Synergistic biochar and Serratia marcescens tackle toxic metal contamination: A multifaceted machine learning approach.

Metal contamination in soil poses environmental and health risks requiring effective remediation strategies. This study introduces an innovative approach of synergistically employing biochar and bacterial inoculum of Serratia marcescens to address toxic metal (TM) contamination. Physicochemical, enzymatic, and microbial analyses were conducted, employing integrated biomarker response (IBR) and machine-learning approaches for toxicity estimation. The combined application significantly reduced the Cd, Cr, and Pb concentrations by 71.6, 31.2, and 57.1%, respectively, while the Cu concentration increased by 85% in the individual Serratia marcescens treatment. Biochar enhanced microbial biomass by 33-44% after 25 days. Noteworthy physicochemical improvements included a 44.7% increase in organic content and a decrease in pH and electrical conductivity. The K⁺ and Ca2⁺ concentrations increased by 196.9 and 21.6%, respectively, while the Mg2⁺ content decreased by 86.4%. Network analysis revealed intricate relationships, displaying direct and indirect negative correlations between metals and soil physicochemical parameters. The IBR index values indicated effective mitigation of TM toxicity in Serratia marcescens and biochar with individual and combined treatments. Binary classification demonstrated high sensitivity (80.1%) and specificity (80.5%) in identifying TM-contaminated soil. These findings indicate significant biochar- and Serratia marcescens-induced impacts on toxic metal availability, physicochemical properties, and enzymatic activities in metal-contaminated soil, suggesting that blending soil with biochar and microorganisms is an effective remediation strategy.

AI-CADR: Artificial Intelligence Based Risk Stratification of Coronary Artery Disease using Novel Non-invasive Biomarkers.

Coronary artery disease (CAD) is one of the most common causes of sudden cardiac arrest, accounting for a large percentage of global mortality. A timely diagnosis and detection may save a person's life. The research suggests a methodological framework for non-invasive risk stratification based on information only possible after invasive coronary angiography. Novel clinical, chemical, and molecular cardiac biomarkers were used as input features from an especially collected dataset. Following a thorough evaluative search in the biomarker feature space, the optimum feature and classifier or regression technique (regressor) set were selected using K-fold cross-validation. Ten machine learning (ML) classifiers were employed in classification tasks to determine the number of affected cardiac vessels, the Gensini group, and the severity of CAD with 82.58%, 86.26%, and 90.91% accuracy, respectively. Eleven approaches were used in regression tasks to calculate stenosis percentage and Gensini score, with R-squared values of 0.58 and 0.56, respectively. Following a thorough evaluative search in the biomarkers feature space, the optimum feature and classifier or regressor set were selected using K-fold cross-validation. The biomarkers and classifier or regressor combinations serve as the foundation for the proposed risk stratification framework, incorporating clinical protocol. Finally, our proposed framework is compared to state-of-the-art studies, offering a robust, well-rounded, early detection capable, and novel 'biomarkers-ML combination' approach to risk stratification.

Synthesis of reduced graphene oxide supported FeCu and its environmental applications.

A significant share of wastewater produced during different processes is released to the surroundings without further treatment. Therefore, polluted water sources are triggering diseases like typhoid. To avoid this, various techniques have been developed for the removal of contaminants from the water. Iron-copper bimetallic nanoparticles (NPs) supported on the reduced graphene oxide (rGOFeCu) were prepared which showed excellent antibacterial activity, efficient dechlorination of 1,1,1-trichloroethane (TCA), and removal of methylene blue (MB). The characterization of prepared nanocomposites was done by transmission electron microscopy (TEM) and X-ray diffraction (XRD). Iron-based bimetallic NPs supported on the graphene were successfully synthesized as confirmed by TEM. Iron has a strong antibacterial effect on microorganisms, especially bacteria. We conducted the antibacterial activity of different compositions of nanocomposite toward Escherichia coli to understand the efficacy of prepared nanocomposites. In the same time and concentration conditions, rGOFeCu showed the best antibacterial activity, as compared to the graphene-based iron. Results show that the excellent antibacterial activity was exhibited by using rGO-Fe95Cu05 within two hours. More than 98% of cell inhibition was observed. The further increase in copper loading has no major effect on antibacterial activity. rGO-Fe95Cu05 exhibited excellent removal efficiency of TCA (99%) within 30 min as compared to other compositions of FeCu. It was found that rGO-Fe95Cu05 exhibited excellent removal efficiency against degradation of methylene blue (MB) through activation of sodium percarbonate (SPC). The results indicated that more than 99% of MB was removed within 15 min. The rGOFeCu represented a great potential material for antibacterial activity towards E. coli and remediation of other pollutants in the wastewater such as TCA and removal of MB.

