Low Number Research Articles

Mastication and oral myofunctional status in excess weight children and adolescents: A cross-sectional observational study.

Masticatory function seems to play a role in the aetiology of obesity. However, literature on the association between oral myofunctional status and overweight and obesity in children and adolescents is scarce and contrasting. To compare masticatory performance, orofacial myofunctional status and tongue strength and endurance between children and adolescents with overweight and obesity and those with normal weight. Thirty children and adolescents with overweight and obesity and 30 subjects with normal weight matched for age and sex were recruited. All subjects were evaluated with the Test of Masticating and Swallowing Solids in Children (TOMASS-C) for masticatory performance and with the Italian Orofacial Myofunctional Evaluation with Scores (I-OMES) for the orofacial myofunctional status. Anterior and posterior maximum tongue pressures and tongue endurance were measured. Parents-reported (PRO) duration of meals was recorded. Data were compared between the groups through the paired samples t-test or the Wilcoxon signed-rank test. Children and adolescents with overweight showed significantly lower number of bites (p = .033), lower I-OMES scores (p < .05), and shorter meal duration (p = .005) compared to their peers with normal weight. No significant differences were found between the two groups for the number of swallows, the number of masticatory cycles and the total time of the TOMASS-C, and none of the tongue pressure measurements. Eating in children and adolescents with overweight and obesity is characterised by a larger bolus sizes and shorter PRO meal duration. Additionally, overweight and obesity seem to be associated with poorer orofacial skills and structures in the paediatric population.

Institutional and patient-related factors influencing the frequency of restraint in a general psychiatric acute care unit

Valid knowledge about risk stratification is essential for the development of preventive approaches to reduce restraints. This retrospective, monocentric study examined all 248 restraining measures used on 79 patients of a university psychiatric department in 2015. Eight institutional and seven patient-related factors were statistically calculated using logistic regression analysis and matched pairs. A statistically significant increased probability of fixation was found in connection with a lower number of nurses per patient, a higher number of patients admitted by law, lower professional experience of nurses and in the nursing late shift as well as when admission occurred via emergency medical service. Based on the results, possible preventive organizational measures are elaborated and preconditions for a prospective evaluation of the complex factors influencing coercive measures are discussed.

Discrete heating of turbulent FSI in a vented lid-driven enclosure

Heat dissipation from a segmental heat source confined in a vented cavity with a moving lid is investigated numerically. The left wall is made flexible with an opening to force the cooling fluid with Rein. The fluid is discharged out from another opening located in the opposite right wall. The lid of the cavity is driven by a speed four times greater than the inlet velocity, ReLid = 4Rein. The κ -ε turbulent model together with the interaction of the fluid with the flexible wall (FSI) are solved numerically using the method of finite element. The impacts of Reynolds, Richardson Ri and Prandtl Pr numbers, elasticity of the flexible wall and the location of the inlet ports are scrutinized. It is found that the location of the inlet port and the Prandtl number play crucial roles in improving the overall performance. It is found that the lower position of the inlet port gives better performance than the higher position, where the performance criterion is 1.69 at Ri = 100. Results reveal that the lower Prandtl number (0.71) gives higher Nusselt number, where at Ri = 100, setting Pr at 0.71 the Nusselt number increases by 125% more than Pr = 6.5. It is concluded that the flexible wall either promotes the Nusselt number or alleviates the pressure drop.

Virtual care for paediatric asthma: A randomized controlled trial.

This work aims to investigate whether virtual care can improve clinical outcomes for children with asthma, similar to face-to-face specialty care. The study used a randomized controlled trial design, with participants allocated to either a virtual care group (n = 47) or a control group (n = 50) using simple randomization. The study was conducted from March to August 2021, and a sample of 97 children with asthma was recruited. Children in the virtual care group received online training in four modules within the first month and support through virtual meetings and phone or video calls, while the control group received standard care. The primary outcome of the study was the Asthma Control Test and Child Asthma Control Test. The virtual care group had significantly better outcomes than the control group in terms of C-ACT scores for children aged 7-11 years, fewer days under 80% of the optimum level of peak expiratory flow, lower peak expiratory flow variability, fewer rescue medication uses, and more symptom-free days. The virtual care group also had a lower number of unscheduled hospital visits and a greater improvement in quality of life compared with the control group. This study demonstrated that virtual care can improve disease management and quality of life for children with asthma.

