy. Ideal biomarkers have been identified for malaria, with the potential for improving treatment, diagnosis, and overall clinical outcomes. This review discusses the types of existing biomarkers and the opportunities for new biomarkers to be used as diagnostic components in detecting Plasmodium, including in terms of sensitivity, detection limit, specificity, and the species of Plasmodium that can be detected. Following a comparison, five main ideal malaria biomarkers were identified, namely HRP2, pLDH, hemozoin, aldolase, and pGDH. These biomarkers distinguished themselves markedly from the others in terms of specificity in Plasmodium detection, sensitivity in analysis, and the use of non-invasive samples. Several other biomarkers, such as CRP, Ang-1, Ang-2, and PCT, show potential for malaria detection in terms of their ability to differentiate disease severity, and the levels of these biomarkers can be determined in the body for comparison with malaria parasitemia. Of the five ideal biomarkers, hemozoin and aldolase can still be developed regarding the types of samples used and their sensitivity to different Plasmodium species. Further research on the biomarkers CRP, Ang-1, Ang-2, and PCT is still needed to evaluate their potential. Full article

In this study, a surface treatment process was introduced into the conventional dispersion process for preparing wet-laid nonwoven fabrics to improve their properties, using recycled carbon fibers (rCFs). The conventional binder solution was replaced with a solution containing different amounts of silane, and the changes in the fiber properties of the prepared nonwoven fabrics were examined after the addition of modified rCFs and polypropylene. FE-SEM analysis confirmed that a silane layer was formed on the rCF surface due to the formation of a siloxane network. FT-IR and XPS analyses further confirmed the presence of siloxane bonds and chemical modification of the rCF surface. When an optimal amount of silane content was used, the mechanical strength increased by 64% compared to untreated rCFs, owing to the improved molecular chain entanglement within the matrix. Our findings indicate that the simultaneous use of dispersion and a surface treatment can produce composites with excellent mechanical properties and improved processing and surface properties; thus, this method can be used to help upcycle rCFs, thereby expanding their applications. Full article

Experiments were designed to investigate the effect of extrusion on the available energy and nutrient digestibility of wheat, and to further evaluate the effects of incorporating extruded wheat into the diet on growth performance, diarrhea rates, health status, and fecal microbiota of weaned piglets. In Exp. 1, twelve crossbred barrows, with an initial body weight (BW) of 12.0 ± 0.73 kg, were randomly assigned to two treatment groups (wheat and extruded wheat) to determine the digestible energy (DE) and metabolizable energy (ME). Additionally, nine crossbred barrows (initial BW, 13.73 ± 0.59 kg) fitted with ileal cannulas, were arranged in a 9 × 2 Youden square design, including three diets (N-free diet, wheat, and extruded wheat), aiming to measure the standard ileal digestibility of amino acids (AAs). In Exp. 2, 96 pigs (initial BW, 8.58 ± 0.52 kg) were randomly divided into two treatments (CON and 35% extruded wheat) based on BW, with each treatment having six pens, each pen containing four boars and four sows. The results indicated that extrusion significantly increased the DE and ME of wheat and the standard ileal digestibility of most AAs (p < 0.05). Incorporating 35% extruded wheat did not affect the growth performance, diarrhea rates, nutrient digestibility, or health status of the weaned piglets (p > 0.05). However, it tended to enhance the α-diversity of fecal microbiota (p = 0.07) and increased the relative abundance of beneficial bacteria (p < 0.05). In conclusion, extrusion increased the feeding value of wheat, and the inclusion of 35% extruded wheat in the diet increased the relative abundance of beneficial microbes in feces. Full article

