Objective: To collect information regarding important aspects of care during and after childbirth and to emphasize the importance of patient-centered healthcare. Design: The study is based on data from the Babies Born Better online survey, version 2. Setting: The maternity care system in Croatia. Population: The study involved 619 women who gave birth in Croatia between 2013 and 2018. Methods: The collected data was analyzed using descriptive statistics for closed questions and content analysis for open-ended questions. Main outcome measures: Discussing and comparing answers to open-ended questions. Results: This study shows that 257 (22.8%) respondents related the friendliness and attitude of medical staff toward the mother as a positive experience related to childbirth, while 106 (9.4%) mentioned the general quality and expertise of health providers. These were also the reasons why the respondents would recommend the facility where they gave birth to others. When asked what they would change regarding childbirth, 139 (15.8%) respondents listed the lack of information during childbirth and respect for the mother’s needs and the right to make decisions, while 97 (11%) mentioned material conditions in the hospital, and 89 (10.1%) emphasized kindness and the attitude towards the mother. Conclusion: This study confirmed that the overall attitude of the medical staff is the most crucial factor in mothers’ evaluation of their birth experience. We also found considerable dissatisfaction with the current healthcare system and a need for change.

Langerhans cell histiocytosis (LCH) is a rare neoplastic disorder characterized by abnormal proliferation of Langerhans cells affecting predominantly pediatric populations [1]. LCH encompasses a spectrum of disease with a range of presentations spanning many organ systems [1]. Thymic involvement (TI) is rarely described; however, we report a case of an 8-month-old female with a dyad of cutaneous and thymic LCH. Following initial subtle findings of thymic calcifications on staging non-contrast computed tomography (CT) scan, TI was clearly characterized via superficial chest and neck ultrasound. In this case, discovery of TI impacted the treatment plan. The purpose of this report is to highlight a potentially underdiagnosed manifestation of LCH in an 8-month-old infant and consider thymic sonography in staging evaluation for infants with LCH.

This article presents a study on the world's first unmanned machine designed for autonomous forestry operations. In response to the challenges associated with traditional forestry operations, we developed a platform equipped with essential hardware components necessary for performing autonomous forwarding tasks. Through the use of computer vision, autonomous navigation, and manipulator control algorithms, the machine is able to pick up logs from the ground and manoeuvre through a range of forest terrains without the need for human intervention. Our initial results demonstrate the potential for safe and efficient autonomous extraction of logs in the cut-to-length harvesting process. We achieved a high level of accuracy in our computer vision system, and our autonomous navigation system proved to be highly efficient. This research represents a significant milestone in the field of autonomous outdoor robotics, with far-reaching implications for the future of forestry operations. By reducing the need for human labour, autonomous machines have the potential to increase productivity and reduce labour costs, while also minimizing the environmental impact of timber harvesting. The success of our study highlights the potential for further development and optimization of autonomous machines in the forestry industry.

A case report of poor ventricular pacingYurongLian Fangwang XuminDuan ChunxiaHuangDepartment of Cardiology, Shanxi Medical University, Lifen Hospital, 041000Corresponding author: YurongLian, M.M.S, Linfen People’s Hospital, Seventh Clinical College of Shanxi Medical University, ChinaTel: +86 13453788799;Mail : ZZL0705@163.comFunding Information: There were no sources of funding for this studyConsent Statements: Confirmation that the author has obtained written informed consent from patient.