Critical Chest Wall Necrotizing Fasciitis Triggered by Herpes Zoster: A Case Report.

BACKGROUND Necrotizing fasciitis is an aggressive type of skin and soft tissue infection that results in necrosis of subcutaneous tissues, including muscle and fascia. Mixed bacteria, including gas-forming organisms, are usually identified. This report describes a 55-year-old male diabetic patient with herpes zoster involving the thoracic dermatomes complicated by skin infection, necrotizing fasciitis, chest wall abscess, and sepsis. CASE REPORT A 55-year-old man with diabetes mellitus presented with thoracic herpes zoster, initially treated with acyclovir and topical agents. He developed swelling, pain, and fever over the left chest, which was unresponsive to topical treatment. Investigations revealed elevated white blood cells and gas on chest X-ray. Computed tomography confirmed a 13×6×11-cm abscess with gas between the latissimus dorsi and serratus anterior muscles, suggesting necrosis. He received intravenous amoxicillin/clavulanic acid and metronidazole and underwent urgent surgical drainage, yielding 200 mL of pus. Cultures identified antibiotic-sensitive Staphylococcus aureus and Clostridium perfringens. Histopathology confirmed necrotizing tissue with acute bacterial inflammation. He was treated postoperatively with dressings and vacuum-assisted closure, followed by sutures, and was discharged in good condition after 16 days. CONCLUSIONS This case underscores the aggressive nature and potential complications of necrotizing soft tissue infections in patients with diabetes mellitus and herpes zoster. Prompt recognition, early intervention with appropriate antibiotics, and surgical drainage are crucial in managing such infections effectively. The successful use of vacuum-assisted closure therapy underscores its role in facilitating wound healing after debridement. Clinicians should maintain vigilance for necrotizing infections in similar high-risk patients to ensure early intervention and improve clinical outcomes.

Evaluation of the geometric and dosimetric accuracies of deformable image registration of targets and critical organs in prostate CBCT-guided adaptive radiotherapy.

PURPOSE: Kilovoltage cone beam computed tomography (kVCBCT)-guided adaptive radiation therapy (ART) uses daily deformed CT (dCT), which is generated automatically through deformable registration methods. These registration methods may perform poorly in reproducing volumes of the target organ, rectum, and bladder during treatment. We analyzed the registration errors between the daily kVCBCTs and corresponding dCTs for these organs using the default optical flow algorithm and two registration procedures. We validated the effectiveness of these registration methods in replicating the geometry for dose calculation on kVCBCT for ART. METHODS: We evaluated three deformable image registration (DIR) methods to assess their registration accuracy and dose calculation effeciency in mapping target and critical organs. The DIR methods include (1) default intensity-based deformable registration, (2) hybrid deformable registration, and (3) a two-step deformable registration process. Each technique was applied to a computerized imaging reference system (CIRS) phantom (Model 062 M) and to five patients who received volumetric modulated arc therapy to the prostate. Registration accuracy was assessed using the 95% Hausdorff distance (HD95) and Dice similarity coefficient (DSC), and each method was compared with the intensity-based registration method. The improvement in the dCT image quality of the CIRS phantom and five patients was assessed by comparing dCT with kVCBCT. Image quality quantitative metrics for the phantom included the signal-to-noise ratio (SNR), uniformity, and contrast-to-noise ratio (CNR), whereas those for the patients included the mean absolute error (MAE), mean error, peak signal-to-noise ratio (PSNR), and structural similarity index measure (SSIM). To determine dose metric differences, we used a dose-volume histogram (DVH) and 3.0%/0.3 mm gamma analysis to compare planning computed tomography (pCT) and kVCBCT recalculations with restimulated CT images used as a reference. RESULTS: The dCT images generated by the hybrid (dCTH) and two-step (dCTC) registration methods resulted in significant improvements compared to kVCBCT in the phantom model. Specifically, the SNR improved by 107% and 107.2%, the uniformity improved by 90% and 75%, and the CNR improved by 212.2% and 225.6 for dCTH and dCTC methods, respectively. For the patient images, the MAEs improved by 98% and 94%, the PSNRs improved by 16.3% and 22.9%, and the SSIMs improved by 1% and 1% in the dCTH and dCTC methods, respectively. For the geometric evaluation, only the two-step registration method improved registration accuracy. The dCTH method yielded an average HD95 of 12 mm and average DSC of 0.73, whereas dCTC yielded an average HD95 of 2.9 mm and average DSC of 0.902. The DVH showed that the dCTC-based dose calculations differed by <2% from the expected results for treatment targets and volumes of organs at risk. Additionally, gamma indices for dCTC-based treatment plans were >95% at all points, whereas they were <95% for kVCBCT-based treatment plans. CONCLUSION: The two-step registration method outperforms the intensity-based and hybrid registration methods. While the hybrid and two-step-based methods improved the image quality of kVCBCT in a linear accelerator, only the two-step method improved the registration accuracy of the corresponding structures among the pCT and kVCBCT datasets. A two-step registration process is recommended for applying kVCBCT to ART, which achieves better registration accuracy for local and global image structures. This method appears to be beneficial for radiotherapy dose calculation in patients with pelvic cancer.