Background/Objectives: Acute ankle sprains are common injuries that significantly affect both sports and daily activities. Syndesmotic injuries, a specific type of ligamentous damage, can occur as a part of a sprain or alongside fractures, affecting approximately 20% of ankle fractures. The aim of this study was to evaluate negative prognostic factors influencing surgical outcomes in tibiofibular syndesmotic injuries associated with ankle fractures. Methods: Data from 246 patients were analyzed to examine the impact of initial ankle dislocation, fracture type, and fixation method on postoperative complications and reoperation rates. Ankle joint fractures were treated with open reduction and internal fixation using an anatomically contoured plate designed for optimal tibia and fibula fixation. Four methods of syndesmosis fixation were recorded: one three-cortical screw, one four-cortical screw, two screws (either both four-cortex screws or one three-cortex and one four-cortex screw), or one endobutton. Data analysis was performed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results: Key findings reveal no significant association between initial dislocation and the necessity for reoperation (p = 0.613). However, smoking combined with dislocation significantly increases reoperation rates (35% vs. 15.5%, p = 0.026). Fixation type influenced outcomes, with single four-cortex screws linked to pain but fewer infections. Infection was the most common complication (33.3%), predominantly after fixation with a single three-cortex screw. Men had higher rates of fixation destabilization and infections, while women experienced pain persisting beyond six months postoperatively Conclusions: Patient-specific factors influence syndesmotic injury outcomes. Smoking, gender, and fixation type impact complications, emphasizing the need for tailored surgical approaches to enhance recovery and minimize reoperation risks. Future research should aim to corroborate these findings in larger, multicentric cohorts to refine surgical strategies for syndesmotic injury management. Full article

In recent years, artificial intelligence has begun to play a salient role in various medical fields, including ophthalmology. This extensive review is addressed to ophthalmologists and aims to capture the current landscape and future potential of AI applications for eye health. From automated retinal screening processes and machine learning models predicting the progression of ocular conditions to AI-driven decision support systems in clinical settings, this paper provides a comprehensive overview of the clinical implications of AI in ophthalmology. The development of AI has opened new horizons for ophthalmology, offering innovative solutions to improve the accuracy and efficiency of ocular disease diagnosis and management. The importance of this paper lies in its potential to strengthen collaboration between researchers, ophthalmologists, and AI specialists, leading to transformative findings in the early identification and treatment of eye diseases. By combining AI potential with cutting-edge imaging methods, novel biomarkers, and data-driven approaches, ophthalmologists can make more informed decisions and provide personalized treatment for their patients. Furthermore, this paper emphasizes the translation of basic research outcomes into clinical applications. We do hope this comprehensive review will act as a significant resource for ophthalmologists, researchers, data scientists, healthcare professionals, and managers in the healthcare system who are interested in the application of artificial intelligence in eye health. Full article

Gastric cancer (GC) ranks as one of the most prevalent malignant tumors globally. The subtle manifestation of its early-stage symptoms often results in many GC patients being diagnosed at a late or advanced stage, thereby posing significant obstacles to the effectiveness of chemotherapy treatments. Therefore, identifying early biomarkers for GC is crucial. In recent years, an increasing number of studies have highlighted the pivotal role that aging plays in the progression of cancer. Among the various proteins involved, Cytoskeleton-associated protein 2 (CKAP2) emerges as a crucial player in controlling cell proliferation, regulating mitosis and cell division, and exerting a significant influence on the aging process. We employed a bioinformatics approach to assess the causal association between aging-related genes and GC and explore the potential significance of CKAP2 in GC by analyzing data sourced from various repositories, including Genotype Tissue Expression (GTEx), GWAS Catalog, The Database of Cell Senescence Genes (CellAge), The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), Human Protein Atlas (HPA), and the Comparative Toxicology Genome Database (CTD). Our research summarized the causal relationship between CKAP2 expression and the development risk of GC, differential expression in GC, the relationship with the prognosis of GC, genetic correlation, functional analysis, and immune cell infiltration, and explored the interaction of CKAP2 and chemical substances. The findings revealed that an elevation in CKAP2 expression correlated with a reduced likelihood of developing GC. There was a significant difference in the expression of CKAP2 between GC and normal patients. Specifically, there was higher expression in GC compared to normal patients. In addition, CKAP2 has been proven to have diagnostic value in GC, and elevated levels of CKAP2 expression are indicative of a more favorable prognosis. Immune infiltration analysis revealed the relationship between CKAP2 and tumor immune microenvironment, while the Comparative Toxicology Genome Database (CTD) identified a small molecule compound that may target CKAP2. In summary, through comprehensive multivariate analyses, we identified and validated the potential role that CKAP2 may play in GC. Therefore, CKAP2 shows potential as an indicator for both the diagnosis and prognosis of GC, making it worthy of further clinical investigation. Full article