Effectiveness of bespoke or customised orthotic treatment in plantar pressure reduction of the central metatarsals: A systematic review and meta-analysis.

Background: Conservative treatment is the first therapeutical option for central heads metatarsalgia, a common foot condition. However, to our best knowledge, systematic review and meta-analysis of its effectiveness in terms of plantar pressure improvement have not been yet carried out. Our aim was to answer the following research question: Is bespoke or customized orthotic treatment effective for plantar pressure reduction in patients with mechanical metatarsalgia in the central metatarsal heads? Methods: A systematic review and meta-analysis of the effectiveness of bespoke or customised orthotic treatment in terms of plantar pressure reduction beneath the central -2nd to 4th - metatarsal heads in mechanical metatarsalgia patients were carried out. Pubmed database was searched from September to November 2022. All type of related-topic studies were included. Cochrane Collaboration tool was used to assess the risk of bias of each study. Descriptive and frequency analyses were performed with SPSS 25.0 software. Review Manager v5.4.1 software was used to analyse the data using the inverse variance method for continuous outcomes according to a fixed or random effects model. Results: A total of 5 studies met our inclusion criteria, with 158 participants. Bespoke or customised orthotic treatment is effective for the improvement of plantar pressure under 2nd to 4th metatarsal heads in mechanical metatarsalgia patients (MD -37.54 [95 % CI -65.84, -9.24], p = 0.009). Customised orthotic treatment is more effective than no treatment in terms of reducing plantar pressure (MD -78.63 [95 % CI -119.70, -39.16], p = 0.0002), but its effectiveness is similar to standardised footwear, standardised foot orthoses and isolated metatarsal domes. Conclusions: We found conservative bespoke or customised orthotic treatment to be effective for the improvement of plantar pressure under the central metatarsal heads.

Prospective observational study on scar sequelae after MPOX infection: an analysis of 40 patients.

BACKGROUND: Monkeypox (MPOX) caused a public health emergency of international concern (PHEIC) outbreak between 2022 and 2023, with a recent rise in cases that prompted the World Health Organization (WHO) to declare the disease a PHEIC once again. There is little information on its long-term scarring sequelae. OBJECTIVES: The objective of this study was to assess the risk and characteristics of scarring in patients with MPOX in a tertiary hospital. METHODS: This is a prospective cohort study including patients diagnosed using polymerase chain reaction (PCR) tests. Clinical data were collected and followed up at 12-15 months to assess scarring and its impact on quality of life. RESULTS: Of the 40 patients, 19 (47.5%) developed scars, which were more common in those with initial cutaneous manifestations. Scars significantly affected the quality of life, especially in the genital and mucosal areas. The limited sample and loss to follow-up may affect the validity of the results. CONCLUSION: Scarring is a frequent and disfiguring sequela of MPOX, particularly in patients with early skin symptoms. Prevention and close follow-up are crucial in mitigating these complications.

Environmental fluoxetine promotes skin cell proliferation and wound healing.

This study investigates the effects of environmentally-relevant concentrations of fluoxetine (FLX, commercial name: Prozac) on wound healing. Pollution of water systems with pharmaceutical and personal care products, including antidepressants such as FLX and other selective serotonin reuptake inhibitors, is a growing environmental concern. Environmentally-relevant FLX concentrations are known to impact physiological functions and behaviour of aquatic animals, however, the effects of exposure on humans are currently unknown. Using a combination of human skin biopsies and a human keratinocyte cell line, we show that exposure to environmental FLX promotes wound closure. We show dose-dependent increases in wound closure with FLX concentrations from 125 ng/l. Using several -omics and pharmaceutical approaches, we demonstrate that the mechanisms underlying enhanced wound closure are increased cell proliferation and serotonin signalling. Transcriptomic analysis revealed 350 differentially expressed genes after exposure. Downregulated genes were enriched in pathways related to mitochondrial function and metabolism, while upregulated genes were associated with cell proliferation and tissue morphogenesis. Kinase profiling showed altered phosphorylation of kinases linked to the MAPK pathway. Consistent with this, phosphoproteomic analyses identified 235 differentially phosphorylated proteins after exposure, with enriched GO terms related to cell cycle, division, and protein biosynthesis. Treatment of skin biopsies and keratinocytes with ketanserin, a serotonin receptor antagonist, reversed the increase in wound closure observed upon exposure. These findings collectively show that exposure to environmental FLX promotes wound healing through modulating serotonin signalling, gene expression and protein phosphorylation, leading to enhanced cell proliferation. Our results justify a transition from the study of behavioural effects of environmental FLX in aquatic animals to the investigation of effects of exposure on wound healing in aquatic and terrestrial animals, including direct impacts on human health.