Practical Recommendations from the Gulf Region on the Therapeutic Use of Cladribine Tablets for the Management of Relapsing Multiple Sclerosis: Impact of the Latest Real-World Evidence on Clinical Practice.

Cladribine tablets (CladT), like alemtuzumab, acts as an immune reconstitution therapy. However, CladT is administered orally (alemtuzumab is given by infusion) and without the potential for serious side effects that limit the therapeutic use of alemtuzumab in multiple sclerosis (MS). Treatment with CladT, given initially as short courses of treatment 1 year apart, provides years of freedom from MS disease activity in responders to treatment. The appearance of mild or moderate MS disease activity after the initial 2 years of treatment may prompt careful follow-up or a further course of CladT, depending on the nature of the activity and individual circumstances. The appearance of severe MS disease activity requires a switch to an alternative high-efficacy disease-modifying treatment (DMT). The accumulating data from CladT-treated people with MS in real-world studies, including those with follow-up durations extending for years beyond the initial treatment, have demonstrated long-term freedom from MS disease activity in a good proportion of patients. This clinical experience has also confirmed that treatment with CladT is generally safe and well tolerated. The best time to prescribe a high-efficacy DMT is the subject of debate, with evidence that earlier versus later use of such agents may provide more effective long-term protection from disability progression. High-efficacy DMTs have traditionally been reserved for use in people with MS and high disease activity on presentation or breakthrough disease on one or more DMTs, as per the current product labels. The latest evidence from real-world studies suggests that CladT is effective and safe in DMT-naïve patients, including those with shorter disease duration.

UV-spectrophotometric and spectroscopic observed Vachellia nilotica and Nigella sativa formulations regularized the histopathological and biochemical parameters during wound contraction.

Diabetes mellitus causes impaired diabetic wounds which is linked to a number of pathological alterations that impede the healing of wounds. In the current research, Swiss albino mice were given alloxan monohydrate to induce diabetes and excision wounds of approximately 6 mm using biopsy punch. The diabetic wounds were treated with various biomaterials including Vachellia nilotica extract (VN), Nigella sativa extract (NS), V. nilotica nanoparticles (VNNPs) and N. sativa nanoparticles (NSNPs). Their effects were determined by evaluating the percent wound contraction, healing time, and histopathological analysis. The serum level of various biochemical parameters that is, pro-inflammatory cytokines,  Matrix metalloproteinases (MMPs) and tissue inhibitor matrix metalloproteinases (TIMPs) were also determined. VNNPs group provided the best outcomes, with wound contraction 100% on 12th day. According to histopathological examination, VNNPs group reduced inflammation and encouraged the formation of blood vessels, fibroblasts, and keratinocytes. VNNPs group significantly alleviated the serum level of pro-inflammatory cytokines that are, TNF-α (19.4 ± 1.5 pg/mL), IL-6 (13.8 ± 0.6 pg/mL), and IL-8 (24.8 ± 1.2 pg/mL) as compared with the diabetic mice. The serum level of MMP2 (248.2 ± 7.9 pg/mL), MMP7 (316 ± 5.2 pg/mL), and MMP9 (167.8 ± 12.1 pg/mL) in the same group VNNPs were also observed much less than the diabetic mice. The serum level of TIMPs (176.8 ± 2.9 pg/mL) in the VNNPs group was increased maximally with respect to diabetic mice. It is concluded that nanoparticles and biomaterials possess healing properties and have the ability to repair the chronic/diabetic wound. RESEARCH HIGHLIGHTS: UV-spectrophotometric and Fourier transform infrared spectroscopy observation for functional group analysis and possible linkage between conjugates Optimization of the histopathological and biochemical markers after application of the formulations Microscopic analysis of epithelial tissues for evaluation of healing mechanisms Speedy contraction of wounds as the alleviation of the inflammatory and necrotic factors.