Analysis of assisted reproductive outcomes for gynecologic cancer survivors: a retrospective study

ObjectiveTo examine the reproductive outcomes of assisted reproductive technology (ART) in gynecologic cancer patients and to assess maternal and neonatal complications.MethodsWomen diagnosed with gynecologic cancer who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment between 2013 and 2021 at Shanghai Ji Ai Genetics and IVF Institute were included in this study. Infertile women without any history of cancer were matched to the cancer group. The primary outcome was the cumulative live birth rate. Baseline and follow-up data were compared between groups using Student’s t-tests for normally distributed variables and with Chi-square test for categorical variables. A propensity score-based patient-matching approach was adopted to ensure comparability between individuals with and without specific cancer type.ResultsA total of 136 patients with a history of gynecologic cancer and 241 healthy infertile controls were included in this study. Endometrial cancer constituted 50.70% of the cases and cervical cancer constituted 34.60% of the cases. The cancer group exhibited significantly shorter duration of stimulation, lower levels of estradiol, lower number of retrieved oocytes, day-3 embryos, and blastocysts compared to the control group (P < 0.05). The cumulative live birth rate of the gynecologic cancer group was significantly lower than that of the control group (36.10% vs. 60.50%, P < 0.001). Maternal and neonatal complications did not significantly differ between the groups (P > 0.05). The endometrial cancer and cervical cancer groups showed significantly lower cumulative live birth rates than their matched controls (38.60% vs. 64.50%, P = 0.011 and 24.20% vs. 68.60%, P < 0.001, respectively).ConclusionsThese findings highlight the decreased occurrence of pregnancy and live birth in female gynecologic cancer patients undergoing ART, particularly in endometrial cancers and cervical cancers. These findings have important implications for counseling and managing gynecologic cancer patients undergoing ART.

Contact pressure in the proton exchange membrane fuel cell: Development of analytical models based on experimental investigation and a posteriori design of experiments

To understand the link between the physical properties of the Gas Diffusion Layer (GDL) and the overall performance of a Proton Exchange Membrane Fuel Cell (PEMFC), it is essential to investigate the impact of compressive loading on the physical parameters of the component, focusing on its electrical properties. This paper's experimental results obtained in the team's previous research are classified and analysed using a posteriori Design of Experiment (DoE). It allows us to determine the influential parameters on the component behaviour. Two analytical models are developed through regression analysis, allowing for predicting the output variables as a function of the input ones. The results are evaluated with statistical tools. The first model predicts the electrical Contact Resistance (CR) variation of the GDL as a function of mechanical compression and component type. The analytical results show that cycling compression has a negligible effect due to the lower number of applied cycles. The Micro Porous Layer (MPL) presence increases the CR, while the polytetrafluorethylene (PTFE) decreases it slightly. The GDL thickness is the most influential geometrical parameter. For this reason, a second analytical model is developed and predicts that CR is reduced primarily by increased mechanical compression and thicker GDLs.

The hidden lessons in textbooks: Gender representation and stereotypes in European mathematics and language books

AbstractThis cross‐national European comparison examined gender representation and stereotypes in mathematics and language textbooks from Germany, Italy, Lithuania, the Netherlands and Romania. The results showed that female characters were numerically underrepresented. Female characters were also less often a main character or individually portrayed compared to male characters, but not proportionally to the overall lower number of female characters. Characters in occupational roles were less often female than male, whereas among characters with gender non‐conform characteristics, these were more often female than male in some textbooks. There was no sexual diversity among characters. The differences in gender representation are found within each country, but gender differences were smaller in more gender‐egalitarian countries. If textbooks are to offer the same learning benefits to both boys and girls, students should be equally represented in a diversity of roles and occupations.