Treatment of recurrent aphthous stomatitis with oral roflumilast, a multicenter observational study.

INTRODUCTION: Severe recurrent aphthous stomatitis (RAS) represents a therapeutic challenge because of its impact on the patient's quality of life. Additionally, no approved systemic therapies are available. Roflumilast, a phosphodiesterase-4 inhibitor, has shown promise in other inflammatory dermatological conditions. This study aimed to assess the characteristics, effectiveness, and safety of roflumilast in treating RAS in routine clinical practice. METHODS: This is a single cohort ambispective observational study conducted in five Spanish centers. Twenty-two patients with RAS treated with roflumilast participated. Data collection included demographic, clinical, and outcome variables. Statistical analysis compared the outcomes of 12 weeks of roflumilast treatment with a similar prior period without treatment. RESULTS: During treatment with roflumilast, a significant reduction in flare-ups (88%) and oral ulcers (94%) was observed compared to the untreated period. A reduction in pain (66%) and ulcer duration (63%) was observed. Adverse effects (AEs) occurred in 13 patients, predominantly headache and gastrointestinal disturbances. Most of these were self-limiting or manageable with dose adjustment. Treatment was withdrawn in three cases, mainly because of AEs. CONCLUSIONS: This study suggests that roflumilast may effectively treat RAS by reducing the number of flare-ups and ulcers, their duration, and the symptomatology produced by the ulcers. In addition, roflumilast has a good safety profile, is well tolerated at low doses, and does not require close monitoring. These characteristics and its favorable economic profile make roflumilast a promising therapeutic option in this pathology.

Janus ScYCBr2 MXene as a Promising Thermoelectric Material.

Finding green energy resources that contribute to the battle against global warming and the pollution of our planet is an urgent challenge. Thermoelectric electricity production is a clean and efficient method of producing energy; consequently, scientists are currently researching and creating thermoelectric materials to increase the efficiency of thermoelectric electricity production and expand the potential of the thermoelectric effect for clean energy production. This work focuses on a comprehensive study of the thermoelectric properties of two-dimensional ScYCBr2. We report here a computational analysis of this Janus-like MXene, which is predicted to exhibit outstanding thermoelectric properties. The study uses density-functional theory to provide evidence of the important role played by symmetry breaking to promote low-thermal transport by favoring certain phonon scattering channels. Compared to its symmetric parent compounds, the asymmetric Janus-type ScYCBr2 displays additional phonon scattering channels reducing the thermal conductivity. An exhaustive investigation of the dynamical stability for both zero-temperature and high-temperature conditions was also performed to support the stability of ScYCBr2. Our analysis shows that thanks to its asymmetric structure, the ScYCBr2 MXene has thermoelectric properties that largely surpass those of its parent symmetric counterpart Sc2CBr2, being a material with a remarkable thermoelectric high figure of merit. Another advantage of ScYCBr2 is its high carrier mobility. This work not only demonstrates that this material is a promising thermoelectric material but also shows that ScYCBr2 can operate efficiently at high temperatures up to 1200 K.