Potential anaphylactoid reaction to nicardipine.

Anaphylactic and anaphylactoid reactions are both acute allergic responses known to be potentially fatal if not treated emergently. Signs include bronchospasm, urticaria, nausea and vomiting, pharyngeal edema and cardiovascular collapse. Nicardipine hydrochloride is a dihydropyridine calcium channel blocker that has emerged as a first-line antihypertensive in which emergent blood pressure control is critical. The patient in this case is a 52-year-old male who arrived at the emergency department (ED) with right-sided hemineglect, severe dysarthria, and aphasia, and he was diagnosed with an acute left thalamic hemorrhage. His blood pressure readings were initially 252/135 mmHg despite multiple intermittent boluses of intravenous hydralazine. He was administered a nicardipine hydrochloride infusion at 2.5 mg/h. Due to poor blood pressure control, the rate was titrated up in increments of 2.5 mg/h in the span of 30 min. While up titrating the infusion rate, he developed diffuse swelling and erythema to his left upper extremity in which the medication was being infused, a body wide urticarial rash, tachycardia, diaphoresis, wheezing, and hypoxemia saturating 85% on room air.

The impact of print orientation and graphene nanoplatelets on biaxial flexural strength and cytotoxicity of a 3D printable resin for occlusal splints.

OBJECTIVES: 3D printing found its way into various medical applications and could be particularly beneficial for dentistry. Currently, materials for 3D printing of occlusal splints lack mechanical strength compared to polymethyl methacrylate (PMMA) used for standard milling of occlusal splints. It is known that print orientation and graphene nanoplatelets (GNP) can increase biaxial strength in a variety of materials. Thus, the aim of this study was to assess if adjustment of print orientation and addition of GNP improve biaxial strength and if they affect cytotoxicity of a 3D printable resin for occlusal splints. METHODS: Specimens were printed vertically and horizontally with a stereolithography (SLA) printer and multilayered GNP powder was added to the resin at different concentrations. Printed specimens were characterized by Raman spectroscopy, optical profilometer analysis and scanning electron microscopy. Biaxial strength was evaluated by biaxial flexural testing. Cytotoxicity of specimens on L929 and gingival stromal cells (GSC) was assessed by the toxdent test, the resazurin-based toxicity assay and live-dead staining. RESULTS: Horizontally printed specimens showed significantly higher biaxial strength and lower deformation. GNP did not improve biaxial strength and material deformation of 3D-printed resins. None of the specimens were cytotoxic to L929 cells or GSC. SIGNIFICANCE: Print orientation in SLA printing has a significant impact on biaxial strength and material deformation. 3D printable materials can reach comparable or even improved biaxial strength compared to PMMA when using the optimal print orientation while GNP has no beneficial effects on the biaxial strength of resins for 3D printing of occlusal splints.

Nationwide exploration: assessing oral microbiome knowledge among dental professionals in Saudi Arabia and its implications for oral health care.