Career Length After Surgically Treated ACL Plus Collateral Ligament Injury in Elite Athletes.

Limited data are available regarding career length and competition level after combined anterior cruciate ligament (ACL) and medial- or lateral-sided surgeries in elite athletes. To evaluate career length after surgical treatment of combined ACL plus medial collateral ligament (MCL) and ACL plus posterolateral corner (PLC) injuries in elite athletes and, in a subgroup analysis of male professional soccer players, to compare career length and competition level after combined ACL+MCL or ACL+PLC surgeries with a cohort who underwent isolated ACL reconstruction (ACLR). Cohort study; Level of evidence, 3. A consecutive cohort of elite athletes undergoing combined ACL+MCL and ACL+PLC surgery was analyzed between February 2001 and October 2019. A subgroup of male elite soccer players from this population was compared with a previously identified cohort having had isolated primary ACLR without other ligament surgery. A minimum 2-year follow-up was required. Outcome measures were career length and competition level. A total of 98 elite athletes met the inclusion criteria, comprising 50 ACL+PLC and 48 ACL+MCL surgeries. The mean career length after surgical treatment of combined ACL+MCL and ACL+PLC injuries was 4.5 years. Return-to-play (RTP) time was significantly longer for ACL+PLC injuries (12.8 months; P = .019) than for ACL+MCL injuries (10.9 months). In the subgroup analysis of soccer players, a significantly lower number of players with combined ACL+PLC surgery were able to RTP (88%; P = .003) compared with 100% for ACL+MCL surgery and 97% for isolated ACLR, as well as requiring an almost 3 months longer RTP timeline (12.9 months; P = .002) when compared with the isolated ACL (10.2 months) and combined ACL+MCL (10.0 months) groups. However, career length and competition level were not significantly different between groups. Among elite athletes, the mean career length after surgical treatment of combined ACL+MCL and ACL+PLC injuries was 4.5 years. Professional soccer players with combined ACL+PLC surgery returned at a lower rate and required a longer RTP time when compared with the players with isolated ACL or combined ACL+MCL injuries. However, those who did RTP had the same career longevity and competition level.

Influence of male body mass index on semen analysis parameters and in vitro fertilization outcomes.

Concurrent global increase of prevalence of obesity and male fertility implies link between overweight and obesity with male subfertility. This hypothesis is supported by numerous population-based epidemiological studies. Increase in body mass index (BMI) is associated with poor sperm quality in fertile, and more noticeable in infertile men. Nevertheless, some studies disprove damaging effect of BMI on semen quality. To examine the influence of men's BMI in infertile couples undergoing in vitro fertilization (IVF) on semen analysis parameters and IVF outcomes. Study encompassed all couples who underwent IVF at Gynecology and Obstetrics Clinic Narodni Front in Belgrade during 2018 and 2019. Exclusion criteria were azoospermia, conditions and diseases that could affect the semen analysis parameters (diabetes, malignant diseases treated with radiation and/or chemotherapy, trauma or surgery of the genital organs, mumps or undescended testicles in childhood). Evaluated semen analysis parameters included semen ejaculate volume, sperm pH, sperm count, sperm motility, and sperm morphology. IVF outcomes comprised total number of embryos, number and percentage of obtained good-quality embryos and clinical pregnancy rates. Based on BMI value, participants were divided into a group of underweight (Group 1), normally weight (Group 2), overweight (Group 3), and obese men (Group 4). After applying inclusion and exclusion criteria, 411 men (couples) were included in the analysis. The largest number of men were overweight, while the smallest belonged to the group of underweight participants. There are no significant differences in the semen analysis parameters between study groups. Correlation analysis shown weak and insignificant correlation between BMI and semen analysis parameters. The number and proportion of good quality embryos is significantly lower in overweight and obese study groups compared to normal weight and underweight groups (2.89, 2.91, 2.42, and 2.36, respectively, P = .041). The differences in other IVF outcomes: total number of embryos (3.61, 3.74, 3.21, and 3.37, respectively) and clinical pregnancy rates (41.26%, 43.09%, 42.78%, and 39.95%, respectively) between study groups were not significant (P > .05). BMI does not significantly affect semen analysis parameters, but a higher BMI is associated with a lower number and proportion of good quality embryos in IVF outcomes.