Size-Dependent Ab Initio Atomistic Thermodynamics from Cluster to Bulk: Application to Hydration of Titania Nanoparticles.

Ab initio atomistic thermodynamics (AIAT) has become an indispensable tool to estimate Gibbs free energy changes for solid surfaces interacting with gaseous species relative to pressure (p) and temperature (T). For such systems, AIAT assumes that solid vibrational contributions to Gibbs free energy differences cancel out. However, the validity of this assumption is unclear for nanoscale systems. Using hydrated titania nanoparticles (NPs) as an example, we estimate the vibrational contributions to the Gibbs free energy of hydration (ΔGhyd(T,p)) for arbitrary NP size and degree of hydration. Comparing ΔGhyd(T,p) phase diagrams for NPs when considering these contributions (AIATnano) relative to a standard AIAT approach reveals significant qualitative and quantitative differences, which only become negligible for large systems. By constructing a size-dependent ΔGhyd(T,p) phase diagram, we illustrate how our approach can provide deeper insights into how nanosytems interact with their environments, with many potential applications (e.g., catalytic nanoparticles, biological colloids, nanoparticulate pollutants).

Filipino Immigrants in Santa Cruz de Tenerife, Spain: Health and Access to Services.

The Philippines is a source of labor for many countries. Roughly 10 million overseas Filipinos are working and living outside of the Philippines. This paper examines the association between sociodemographic characteristics (sex, age, educational level, and income) and self-rated physical and mental health, access to healthcare, and health habits among immigrant Filipinos living in Santa Cruz de Tenerife, Spain. Through convenience sampling, Filipino migrants (n = 103) aged 18 years and above participated in the online survey between October 2022 and March 2023. The data were analyzed using descriptive statistical analysis and chi-square. Almost all respondents self-rated their health as excellent and very good. Female respondents are more affected by mental health. Most are enrolled in the Universal Health System of Spain (public insurance). There is more utilization of private health insurance among respondents aged 60 years and above and high-wage earners. Cigarette smoking and alcohol drinking are associated with males. More than half of the respondents perform weekly exercise occasionally or never. These findings suggest a potential need for targeted interventions with an emphasis on the practice of preventive health and the promotion of healthy lifestyles, especially among financially disadvantaged migrants with lesser health access.

First principles modeling of composites involving TiO2 clusters supported on M2C MXenes.

First-principles calculations based on density functional theory are performed to investigate the formation of titania/MXene composites taking (TiO2)5/M2C (M = Ti, Zr, Hf, V, Nb, Ta, Cr, Mo, and W) as cases of study. The present systematic analysis confirms a favorable, high exothermic interaction, which promotes important structural reconstructions of the (TiO2)5 cluster along with charge transfer from the MXene to titania. MXenes composed of d3 transition metals promote the strongest interaction, deformation energy, and charge transfer, followed by d4 and d5 M2C MXenes. We provide evidence that the formation of these (TiO2)5/M2C composites is governed by charge transfer, leading to scaling relationships. By using the electronegativity of the metal composing MXene and the MXene d-band center, we also establish linear correlations that can be used to predict the interaction strength of (TiO2)5/M2C composites just from the knowledge of the MXene composition. It is likely that the present trends hold for other TiO2/MXene composites.

Correction: The nature of the electronic ground state of M2C (M = Ti, V, Cr, Zr, Nb, Mo, Hf, Ta, and W) MXenes.

Correction for 'The nature of the electronic ground state of M2C (M = Ti, V, Cr, Zr, Nb, Mo, Hf, Ta, and W) MXenes' by Néstor García-Romeral et al., Phys. Chem. Chem. Phys., 2023, 25, 31153-31164, https://doi.org/10.1039/D3CP04402E.

p53 Genetics and Biology in Lung Carcinomas: Insights, Implications and Clinical Applications.