Cause for optimism in mild hypoxic ischaemic hypoxic encephalopathyWilliam M. Curtin, MD, corresponding authorDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology & Pathology and Laboratory Medicine, Penn State College of Medicine, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USAwcurtin@pennstatehealth.psu.eduMail code H103500 University Dr, PO Box 850Hershey, PA 17033-0850Maternal-Fetal Medicine, Rm C3620Phone 717-531-8142/Option #5Fax 717-531-0947Acknowledgements: noneDisclosure of Interests: The author has no conflicts nor competing interests to disclose, financial or otherwise, in connection with this manuscript.Contribution to Authorship: Dr. Curtin alone completed review of the Törn et al. final manuscript entitled “Outcomes in children after mild neonatal hypoxic ischaemic encephalopathy: A population-based cohort study” The writings and opinions expressed in his mini commentary are solely the work of Dr. Curtin.Details of Ethics Approval: not applicable at our institution’s IRB as a commentary is not considered research and does not involve human subjects.Funding: Dr. Curtin neither received nor utilized any funds in writing this mini commentary.The objective of the study by Törn et al. was to determine if mild hypoxic ischaemic encephalopathy (HIE) was associated with severe neurological outcomes utilizing a population-based approach facilitated by five linked Swedish national databases. The rationale given was that while moderate to severe HIE is known to be associated with significant neurological morbidity, long-term disability, and mortality in children, less is known about mild HIE. The authors note that half of the cases of HIE are mild and they cite a systematic review of 250 infants (Conway JM, et al. Early human development . 2018; 120:80-7) showing a 22% prevalence of abnormal neurological outcomes in this disorder. There is therefore potential for significant burden of disease in mild HIE. Törn et al. chose a primary composite outcome that included cerebral palsy, epilepsy, mental retardation and death in children with mild HIE and non HIE cohorts followed up to 6 years of age. With a median follow-up of 3.3 years of age, 17 of 414 (4.1%) and 4786 of 504,661 (0.95%), in the mild HIE and non HIE cohorts respectively, had the composite outcome with an adjusted hazard ratio of 3.85 (95% CI: 2.27-6.50)In 1976 Sarnat and Sarnat reported clinical and EEG features of 21 neonates at term who experienced ischaemic-anoxic encephalopathy (Sarnat HB et al. Arch Neurol. 1976; 33:696–705). This temporal classification divided the infants into three progressively deteriorating stages. Fast forward to the current millennium and Sarnat’s original classification is used to differentiate between infants with mild and moderate/severe HIE, the latter two categories benefiting from therapeutic hypothermia (Jacobs SE et al. Cochrane Database Syst Rev. 2013, Issue 1. Art. No.: CD003311). Seven infants with moderate or severe HIE is the number needed to treat (NNT) to prevent one adverse neurological outcome.Therapeutic hypothermia is not standard of care in mild HIE; however, in a survey of neonatal clinicians from 35 countries the vast majority would support a large randomized controlled trial to examine neurodevelopmental outcomes (Singla M, et al. Neonatology. 2022; 119:712-718). The results from this methodical Swedish cohort study provide data that can be used to direct further research. The composite outcomes in HIE are lower than expected, and one could infer similar outcomes in high resource settings. The data are reassuring and will be useful for clinicians in counseling and reassuring parents with infants affected by mild HIE. Regarding a randomized controlled trial of therapeutic hypothermia in mild HIE: it would appear, based on the data provided by Törn et al., if we hypothesize this therapy would result in a 50% reduction in the composite outcome, the NNT would be approximately 50. This compares unfavorably to the NNT of 7 in moderate/severe HIE. Perhaps, further insight could be gained by review of individual patient data, particularly with respect to antenatal and neonatal course, imaging, EEG, and biochemical data in order to identify a subset that might benefit from therapeutic hypothermia or other novel therapy.Word count: 490

A recurring question is whether rating scales should be considered metrically scaled or merely ordinally scaled. This has direct implications for the permissible statistical procedures for significance testing. Based on the results of a simulation study, it is shown that the use of parametric procedures for rating scales has distinct advantages over the non-parametric alternatives. It is also shown that the parametric procedures are robust to violations of the assumption of normality, which only result in a modest loss of power compared with continuous variables. This loss should be taken into account when calculating the optimal sample size. The results suggest that sample sizes about 25% larger should be chosen for discrete rating scales than for continuous variables.