BACKGROUND: The relationship between the microbiome and oral health is intricate, yet there is a lack of comprehensive knowledge regarding the microbiome's impact on oral health. Integrating knowledge regarding the oral microbiome and its significance in oral and systemic diseases holds profound implications for dental professionals in patient care and professional development. This study assessed dental professionals' oral microbiome comprehension and knowledge levels in Saudi Arabia and its implications for oral healthcare. METHODS: Data were gathered using a cross-sectional design by administering a comprehensive online questionnaire to 253 dental professionals from diverse demographic backgrounds. The questionnaire, administered in English, was divided into four sections: (1) Microbiome awareness and understanding, (2) Diet, nutrition, and microbiome relationship, (3) Microbiome and oral and systemic diseases, and (4) Counselling, education, and implications. Statistical analyses were used to identify and understand underlying patterns, including descriptive statistics, chi-squared tests, ANOVA, and post hoc tests. The Spearman rank correlation coefficient was applied to assess self-rated knowledge. RESULTS: Of the 253 participants, 94.6% were familiar with the term "microbiome." Merely 13% of participants considered the oral microbiome to be the second most diverse, following the gut microbiome. About 39.9% of participants knew the connection between oral mucosal diseases and the oral microbiome. Furthermore, only 6.7% thought there was a connection between systemic diseases and the oral microbiome. Participant comprehension of oral microbiome questions averaged 9.19 out of 13, with 83.7% scoring "good". There were significant differences in knowledge scores among dental specializations (F = 7.082, P < 0.001) and years of professional experience (F = 4.755, P = 0.003). Significantly, 53.8% of participants had uncertain self-perceptions of their knowledge of the oral microbiome, while only 0.8% rated their understanding as 'very good'. CONCLUSION: Our findings reveal that dental professionals have varying levels of awareness and comprehension of the oral microbiome. Despite widespread awareness, understanding its diversity and implications for oral and systemic health remains limited. It is essential to address these gaps in knowledge through future research and educational interventions, considering the vital part that dental professionals play in promoting oral health through personalised dietary recommendations, lifestyle changes, and hygiene practices. These initiatives may promote a robust oral microbial community, enhance patient outcomes, and advance oral healthcare locally and globally.

Multiscale Approach for Tuning Communication among Chemical Oscillators Confined in Biomimetic Microcompartments.

ConspectusInspired by the biological world, new cross-border disciplines and technologies have emerged. Relevant examples include systems chemistry, which offers a bottom-up approach toward chemical complexity, and bio/chemical information and communication technology (bio/chemical ICT), which explores the conditions for propagating signals among individual microreactors separated by selectively permeable membranes. To fabricate specific arrays of microreactors, microfluidics has been demonstrated as an excellent method. In particular, droplet-based microfluidics is a powerful tool for encapsulating biological entities and chemical reagents in artificial microenvironments, mostly water-in-oil microdroplets. In these systems, the interfaces are liquid-liquid, and their physicochemical properties are key factors for tuning the coupling between molecular diffusion. Simple and double emulsions, where aqueous domains are in equilibrium with oil domains through boundary layers of amphiphilic molecules, are organized assemblies with high interfacial-area-to-volume ratios. These membranes can be engineered to obtain different surface charges, single- or multilayer stacking, and a variable degree of defects in molecular packing. Emulsions find application in many fields, including the food industry, pharmaceutics, and cosmetics. Furthermore, micro- and nanoemulsions can be used to model the propagation of chemical species through long distances, which is not only vital for cell signaling but also significant in molecular computing. Here we present in-depth research on the faceted world of solutions confined in restricted environments. In particular, we focused on the multiscale aspects of structure and dynamics from molecular to micro and macro levels. The Belousov-Zhabotinsky chemical reaction, known for its robustness and well-documented oscillatory behavior, was selected to represent a generic signal emitter/receiver confined within microenvironments separated by liquid-liquid interfaces. In this pulse generator, the temporal and spatial progressions are governed by periodic fluctuations in the concentration of chemical species, which act as activatory or inhibitory messengers over long distances. When organized into "colonies" or arrays, these micro-oscillators exhibit emergent dynamical behaviors at the population level. These behaviors can be finely tuned by manipulating the geometrical distribution of the oscillators and the properties of the interfaces at the nanoscale. By carefully selecting the membrane composition, it is possible to drive the system toward either in-phase, antiphase, or mixed synchronization regimes among individual oscillators, depending on messenger molecules. This relatively simple lab-scale model replicates some of the communication strategies commonly found in biological systems, particularly those based on the passive diffusion of chemical and electrical signals. It can help shed light on fundamental life processes and inspire new implementations in molecular computing and smart materials.

Postbiotic mediators derived from Lactobacillus species enhance riboflavin-mediated antimicrobial photodynamic therapy for eradication of Streptococcus mutans planktonic and biofilm growth.