The TP53 gene is renowned as a tumor suppressor, playing a pivotal role in overseeing the cell cycle, apoptosis, and maintaining genomic stability. Dysregulation of p53 often contributes to the initiation and progression of various cancers, including lung cancer (LC) subtypes. The review explores the intricate relationship between p53 and its role in the development and progression of LC. p53, a crucial tumor suppressor protein, exists in various isoforms, and understanding their distinct functions in LC is essential for advancing our knowledge of this deadly disease. This review aims to provide a comprehensive literature overview of p53, its relevance to LC, and potential clinical applications.

Cervical Cancer Evades the Host Immune System through the Inhibition of Type I Interferon and CXCL9 by LIF.

PURPOSE: Cervical cancer is a viral-associated tumor caused by the infection with the human papilloma virus. Cervical cancer is an immunogenic cancer that expresses viral antigens. Despite being immunogenic, cervical cancer does not fully respond to immune checkpoint inhibitors (ICI). LIF is a crucial cytokine in embryo implantation, involved in maternal tolerance that acts as an immunomodulatory factor in cancer. LIF is expressed in cervical cancer and high levels of LIF is associated with poor prognosis in cervical cancer. EXPERIMENTAL DESIGN: We evaluated the impact of LIF on the immune response to ICI using primary plasmocytoid dendritic cells (pDC) and macrophage cultures, syngeneic animals and patient-derived models that recapitulate the human tumor microenvironment. RESULTS: We found that the viral proteins E6 and E7 induce the expression of LIF via the NFκB pathway. The secreted LIF can then repress type I interferon expressed in pDCs and CXCL9 expressed in tumor-associated macrophages. Blockade of LIF promotes the induction of type I interferon and CXCL9 inducing the tumor infiltration of CD8 T cells. This results in the sensitization of the tumor to ICI. Importantly, we observed that patients with cervical cancer expressing high levels of LIF tend to be resistant to ICI. CONCLUSIONS: Our data show that the HPV virus induces the expression of LIF to provide a selective advantage to the tumor cell by generating local immunosuppression via the repression of type I interferon and CXCL9. Combinatory treatment with blocking antibodies against LIF and ICI could be effective against cervical cancer expressing high levels of LIF.

Altered dynamics of calcium fluxes and mitochondrial metabolism in platelet activation-related disease and aging.

Understanding the mechanisms controlling platelet function is crucial for exploring potential therapeutic targets related to atherothrombotic pathologies and primary hemostasis disorders. Our research, which focuses on the role of platelet mitochondria and Ca2+ fluxes in platelet activation, the formation of the procoagulant phenotype, and thrombosis, has significant implications for the development of new therapeutic strategies. Traditionally, Ca2+-dependent cellular signaling has been recognized as a determinant process throughout the platelet activation, controlled primarily by store-operated Ca2+ entry and the PLC-PKC signaling pathway. However, despite the accumulated knowledge of these regulatory mechanisms, the effectiveness of therapy based on various commonly used antiplatelet drugs (such as acetylsalicylic acid and clopidogrel, among others) has faced challenges due to bleeding risks and reduced efficacy associated with the phenomenon of high platelet reactivity. Recent evidence suggests that platelet mitochondria could play a fundamental role in these aspects through Ca2+-dependent mechanisms linked to apoptosis and forming a procoagulant phenotype. In this context, the present review describes the latest advances regarding the role of platelet mitochondria and Ca2+ fluxes in platelet activation, the formation of the procoagulant phenotype, and thrombosis.

A Review of Natural Fiber-Reinforced Composites for Lower-Limb Prosthetic Designs.

This paper presents a comprehensive review of natural fiber-reinforced composites (NFRCs) for lower-limb prosthetic designs. It covers the characteristics, types, and properties of natural fiber-reinforced composites as well as their advantages and drawbacks in prosthetic designs. This review also discusses successful prosthetic designs that incorporate NFRCs and the factors that make them effective. Additionally, this study explores the use of computational biomechanical models to evaluate the effectiveness of prosthetic devices and the key factors that are considered. Overall, this document provides a valuable resource for anyone interested in using NFRCs for lower-limb prosthetic designs.