In the meantime, this work has undergone peer review under the auspices of Swabian Research. In some instances, however, the repository in which it is deposited has not implemented this important change in status, and this note is therefore being provided for clarification.This report examines the pharmacological properties and therapeutic potential of Dimetindene maleate as a medium strong tranquilizer and anxiolytic. Dimetindene maleate is an antihistamine with additional sedative effects, making it suitable for managing anxiety and promoting relaxation. This report delves into the mechanism of action, pharmacokinetics, clinical applications, and potential side effects of Dimetindene maleate, providing a comprehensive understanding of its therapeutic benefits and limitations. Additionally, this report explores current research trends and future prospects for Dimetindene maleate as a promising option in the management of anxiety disorders.

We propose and experimentally demonstrate an on-chip all-optical multicasting (AOM) for 40 Gbit/s mode-division-multiplexed quadrature phase-shift keying (MDM-QPSK) signals based on a parallel dispersion-engineered multimode nonlinear silicon waveguide. Five dual-mode multicast wavelengths are successfully obtained on the generate idlers, and the power penalties of all the multicast channels are less than 1.1 dB at the bit error rate (BER) of 3.8×10-3. The dual-mode AOM scheme has the potential to promote the ability of optical cross-connect in practical hybrid multiplexed networks including MDM channels.

The global expansion for massively introduced managed species has profoundly impacted biodiversity and ecosystem functions. However, it is unclear how introduced pollinators and mass-flowering crops simultaneously affect the structure and function of pollination networks. Here, we conducted field experiments to investigate the ecological impacts of introduced honey bee (Apis mellifera) during the flowering period of a mass-flowering crop (Brassica rapa var. oleifera) on plant-pollinator interaction networks and reproductive performance of wild plants in 48 alpine grasslands. We showed that the spillover of introduced honey bees had weak effects on the pollinator communities. In addition, honey bee spillover strengthened the pollination network structure’s stability and improved plant communities’ pollination function. These effects can be observed when the introduced honey bees and mass-flowering plants coexist in the alpine grasslands, highlighting the positive effects of honey bee spillover on the pollination-limitation alpine ecosystem.

A document by Said Yasin. Click on the document to view its contents.

Malignant pleural effusions (MPE) are common in lung cancer, which were a complex microenvironment containing a plethora of immune and tumor signals. Gene alterations such as driver gene mutations were considered to affect the components in the TIME of NSCLC. Here, we demonstrated that pleural CD39+CD8+T cells were selectively elevated in firstly-diagnosed lung adenocarcinoma with wild-type EGFR compared to that in mutant EGFR, while abnormally more represented in MPE with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) acquired resistance. Analysis showed that pleural CD39+CD8+T cells display exhausted phenotype and potential cytolytic function, together with skewed usages of T cell receptor (TCR)-Vβ repertoire in comparison with CD39-CD8+T cells, which constituted common feature of lung adenocarcinoma related MPE. Further study revealed TCR-Vβ diversity tended to be more enhanced in pleural CD39+CD8+T cell from MPE coupled with EGFR-TKI acquired resistance. Taken together, we have identified a subset of CD8+T cells expressing CD39 in MPE, whom proposed as the potential tumor-reactive CD8+T cells, and further provided a new understanding of dynamic immune composition of EGFR-mutant tumor microenvironment.

Characteristics and treatments of patients with significantly elevated creatine kinase levels induced by seizures: case report and literature reviewKai Wang, Jinwei Yang, Wenhao Xu, Lei Wang, Yu Wang*The First Affiliated Hospital of Anhui Medical UniversityCorrespondence: Yu WangDepartment of Neurology, The First Affiliated Hospital of Anhui Medical UniversityJixi Road 218, Shushan District, Hefei, Anhui Province 230032,People’s Republic of China. Email yw4d@hotmail.com

Clival Ectopic Pituitary Prolactinoma was Successfully Managed by Transsphenoidal Surgery: A Rare Case Report