Water stress combining weather condition shapes wheat yield and inter-annual yield variability: Field observations from a six-year study

Irrigation has played a pivotal role in Chinese wheat production and is becoming increasingly crucial in adapting to the changing climate. However, the benefits of water-saving wheat production in the long-term period and its response to climate change have received limited attention. In this study, a 6-year field experiment was conducted to investigate the grain yield and water use with three treatments such as Irrigation three times (I3), Irrigation two times (I2), and disposable pre-sowing irrigation (I0), and their sensitivity to weather conditions. The average yield over six years for the I2 treatment is 8.3 Mg ha−1, similar to I3 treatment while using 10.2 % less irrigation water and improving 8.0 % water use efficiency. In contrast, the grain yield in I0 treatment is 28.4 % lower than I3 treatment while consuming 36.9 % less irrigation water. Furthermore, 90.2 % of the yield decrease in I0 treatment results from the lower ear number. Water stress from jointing to flowering accounts for 58.8 % of ear number decrease. Although interannual yield variation is similar among the three treatments, the source of the variation is very different. Kernel weight explains the yield variation by 92.3 % in I3 treatment and 66.1 % in I2 treatment, while ear number accounts for 60.7 % of the variation in I0 treatment. Minimum temperature for kernel weight in both I3 and I2 treatments and rainfall for ear number in I0 treatment is the most important weather factor, respectively. In summary, this study provides valuable insights into the delicate balance between water conservation and food security while adapting to varying weather conditions.

Predicting effects of tunnel throttling of annular freeway vehicular flow by a continuum model

Fluid flow throttling is common in industrial and building services engineering. Similar tunnel throttling of vehicular flow is caused by the abrupt number reduction of roadway lane, as the tunnel has a lower lane number than in the roadway normal segment. To predict the effects of tunnel throttling of annular freeway vehicular flow, a three-lane continuum model is developed. Lane III of the tunnel is completely blocked due to the need of tunnel rehabilitation, etc. There exists mandatory net lane-changing rate from lane III to lane II just upstream of the tunnel entrance, which is described by a model of random number generated through a golden section analysis. The net-changing rate between adjacent lanes is modeled using a lane-changing time expressed explicitly in algebraic form. This paper assumes that the annular freeway has a total length of 100 km, a two-lane tunnel of length 2 km with a speed limit of 80 km/h. The free flow speeds on lanes I, II and III are assumed to be 110, 100 and 90 km/h respectively. Based on the three-lane continuum model, numerical simulations of vehicular flows on the annular freeway with such a tunnel are conducted with a reliable numerical method of 3rd-order accuracy. Numerical results reveal that the vehicular flow has a smaller threshold of traffic jam formation in comparison with the case without tunnel throttling. Vehicle fuel consumption can be estimated by interpolation with time averaged grid traffic speed and an assumed curve of vehicle performance. The vehicle fuel consumption is lane number dependent, distributes with initial density concavely, ranging from 5.56 to 8.00 L. Tunnel throttling leads to an earlier traffic jam formation in comparison with the case without tunnel throttling.