Family Caregivers' Experiences during the COVID-19 Pandemic: Qualitative Study.

Background: The COVID-19 pandemic imposed lockdown measures that affected caregiving. Understanding caregivers' context provides reveals their adaptive strategies to continue caring in this situation of uncertainty and isolation. Objective: To better understand the caregiving experiences of caregivers looking after dependent individuals living in the community during the pandemic. Design: Qualitative research, phenomenological approach. Setting: Primary healthcare centers in Madrid region (Spain). Participants: 21 family caregivers. Methods: Purposive and theoretical sampling was used to recruit caregivers across nurses from primary healthcare centers. Participants were interviewed using a semi-structured interview guide to explore the caring experience. Interview transcripts were evaluated using thematic analysis. Results: The findings were categorized into two themes: "Caregivers during lockdown-providing care in a time of adversity" and "Caregiving toward normality". The sub-themes identified were the re-structuring of before-care services and the introduction of new care approaches, managing the dependent person's health problems, looking after oneself, and dealing with adversity. To adapt to the new normal, strategies were put in place designed to recover confidence and trust, reincorporate assistance, and reconnect with others. Conclusions: Care intensified during the pandemic. Caregivers took on the task without assistance, focusing on preventing contagion and protecting themselves to be able to continue giving care.

Infrared thermography for normal endothelial function screening.

BACKGROUND: Endothelial dysfunction (ED) suspicion will allow to prevent accelerated atherosclerosis and premature death. OBJECTIVE: To establish the usefulness of thermography for endothelial function screening in adults with cardiovascular risk factors. MATERIAL AND METHODS: Cross-sectional, analytical diagnostic test. A brachial arterial diameter (BAD) increase < 11% at one-minute post-ischemia meant probable ED and was confirmed if BAD was ≥ 11% post-sublingual nitroglycerin. Thermographic photographs of the palmar region were obtained at one minute. Descriptive statistics, ROC curve, Mann-Whitney's U-test, chi-square test, or Fisher's exact test were used. RESULTS: Thirty-eight subjects with a median age of 50 years, and with 624 thermographic measurements were included. Nine had ED (flow-mediated vasodilation [FMV]: 2.5%). The best cutoff point for normal endothelial function in subjects with cardiovascular risk factors was ≥ 36 °C at one minute of ischemia, with 85% sensitivity, 70% specificity, positive and negative predictive values of 78 and 77%, area under the curve of 0.796, LR+ 2.82, LR- 0.22. CONCLUSION: An infrared thermography-measured temperature in the palmar region greater than or equal to 36 °C after one minute of ischemia is practical, non-invasive, and inexpensive for normal endothelial function screening in adults with cardiovascular risk factors.

ANTECEDENTES: La sospecha de disfunción endotelial (DE) permitirá prevenir la aterosclerosis acelerada y la muerte prematura. OBJETIVO: Establecer la utilidad de la termografía en el cribado de la función endotelial en adultos con factores de riesgo cardiovascular. MATERIAL Y MÉTODOS: Estudio transversal analítico de prueba diagnóstica. El incremento del diámetro de la arteria braquial < 11 % a un minuto posisquemia significó probable DE, confirmada si el diámetro fue ≥ 11 % posnitroglicerina sublingual. Se obtuvieron fotografías termográficas al minuto de la región palmar. Se aplicó estadística descriptiva, curva ROC, pruebas U de Mann-Whitney, chi cuadrada o exacta de Fisher. RESULTADOS: Se incluyeron 38 sujetos, mediana de edad de 50 años, con 624 mediciones termográficas; nueve presentaron DE (vasodilatación mediada por flujo de 2.5 %). El mejor punto de corte para la función endotelial normal en sujetos con factores de riesgo cardiovascular fue ≥ 36 °C al minuto de isquemia, con sensibilidad de 85%, especificidad de 70%, valores predictivos positivo y negativo de 78 y 77%, área bajo la curva de 0.796, razón de verisimilitud positiva de 2.82 y razón de verisimilitud negativa de 0.22. CONCLUSIÓN: La medición de la temperatura en la región palmar mediante termografía infrarroja ≥ 36 °C tras un minuto de isquemia es práctica, no invasiva y económica para el cribado de la función endotelial normal en adultos con factores de riesgo cardiovascular.