So far, sepsis is still a global disease and health problem facing mankind. Due to the complexity of the pathophysiology and pathogenesis of sepsis, the idea that a drug corresponds to a single target - a single disease is no longer suitable for the treatment of complex diseases such as sepsis. The application of network pharmacology to explore the signal network relationship between diseases, targets, and drugs has gradually become a new disease treatment methodology. This effective treatment for disease targets can improve the effectiveness and success of drug therapy, and it is possible to develop from the current treatment of symptoms of complex diseases to the real cure of complex diseases. This paper will discuss the application and discovery of network pharmacology in the treatment of sepsis, to provide a certain scientific theoretical basis for the subsequent basic and clinical research of sepsis treatment.

Agricultural intensification has resulted in a decline of soil biodiversity, and concerns about the deterioration of the biological condition of soils prompted the development of measures to restore soil life. Due to the overwhelming biodiversity of soils, evaluation of such measures is not straightforward, and proxies are used to assess soil health. Because of their trophic diversity, high abundance, and relatively well-characterized ecologies, nematodes are often used as soil health indicators. However, the scarcity of informative morphological characters hampers the upscaling of this proxy. Here we present a community analysis approach that uses nanopore sequencing to generate full-length sequences of small subunit ribosomal DNAs (SSU rDNA). Cover cropping is a common agricultural practice that stimulates soil life, and we mapped the effects of ten cover crop treatments on nematode communities in a field experiment. These analyses included the monitoring of a high impact plant-parasite, Meloidogyne chitwoodi. In total 132 nematode samples were analysed, and 65 nematode taxa were detected, mostly at species level, including representatives of all trophic groups. As a validation, all samples were analysed microscopically for M. chitwoodi, and comparison of count and DNA read data revealed highly similar results. Treatments did not only affect plant-parasitic nematodes, but also free-living nematodes in a cover crop-specific manner. Free-living nematodes from the same trophic group, and even congeneric species, responded differentially to plant-mediated manipulations of the soil microbiome. Hence, nanopore-based SSU rDNA sequencing could facilitate a substantial refinement of the use of nematodes as indicators for soil health.

Chlamydomonas reinhardtii has been successfully engineered to produce compounds of interest following transgene integration and heterologous protein expression. The advantages of this model include the availability of validated tools for bioengineering, its photosynthetic ability and its potential use as biofuel. Despite this, breakthroughs have been hindered by its ability to silence transgene expression through epigenetic changes. Histone deacetylases (HDAC) are main players in gene expression. We hypothesized that transgene silencing can be reverted with chemical treatments using HDAC inhibitors. To analyze this, we transformed C. reinhardtii, integrating into its genome the mVenus reporter gene under the HSP70-rbcs2 promoter. From 384 transformed clones, 88 (22.9 %) displayed mVenus positive (mVenus+) cells upon flow-cytometry analysis. Five clones with different fluorescence intensities were selected. The number of integrated copies was measured by qPCR. Transgene expression levels were followed over the growth cycle and upon SAHA treatment, using a microplate reader, flow cytometry, RT-qPCR, and western blot analysis. First, we observed that expression varies with the cell cycle, reaching a maximum level just before the stationary phase in all clones. Second, we uncovered that supplementation with HDAC inhibitors of the hydroxamate family, such as vorinostat (suberoylanilide-hydroxamic-acid, SAHA) at the initiation of culture increases the frequency (% of mVenus+ cells) and the level of transgene expression per cell over the whole growth cycle, through histone deacetylase inhibition. Thus, we propose a new tool to successfully trigger the expression of heterologous proteins in the green algae C. reinhardtii, overcoming its main handicap as an expression platform.