Effect of alternative natural diet on microplastic ingestion, functional responses and trophic transfer in a tri-trophic coastal pelagic food web

The patchy distribution of microplastics (MP) and their size range similar to planktonic organisms, are likely to have major ecological consequences, through MP ingestion, food dilution, and transfer across trophic levels. Our study applied a community module using tritrophic food chain with zooplankton as prey, and a planktivorous seabass fry as predator. We conducted a series of feeding experiments and recorded the direct uptake of MP under six different concentrations ranging from 25 to 800 particles L−1. We also estimated the indirect transfer of MP via trophic link. The ingestion rates for Brachionus plicatilis, Mesocyclops isabellae, and Lates calcarifer, were 3.7 ± 0.3 MP ind−1 min−1, 1.69 ± 0.1 MP ind−1 min−1, and 3.51 ± 0.52 MP ind−1 h−1, respectively. In the presence of a natural diet, rotifers and copepods ingested significantly lower number, whereas, fish fry ingested a higher number of MP, suggesting further vulnerability to the consumers of MP-contaminated fish and potential biomagnification at higher trophic levels. Overall, the MP uptake rate increased with increasing concentration, and finally leveled off, indicating a type II functional response to MP concentration. The presence of natural diet led to a lower Km value. In the indirect transfer experiment, 74 % of B. plicatilis and 78 % of M. isabellae individuals were contaminated with MP, when offered as prey. Brachionid mastax and MP particles were observed in the gut of copepods. The fish fry gut content also recorded brachionid mastax, MP-contaminated copepods, and MP particles, showing direct evidence of trophic transfer pointing to a cascading effect on higher trophic levels including humans via piscivory.

Computational study on the impact of geometric parameters on the overall efficiency of multi-branch channel heat sink in the solar collector

Enhancing the thermal performance of electronic devices is a persistent challenge. Liquid-cooled Multi-branch-channel heat sinks (MBCHSs) offer a promising solution. The present study focuses on optimizing MBCHS hydrothermal efficiency and temperature uniformity. Various MBCHSs, including a foundational case and cases denoted as 1 through 4, have been developed to assess the impact of geometric parameters on performance. Using a performance evaluation criterion (PEC), it quantitatively assesses hydrothermal improvements in each model. Additionally, this study explores the use of a water-based ternary hybrid nanofluid (THNF) with GO-Al2O3-ZnO ternary hybrid nanoparticles in an optimized multi-branch channel. Furthermore, an analysis and generation of entropy were examined. The COMSOL software has been employed for the simulation of the problem in this study. This promising fluid replacement for pure water demonstrates superior performance and temperature control. The findings indicate that among the various cases, case 2 exhibits the highest PEC. At Reynolds number 500, the optimal MBCHS geometry (case 2) featuring THNF with a volumetric fraction of 0.06 exhibits a 16.63% higher Heat Transfer Coefficient (HTC) compared to pure water. In contrast, MBCHS, with the same volumetric fraction, demonstrates a 29.82% lower Nusselt number. Contrastingly, at a volumetric fraction of 0.06, MBCHS displays a pressure drop 70.27% higher than that of pure water. Overall, the PEC of MBCHS with a volumetric fraction of 0.06 has decreased by 41% compared to pure water. At Reynolds number 500, lamina-shaped nanoparticles exhibit a 50.34% and 56.56% higher HTC in comparison to spherical and pure water, respectively. Moreover, the PEC for lamina-shaped nanoparticles at Reynolds 500 undergoes a 49.58% and 62.37% reduction when compared to spherical and pure water, respectively.

On-demand bactericidal and self-adaptive antifouling hydrogels for self-healing and lubricant coatings of catheters