BACKGROUND: Streptococcus mutans has been implicated as a primary causative agent of dental caries and one of its important virulence properties is an ability to form biofilm on tooth surfaces. Thus, strategies to prevent and control S. mutans biofilms are requested. The present study aimed to examine the eradication of S. mutans planktonic and biofilm cells using riboflavin (Rib)-mediated antimicrobial photodynamic therapy (aPDT) enhanced by postbiotic mediators derived from Lactobacillus species. MATERIALS AND METHODS: Minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of Rib and postbiotic mediators were determined. The antimicrobial and anti-biofilm effects of Rib-mediated aPDT (Rib plus blue light), Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus casei (LC) (aPDT+ LC), and Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus plantarum (LP) (aPDT+ LP) were evaluated. The anti-virulence potential of Rib-mediated aPDT, aPDT+ LC, and aPDT+ LP were assessed by measuring the expression of the gtfB gene using quantitative real-time polymerase chain reaction (qRT-PCR) at the highest concentrations of Rib, LC, and LP, at which the S. mutans had proliferation as the same as in the control (non-treated) group. RESULTS: According to the results, the MIC doses of LC, LP, and Rib were 64 µg/mL, 128 µg/mL, and 128 µg/mL, respectively, while the MBC values of LC, LP, and Rib were 128 µg/mL, 256 µg/mL, and 256 µg/mL, respectively. Rib-mediated aPDT, aPDT+ LP, and aPDT+ LC showed a significant reduction in Log10 CFU/mL of S. mutans compared to the control group (4.2, 4.9, and 5.2 Log10 CFU/mL, respectively; all P < 0.05). The most destruction of S. mutans biofilms was observed after treatment with aPDT+ LC followed by aPDT+ LP and Rib-mediated aPDT (77.5%, 73.3%, and 67.6%, respectively; all P < 0.05). The concentrations of 31.2 µg/mL, 62.5 µg/mL, and 62.5 µg/mL were considered as the highest concentrations of LC, LP, and Rib, respectively, at which S. mutans replicates as same as the control group and were used for gtfB gene expression assay using qRT-PCR during Rib-mediated aPDT, aPDT+ LP, and aPDT+ LC treatments. Gene expression results revealed that aPDT+ LP and aPDT+ LC could decrease the gene expression level of gtfB by 6.3- and 5.7-fold, respectively (P < 0.05), while only 5.1-fold reduction was observed after Rib-mediated aPDT (P < 0.05). CONCLUSION: Our findings indicate that aPDT+ LP and aPDT+ LC hold promise for use as a treatment to combat S. mutans planktonic and biofilms growth as well as anti-virulence as a preventive strategy to inhibit biofilms development via reduction of gtfB gene expression.

BARIATRIC SURGERIES IN THE BRAZILIAN PUBLIC HEALTH SYSTEM FROM 2012 TO 2022: DESCRIPTIVE STUDY OF HOSPITALIZATIONS IN THE STATE OF PARANÁ.

BACKGROUND: Obesity is a chronic health condition with a multifactorial etiology, resulting from the interplay of genetic, environmental, and behavioral factors leading to an energy imbalance. OBJECTIVE: To characterize hospitalizations for bariatric surgeries through the Brazilian Unified Health System (SUS) in the state of Paraná from 2012 to 2022. METHODS: This is a descriptive and retrospective study, utilizing a time series design, based on secondary data. Public data from the SUS Hospital Information System for the period from 2012 to 2022 were consulted, focusing on the population of obese patients undergoing bariatric surgery. RESULTS: In Paraná, concerning SUS procedures data from 2012 to 2022, 39,793 hospitalizations for bariatric surgeries were observed. Among the five modalities, Roux-en-Y gastric bypass predominated with 38,849 hospitalizations (97.6%), showing a lower mortality rate. CONCLUSION: The research highlights a notable variation in costs, emphasizing the importance of economic evaluation. The correlation between obesity and diabetes underscores the complexity of the situation, justifying the superiority of surgical treatment in comorbidity remission. The study reveals a decline in bariatric surgeries in 2020, coinciding with the pandemic, and alerts to the increased vulnerability of obese patients to SARS-CoV-2.

KATP channels in cerebral hemodynamics: a systematic review of preclinical and clinical studies.