Mechanical intravascular hemolysis can occur after cardiac artificial prosthesis implantation. With the development of medical technology and the improvement of valve design, the incidence of severe mechanical hemolysis after surgery has been significantly reduced, but it cannot be completely avoided. At the same time, subclinical hemolysis after surgery is common but often ignored. With the extensive development of cardiac interventional surgery, the issue of postoperative hemolysis deserves further attention. Ultrasound can effectively evaluate cardiac artificial prosthesis implantation and provide imaging evidence for predicting and diagnosing postoperative hemolysis. This article introduces and explores the latest progress in applying echocardiography parameters in mechanical hemolysis after cardiac artificial prosthesis implantation.

As the field of stem cell-based therapies continues to evolve, the ability to monitor the regenerative capacity of stem cell following delivery to target tissues has become increasingly relevant. While Bromodeoxyuridine (BrdU) and green-fluorescent protein (GFP) labeling techniques are often used, limited knowledge exists regarding their effects on the regeneration capacity of stem cells. In order to further understand the impact of these techniques in a clinical scenario, porcine adipose stem cells (ASCs) were derived, cultured and subsequently labeled with BrdU or GFP using transfection (GFP-t) or infection (GFP-i) by lentivirus, followed by investigation of downstream labeling effects on ASCs proliferation, differentiation, colony formation, secretion of regenerative cytokines, growth factors and healing ability. Neither BrdU nor GFP labeling led to gross morphological changes in adipose stem cells. Both groups of GFP labeled cells maintained a high percentage of signal intensity for at least 28 days, with a decrease in cell proliferation ability in the GFP-i group. In contrast, BrdU labelling began displaying weaker signal strength after 7-days of experiments. Both tracers negatively affected osteogenic and adipogenic differentiation of ASCs, causing decrease in the secretion of the regeneration markers VEGF and TNF-α. In contrast, in-vitro wound healing ability of labeled ASCs and secretion of IL-8, IL-10, and TGF-β was not affected by either method. Our results demonstrate that BrdU labelling may be more effective for short-term in-vitro studies due to the relative ease of preparation and shorter lifespan of the tracer signal. Contrarily, for studies with a longer duration, GFP labeling of cells by transfection provides more durable and stable signal. While further studies are needed, our results indicate that labelling mode can alter regeneration capacity of stem cells and should, therefore, be optimized prior to clinical translation experiments.

Background and purpose: Recent preclinical studies suggest that botulinum toxin type A (BoNT-A) reduces abnormal muscle tone following its traffic to second order spinal synapses. However, possible consequences of such actions on spinal neuromotor control that coordinates skilled movement have not been characterized. Therefore, we studied the central effect of BoNT-A on different motor functions and coordination in rats. Experimental approach: The lower limb motor pools were targeted by BoNT-A injection into both sciatic nerves (2 U per nerve) in combination with blockage of spinal transcytosis by intrathecal BoNT-A-specific antitoxin (5 iu). Motor effects on balance, fatigue, swimming, gait and digit abduction were followed up to day 56 post BoNT-A. Afterwards, the rats’ gastrocnemius was injected with tetanus toxin (TeNT) to evoke muscle spasm and exaggerated monosynaptic reflex. Immunodetection of BoNT-A-cleaved synaptosomal-associated protein 25 was performed in muscles and spinal cord at day 78 post BoNT-A. Key results: After sciatic injection, BoNT-A was anterogradely and retrogradely transported to muscle and spinal cord. Combined peripheral and central trans-synaptic BoNT-A action induced more pronounced deficits of examined motor functions vs its isolated peripheral action. Centrally mediated alleviation of TeNT-evoked muscle spasm was not accompanied by changes in monosynaptic reflex excitability. Conclusions and implications: Present results suggest that BoNT-A trans-synaptic actions in motor system involves spinal premotor circuits participating in normal locomotion and involuntary muscle spasm. This proposes the need for investigation of non-canonical modes and sites of toxin action on neuromotor control to fully understand its therapeutically desirable effect in movement disorders.