Catheter-related infections are one of the most common nosocomial infections with increasing morbidity and mortality, and robust antibacterial or antifouling catheter coatings remain great challenges for long-term implantation. Herein, multifunctional hydrogel coatings were developed to provide persistent and self-adaptive antifouling and antibacterial effects with self-healing and lubricant capabilities. Polyvinyl alcohol (PVA) with β-cyclodextrin (β-CD) grafts (PVA-Cd) and 4-arm polyethylene glycol (PEG) with adamantane and quaternary ammonium compound (QAC) terminals (QA-PEG-Ad) were crosslinked through host-guest recognitions between adamantane and β-CD moieties to acquire PVEQ coatings. In response to bacterial infections, QACs exhibit reversible transformation between zwitterions (pH 7.4) and cationic lactones (pH 5.5) to generate on-demand bactericidal effect. Highly hydrophilic PEG/PVA backbones and zwitterionic QACs build a lubricate surface and decrease the friction coefficient 10 times compared with that of bare catheters. The antifouling hydrated layer significantly inhibits blood protein adsorption and platelet activation and reveals negligible hemolysis and cytotoxicity. The dynamic host-guest crosslinking achieves full self-healing of cracks in PVEQ hydrogels, and the mechanical profiles were recovered to over 90% after rejuvenating the broken hydrogels, exhibiting a long-term stability after mechanical stretching, twisting, knotting and compression. After subcutaneous implantation and local bacterial infection, the retrieved PVEQ-coated catheters display no tissue adhesion and 3 log folds lower bacterial number than that of bare catheters. PVEQ coatings effectively prevent the repeated bacterial infections and there are few inflammatory reactions in the surrounding tissue, while substantial lymphoid infiltration and inflammatory cell aggregation occur in muscle tissues around the bare catheter. Thus, this study demonstrates a catheter coating strategy by on-demand bactericidal, self-adaptive antifouling, self-healing and lubricant hydrogels to address medical devices-related infections. Statement of SignificanceIt is estimated over two billion peripheral intravenous catheters are annually used in hospitals around the world, and catheter-associated infection has become a great clinical challenge with rapidly rising morbidity and mortality. Surface coating is considered a promising approach, but substantial challenges remain in the development of coatings that simultaneously satisfy both anti-fouling and antibacterial attributes. Even more, few attempts have been made to design mechanically robust coatings and reversible antibacterial or antifouling capabilities, which are critical for long-term medical implants. To address these challenges, we propose a concise strategy to develop hydrogel coatings from commercially available poly(ethylene glycol) and polyvinyl alcohol. In addition to self-healing and lubricant capabilities, the reversible conversion between zwitterionic and cationic lactones of quaternary ammonium compounds enables on-demand bactericidal and self-adaptive antifouling effects.

Surgical Treatment of Oropharyngeal Cancer - Recommendations of the Current German S3 Guideline, Part I

In general, a trend towards transoral resection (as opposed to classic open approaches) + neck dissection + adjuvant radio- (chemo-) therapy has been observed for oropharyngeal carcinoma over the last 20 years. Techniques of transoral surgery (TOS), including transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) have been propagated in retrospective comparisons with conventional surgery or primary radiochemotherapy as gentle, minimally invasive procedures with good late functional results. Meta-analyses of mostly uncontrolled retrospective analyses suggest that TORS may have better disease-free survival (DFS) and a reduced risk of free flap reconstruction compared with open surgery. TORS (TOS) was associated with fewer tumor-positive resection margins (R1), a lower number of recurrences, fewer intraoperative tracheostomies, a shorter inpatient stay and a shorter duration of postoperative nasal tube feeding compared to open surgery. In principle, based on the best evidence currently available from registry studies, stage I-II oropharyngeal carcinomas can be treated either with primary surgery or radiochemotherapy with a comparable chance of survival. With comparable evidence for stage III and IVa, p16neg. oropharyngeal carcinomas, the majority of authors advocate primary surgery followed by adjuvant radiotherapy or radiochemotherapy as the treatment of first choice. For p16pos. patients the results of registry studies are inconsistent, although the largest registry study on 450 HPV-positive stage III patients shows a significant superiority of primary surgery + adjuvant radiochemotherapy. Since all registry studies did not adjust for smoking status, among other factors, the current data situation should be evaluated with the necessary caution.