Cumulative evidence suggests that ATP-sensitive potassium (KATP) channels act as a key regulator of cerebral blood flow (CBF). This implication seems to be complicated, since KATP channels are expressed in several vascular-related structures such as smooth muscle cells, endothelial cells and pericytes. In this systematic review, we searched PubMed and EMBASE for preclinical and clinical studies addressing the involvement of KATP channels in CBF regulation. A total of 216 studies were screened by title and abstract. Of these, 45 preclinical and 6 clinical studies were included. Preclinical data showed that KATP channel openers (KCOs) caused dilation of several cerebral arteries including pial arteries, the middle cerebral artery and basilar artery, and KATP channel inhibitor (KCI) glibenclamide, reversed the dilation. Glibenclamide affected neither the baseline CBF nor the baseline vascular tone. Endothelium removal from cerebral arterioles resulted in an impaired response to KCO/KCI. Clinical studies showed that KCOs dilated cerebral arteries and increased CBF, however, glibenclamide failed to attenuate these vascular changes. Endothelial KATP channels played a major role in CBF regulation. More studies investigating the role of KATP channels in CBF-related structures are needed to further elucidate their actual role in cerebral hemodynamics in humans. Systematic review registration: Prospero: CRD42023339278 (preclinical data) and CRD42022339152 (clinical data).

Ribbing disease of the femur: a rare entity.

Ribbing disease is a rare benign bone dysplasia characterized by progressive cortical thickening of the diaphyses of long bones in adult patients. The literature provides limited insight into its natural radiological progression and anatomical distribution. Single-bone involvement is particularly uncommon, with prior cases exclusively affecting the tibia. This case report outlines the unique presentation of Ribbing disease in a 20-year-old male, localized to the left femur. The patient's history revealed intermittent left thigh pain persisting for more than 2 years, with no identifiable triggers or relief factors. Early radiographic imaging revealed no significant abnormalities, but subsequent imaging, conducted 1 year after the initial presentation, revealed focal fusiform widening and cortical thickening of the mid-diaphysis of the left femur. MRI further revealed circumferential cortical thickening with bone marrow edema, corroborated by CT, which revealed cortical thickening with near-complete obliteration of the intramedullary cavity. The patient was managed with nonsteroidal anti-inflammatory drugs and activity modifications. Misinterpretation of the radiographic findings of the osteoid osteoma led the patient to undergo radiofrequency ablation. This case highlights the challenges in diagnosing Ribbing disease and emphasizes the importance of considering it in the differential diagnosis of chronic limb pain. Continued reporting of cases contributes to enhancing our understanding and management of this rare skeletal dysplasia.

A unique wheel-shaped exposed core LSPR-PCF sensor for dual-peak sensing: Applications in the optical communication bands, M-IR region and biosensing.

Photonic Crystal Fibers (PCF) effectiveness in practice decreases if the fabrication of the sensor becomes too complex. Keeping this in mind, we propose a one-of-a-kind wheel shaped PCF sensor with an exposed core containing only three air holes with exceptional sensing features. The sensor is equipped with dual plasmonic layers, Indium Tin Oxide (ITO, 10 % wt) and silver (Ag) with a coating of TiO2 to enhance the sensing capabilities and provide protection against oxidation. The sensor's distinctive configuration enables it to exhibit two distinct peaks within a range of refractive index from 1.32 to 1.38 for y-polarization and from 1.35 to 1.38 for x-polarization. The sensor specifications have been optimized to achieve the maximum levels of wavelength sensitivity (WS) and double peak shift sensitivity (DPSS). The sensor portrays a WS of 50,652 nm/RIU and the highest DPSS ever recorded, measuring 50,000 nm/RIU. Additionally, the sensor exhibits a significantly high scale of amplitude sensitivity (AS) of 1668.34 RIU-1 which is a very remarkable value considering silver as plasmonic material along with an outstanding figure of merit (FOM) of 1017.11 RIU-1. In addition, our sensor is able to manifest resolutions in the order of 10-6, demonstrating a resolution of 5.94 × 10-6 RIU with the deployment of amplitude interrogation method and 1.97 × 10-6 RIU with the wavelength interrogation method. The design spans an extensive spectrum, covering ultraviolet to mid-infrared wavelengths, enabling detection of biomolecules and biochemicals, along with operation in the optical communication band.