Methotrexate (MTX) is an important drug for rheumatic and non-rheumatic disease therapy. MTX has been associated with many adverse effects ranging from asymptomatic transaminase elevation to fibrotic tissue formation and fatal hepatic necrosis due to oxidative stress. Concerns regarding potential liver toxicity have led to the avoidance of medication, termination, or advice for inquiries in clinical care. The protective and therapeutic effects of a new generation anti-angina drug, ranolazine (RAN), on MTX-induced liver damage were investigated by evaluating its antioxidant mechanism in rats. Thirty-two female Wistar Albino rats were randomly assigned to Control, RAN, prophylaxis, and treatment groups (n=8/group). Liver function enzymes, histopathological assessment and serum biochemical parameters were examined. Malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and reduced glutathione (GSH) were also measured in liver tissue. MTX administration caused mononuclear inflammation, vascular congestion, ductal proliferation, vacuolization, and fibrosis as evaluated using Roening grading and increases in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and lactate dehydrogenase levels ( p<0.05) in the blood, which is compatible with hepatocyte damage in the blood and increased MDA levels in the tissue. Histopathologically, vascular congestion and ductal proliferation, and biochemically, MDA and SOD levels and serum biochemical parameters, significantly decreased in the RAN+MTX and MTX+RAN groups ( p<0.001) when compared with the MTX group. No significant changes were observed in terms of SOD and GSH levels and fibrosis scores in RAN-administered groups ( p>0.05). According to our results, RAN may be a potential hepatoprotective agent against MTX-induced liver injury.

A document by MD Adewale. Click on the document to view its contents.

Pharmacoepidemiology and Drug Safety’s Core Concepts in Pharmacoepidemiology Section at One Year: Where Do We Go from Here? Jennifer L. Lund,1,2 Vincent Lo Re III3,41University of North Carolina at Chapel Hill, Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC, USA2Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA3Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA4Division of Epidemiology, Center for Real-World Effectiveness and Safety of Therapeutics, Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USARunning title: Core Concepts in Pharmacoepidemiology – Year 2Conflicts of interest: The authors report no conflicts of interest.Acknowledgements: The authors appreciated the critical input on the Core Concepts in Pharmacoepidemiology section from Brian Strom, Olaf Klungel, BJ Park, and the members of the International Society for Pharmacoepidemiology’s Publications and Communications Committee, particularly Elena Rivero, Patricia Saddier, Joan Largent, and Blànaid Hicks.

Lymphatic filariasis (LF) is a chronic, neglected nematode parasite that infected filarial parasites. It is abundant in underprivileged communities across the globe. It is belonging to the group of rare neglected tropical diseases (NTD). After malaria, it is the leading infectious disease. Causative organisms Wuchereria bancrofti, Brugia malayi, and Brugia timori belong to the phylum Nematode. It affects billions of people in India and several other countries. They were asymptomatic, but now a day few symptoms have been observed such as lymphedema, elephantiasis and hydrocele. This disease shows close communication with humans by interacting with host immune systems. They disrupt monocytes/macrophages, dendritic cells, granulocytes, eosinophils, basophils, and Toll-like receptors. This review demonstrated macrophage cells’ (mɸs) role and their therapeutic approaches.

Transcription therapy is an emerging approach that centers on identifying the factors associated with the malfunctioning gene transcription machinery that causes diseases and controlling them with designer agents. Until now, small molecule drugs targeting the epigenetic enzymes and critical signaling pathways have been the primary research focus in therapeutic gene modulation. However, nucleic acid-based small molecules have gained popularity in recent years as they could be pre-designed on demand to achieve operative control over the dynamic transcription machinery that governs how the immune system responds to diseases. Pyrrole-imidazole polyamides (PIPs) are well-established DNA-based small molecule gene regulators that overcome the limitations of their conventional counterparts owing to their sequence-targeted specificity, versatile regulatory efficiency and biocompatibility. Here, we emphasize the rational design of PIPs, their functional mechanism and their potential as targeted transcription therapeutics for diseases by regulating the immune response. Furthermore, we also discuss the challenges and foresight of this approach in personalized immunotherapy in precision medicine.