Disease Activity and Bone Microarchitectural Phenotype in Patients With Axial Spondyloarthritis

Background: Axial spondyloarthritis (AxSpA) is a chronic rheumatic disease characterized by spine inflammation, abnormal bone growth, and paradoxically osteoporosis and vertebral fractures. The pathogenesis of skeletal deficits in this disease is poorly understood. Purpose: We sought to evaluate volumetric bone mineral density (vBMD) and bone microarchitecture in patients with AxSpA and to identify disease-related factors associated with skeletal abnormalities. Methods: We enrolled patients between 2018 and 2021 as part of a 2-year prospective study at a single institution investigating skeletal health and the skeletal effects of interleukin-17 (IL-17) treatment. Patients with AxSpA who met Assessment in SpondyloArthritis International Society (ASAS) classification criteria by X-ray or had evidence of active inflammation on magnetic resonance imaging suggestive of sacroiliitis were referred to the study by their rheumatologists. We excluded those with a history of fragility fracture, multiple myeloma, Cushing’s disease, primary hyperparathyroidism, osteomalacia, untreated vitamin D deficiency, secondary osteoporosis, or other systemic rheumatic diseases, as well as use of oral steroids for 2 or more weeks in the 6 months prior or current use of hormone replacement therapy, current oral bisphosphonate, past or current intravenous bisphosphonate, teriparatide, or denosumab therapies. A total of 1606 patients were screened for eligibility. Of these, 30 participants were enrolled (mean age 43 years, 50% male). Patients with AxSpA had dual-energy X-ray absorptiometry (DXA) measurements of areal BMD (aBMD) and high-resolution peripheral quantitative computed tomography (HR-pQCT) measurements of vBMD microarchitecture and failure load by finite element analysis. Standardized disease assessment tools used included the Bath Ankylosing Spondylitis Disease Activity (BASDAI), Metrology Index (BASMI), and Functional Index (BASFI). Results: In the 30 included patients, mean DXA and HR-pQCT Z-scores were within 1 standard deviation (SD) of normal for all indices, except for total vBMD in males (–1.2 SD below mean). Mean symptom duration was 11.7 years and mean scores for BASDAI, BASFI, and BASMI were 4.6, 3.6, and 2.7, respectively (range 1–10, 10 = severe limitation). Longer disease duration was associated with more severe skeletal deficits at the hip and tibia—specifically, lower hip aBMD, lower meta- and inner-trabecular vBMD, lower trabecular number, and higher trabecular separation and heterogeneity. Conclusion: This study of 30 patients with AxSpA found that abnormalities in bone density and microarchitecture at weightbearing sites were associated with longer disease duration. Because of its small sample size, larger studies are needed to better characterize the pathogenic disease factors that govern skeletal damage in AxSpA.

Effects of combined aerobic and resistance training on the inflammatory profile of children with overweight/obesity: A randomized clinical trial.

We assessed the effects of a 20-week combined (aerobic and resistance) exercise training programme on the inflammatory profile of prepubertal children with overweight or obesity. Totally 109 participants (10.1 ± 1.1 years, 41% girls) were randomly allocated to an exercise or control group. Adiponectin, C-reactive protein, epidermal growth factor, insulin-like growth factor-1, interleukin (IL)-1β, IL-6, leptin, tumour necrosis factor-α and vascular endothelial growth factor A (VEGFA) were analysed in plasma. Total white blood cell (WBC) count and immune subpopulations (eosinophils, basophils, neutrophils, lymphocytes and monocytes) were also determined. No intervention effect was found for any of the analysed biomarkers (all p ≥ 0.05). We observed a significant sex by intervention interaction for IL-1β (p = 0.03). When stratifying the sample by sex, the exercise programme induced a significant effect on IL-1β levels (mean Z-score difference, 0.66 [95% confidence interval 0.32-1.01]) in girls, but not in boys. A lower number of girls in the exercise group showed a meaningful reduction in IL-1β (i.e., ≥0.2 standard deviations) than in the control group (15% vs. 85%, p = 0.01). This exercise programme failed to improve the inflammatory profile in prepubertal children with overweight/obesity. Future studies should explore the effect of longer exercise interventions and in combination with diet.