Data-Monitoring Solution for Desalination Processes: Cooling Tower and Mechanical Vapor Compression Hybrid System.

The advancement of novel water treatment technologies requires the implementation of both accurate data measurement and recording processes. These procedures are essential for acquiring results and conducting thorough analyses to enhance operational efficiency. In addition, accurate sensor data facilitate precise control over chemical treatment dosages, ensuring optimal water quality and corrosion inhibition while minimizing chemical usage and associated costs. Under this framework, this paper describes the sensoring and monitoring solution for a hybrid system based on a cooling tower (CT) connected to mechanical vapor compression (MVC) equipment for desalination and brine concentration purposes. Sensors connected to the data commercial logger solution, Almemo 2890-9, are also discussed in detail such as temperature, relative humidity, pressure, flow rate, etc. The monitoring system allows remote control of the MVC based on a server, GateManager, and TightVNC. In this way, the proposed solution provides remote access to the hybrid system, being able to visualize gathered data in real time. A case study located in Cartagena (Spain) is used to assess the proposed solution. Collected data from temperature transmitters, pneumatic valves, level sensors, and power demand are included and discussed in the paper. These variables allow a subsequent forecasting process to estimate brine concentration values. Different sample times are included in this paper to minimize the collected data from the hybrid system within suitable operation conditions. This solution is suitable to be applied to other desalination processes and locations.

Amended Vegetation Filters as Nature-Based Solutions for the Treatment of Pharmaceuticals: Infiltration Experiments Coupled to Reactive Transport Modelling.

In small populations and scattered communities, wastewater treatment through vegetation filters (VFs), a nature-based solution, has proved to be feasible, especially for nutrient and organic matter removal. However, the presence of pharmaceuticals in wastewater and their potential to infiltrate through the vadose zone and reach groundwater is a drawback in the evaluation of VF performances. Soil amended with readily labile carbon sources, such as woodchips, enhances microbial activity and sorption processes, which could improve pharmaceutical attenuation in VFs. The present study aims to assess if woodchip amendments to a VF's soil are able to abate concentrations of selected pharmaceuticals in the infiltrating water by quantitatively describing the occurring processes through reactive transport modelling. Thus, a column experiment using soil collected from an operating VF and poplar woodchips was conducted, alongside a column containing only soil used as reference. The pharmaceuticals acetaminophen, naproxen, atenolol, caffeine, carbamazepine, ketoprofen and sulfamethoxazole were applied daily to the column inlet, mimicking a real irrigation pattern and periodically measured in the effluent. Ketoprofen was the only injected pharmaceutical that reached the column outlet of both systems within the experimental timeframe. The absence of acetaminophen, atenolol, caffeine, carbamazepine, naproxen and sulfamethoxazole in both column outlets indicates that they were attenuated even without woodchips. However, the presence of 10,11-epoxy carbamazepine and atenolol acid as transformation products (TPs) suggests that incomplete degradation also occurs and that the effect of the amendment on the infiltration of TPs is compound-specific. Modelling allowed us to generate breakthrough curves of ketoprofen in both columns and to obtain transport parameters during infiltration. Woodchip-amended columns exhibited Kd and µw values from one to two orders of magnitude higher compared to soil column. This augmentation of sorption and biodegradation processes significantly enhanced the removal of ketoprofen to over 96%.