Preparation and characterization of chitosan and hydroxyapatite composite

Chitosan and hydroxyapatite (HAp) composites were prepared at different ratios (60% chitosan &amp; 40% HAp, 50% chitosan &amp; 50% HAp, 40% chitosan &amp; 60% HAp). The mixtures are dissolved in a 2% acetic acid solution and heated to about 60°C-70°C with continuous stirring for about 1 hour. After that, the solutions are naturally dried on heat-sealing paper placed above a glass sheet. After about 24 hours, chitosan and hydroxyapatite composite films are prepared. Fourier Transform Infrared Spectroscopy (FTIR) analysis showed that Hydroxyapatite is mainly found at lower wave numbers in the range 400–600 cm-1. X-ray diffraction patterns were showed, the crystalline properties of the composites increase with Hydroxyapatite. Differential Thermal Gravimetry (DTG) analysis of the composites indicated that the material is thermally stable up to 300°C. This paper aims to review the literature concerning chitosan-hydroxyapatite composites for bone restoration and discuss the primary methods of preparation and mechanical properties of these materials.

Apical periodontitis as an aggravating factor for the severity of rheumatoid arthritis: An animal study.

The present study investigated the influence of apical periodontitis (AP) on the severity of rheumatoid arthritis (RA) using a Wistar rat model. Forty male Wistar rats were distributed across four groups (n = 10) based on the induction of RA and AP: Control, RA, AP, and RA + AP. RA was induced through two immunisations with type II collagen emulsified in incomplete Freund's adjuvant, followed by one immunisation with complete Freund's adjuvant. After 21 days of RA induction, AP was induced by exposing the pulp of four molars. Animals were euthanized after 28 days of pulp exposure. Through the experiment, visual and behavioural assessments tracked RA development and the knees and hind paw joints were measured. Micro-computed tomography scans of knees and hind paws, as well as mandibles and maxillae, were conducted to evaluate RA severity and the presence of AP, respectively. Serum samples were collected to analyse proinflammatory cytokines (IL-1β, IL-2, IL-17, and TNF-α). Non-parametric data were analysed using the Kruskal-Wallis test followed by Student-Newman-Keuls test, while one-way anova followed by Tukey's test was performed for parametric data. A significance level of 5% was employed. All molars submitted to access cavity developed AP. All joints subjected to arthritis induction developed the disease, with AP + RA demonstrating a higher arthritis severity when compared to the RA group (p < .05). RA + AP group displayed a significantly larger hind paw and knee circumference compared to the RA group (p < .05). Micro-CT images of RA and RA + AP groups revealed joints with erosions and bone deformities, with a significantly lower bone surface density, lower trabecular number and higher trabecular separation in the hind paw and a significantly lower percent bone volume and higher trabecular separation in the knees of RA + AP group compared to RA group (p < .05). RA + AP group exhibited a significantly higher level of TNF-α and a lower level of IL-2 compared to all other groups (p < .05). Both RA and RA + AP groups had significantly higher IL-17 levels (p < .05), while there was no significant difference in IL-1β levels among the groups (p > .05). The findings from this study underscore a possible relationship between apical periodontitis and the exacerbation of rheumatoid arthritis.

Number of serotonergic neurons in the subthalamic nucleus and globus pallidus internus could influence the effects of deep brain stimulation in Parkinson's disease.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) is a standard treatment for Parkinson's disease (PD), with both regions exhibiting similar treatment effectiveness. However, posttreatment neuropsychiatric side effects, such as severe depression, are common, primarily due to the loss of serotonergic cells. Identifying a region with fewer serotonergic neurons could potentially reduce these side effects. This study aimed to quantify the number of serotonergic neurons in the STN and GPi. Both regions were analyzed using hematoxylin and eosin staining and immunohistochemistry. The GPi exhibited a significantly lower number and H-score of serotonergic neurons than the STN. Within the STN, the number and H-score of serotonergic neurons were higher in the medial aspect than in the lateral aspect. Three different types of neurons, large and small, were observed. In STN, large neurons were concentrated in the center and small neurons in the periphery. This distribution was not observed in GPi. In addition, the concentration of the serotonergic neurons is less in GPi. These findings suggest that the GPi may be a safer target region, potentially reducing the incidence of post-DBS depression.