Food Allergy (FA) is now one of the most common chronic diseases of childhood often lasting throughout life and leading to significant worldwide healthcare burden. The precise mechanisms responsible for the development of this inflammatory condition are largely unknown; however, a multifactorial aetiology involving both environmental and genetic contributions is well accepted. A precise understanding of the pathogenesis of FA is an essential first step to developing comprehensive prevention strategies that could mitigate this epidemic. As it is frequently preceded by atopic dermatitis and can be prevented by early antigen introduction, the development of FA is likely facilitated by the improper initial presentation of antigen to the developing immune system. Primary oral exposure of antigens allowing for presentation via a well-developed mucosal immune system, rather than through a disrupted skin epidermal barrier, is essential to prevent FA. In this review, we present the data supporting the necessity of 1) an intact epidermal barrier to prevent epicutaneous antigen presentation, 2) the presence of specific commensal bacteria to maintain an intact mucosal immune system and 3) maternal/infant diet diversity, including vitamins and minerals, and appropriately timed allergenic food introduction to prevent FA.

Atopic eczema (AE) is an inflammatory skin disease with involvement of genetic, immunological, and environmental factors. One hallmark of AE is a skin barrier disruption on multiple, highly interconnected levels: filaggrin mutations, increased skin pH, and a microbiome dysbiosis towards Staphylococcus aureus overgrowth are observed in addition to an abnormal type 2 immune response. Extrinsic factors seem to play a major role in the development of AE. As AE is a first step in the atopic march, its prevention and appropriate treatment is essential. Although standard therapy remains topical treatment, powerful systemic treatment options emerged in the last years. However, thorough endotyping of the individual patients is still required for ideal precision medicine approaches in the future. Therefore, novel microbial and immunological biomarkers were described recently for the prediction of disease development and treatment response. This review summarizes the current state of the art in AE research.

We live challenging times on several levels, and in this context the second encyclical, Laudato Si’ (LS), of Pope Francis, published in 2015, has provided a special challenge for academics. As Pope Francis suggested in 2015, societies are challenged to modify the paradigms of life to achieve more sustainable development. LS has quickly become a widely quoted document, even by academics. This paper is the first bibliometric research about LS aiming to analyze this encyclical and explore several works published about LS between 2015 and 2020.To this end, we studied all documents published in the Web of Science Core Collection (238) and Scopus (222) about the topic “Laudato Si” in depth and analyzed them using bibliometric methods. The results show that there are scientific fields focused on studying LS in particular, namely Religious Sciences and the fields of Sustainability and Environment Studies. We also observed a small amount of networking among the authors publishing about LS.

Este exercício foi elaborado por Robert Junqueira no âmbito da Unidade Curricular de Negociação, Avaliação e Elaboração de Candidaturas da Pós-Graduação em Gestão e Políticas de Ciência e Tecnologia da Faculdade de Ciências Sociais e Humanas da Universidade NOVA de Lisboa, ministrada por Filipa Borrego, João Cortez e Margarida Trindade.1: Âmbito Temático2: Propósito3: Elegibilidade3.1: Candidata/os3.2: Propostas4: Financiamento5: Processos5.1: Candidatura5.2: Avaliação6: Recurso7: BibliografiaA fim de estimular a qualidade e o impacto dos projetos de investigação sobre a Idade Latina na área das Humanidades, a Agência Executiva do Conselho Europeu de Investigação (CEI) irá proceder ao lançamento do «Concurso Europeu na Área das Humanidades: a Idade Latina como Fonte de Respostas às Interrogações Prementes da Atualidade».1: Âmbito TemáticoPor Idade Latina entende-se, aqui, o período da história das ciências e culturas na Europa compreendido entre 354, o final da Idade Antiga, de expressão predominantemente grega, e 1644, a ascensão da Idade Moderna, de expressão multilinguística e inovador critério de cientificidade (cf. Deely 2001, 2010 e 2020). A datação é apresentada de forma tão precisa porque carrega um caráter simbólico, apresentando como ponto de partida o nascimento de Agostinho de Hipona e como fronteira última o ano de publicação dos Princípios de Filosofia de René Descartes e a morte de João de São Tomás. A Idade em que se originaram as chamadas Artes Liberais—o quadrívio da aritmética, geometria, astronomia e música mais  trívio da gramática, dialética e retórica, formando o cânone educativo que recebeu, no coração da Idade Latina e muito graças a Hugo de São Vítor, também as ditas Artes Técnicas, como sejam a carpintaria e a agricultura (cf. Lagerlund 2019, 36)—tem sido relegada para a escuridão que naturalmente se reserva a uma extensão temporal que se tem depreciado com o título de Idade das Trevas. A busca pelo controlo e por possibilidades de exploração desmesurada de recursos naturais e humanos por parte da própria humanidade, que se acentuaram na Idade Moderna com a evolução da técnica e o estabelecimento, desenvolvimento e instrumentalização de doutrinas científicas baseadas na experimentação, desembocou nos séculos XX e XXI numa realidade que apresenta dois rostos que destoam: por um lado, herdámos um mundo infestado de necessidades às quais urge acudir; por outro, foi-nos legada a competência científico-técnica para que a resposta às urgências do agora seja sustentada em conhecimentos consistentes e aprofundados. Contudo, os excessos da secularização moderna—seguramente alimentados mas nunca justificados pelos da Inquisição—levaram quase ao oblívio completo do legado proveniente de várias geografias ao longo de um período de tempo que abarca cerca de 1290 anos, Idade em que para além de abusos e erros foi também forjado um quadro intelectual que visa justificar a coexistência pacífica de esferas relativas—como sejam diferentes personalidades, povos e culturas ou também a fé e a razão—, tal como o quão desacertado é proceder à interpretação das diferentes esferas sem reconhecer-lhes uma autonomia hermenêutica relativa (para uma interessante leitura sobre este tema e sobre o papel central desempenhado pela tradição arábico-islâmica veja-se Deely 2001, 186-193 e Carvalho 2020, 10; 37). Importa, ainda, notar que não é apenas no âmbito das relações entre personalidades, povos e culturas que poderá a recuperação da Idade Latina ser valiosa: também para o pensamento que no presente é dedicado à relação entre a humanidade e o meio ambiente poderemos encontrar na Idade Latina uma interlocução à altura: na Idade Latina, lembrou Deely (2001, 72), já se reconhecia que não existem indivíduos senão em relação com o seu ambiente, este que é elemento incontornável no próprio ser de cada qual.2: PropósitoEste programa visa financiar projetos centrados em temas, tradições e autora/es da Idade Latina, por forma a colocá-los diante dos desafios da contemporaneidade. Os projetos devem buscar contribuir para que os Objetivos de Desenvolvimento Sustentável (ODS) da Organização das Nações Unidas (ONU) sejam melhor compreendidos, transmitidos e alcançados. Os projetos deverão, preferencialmente, abordar questões sobre a forma como que a herança da Idade Latina nos pode ajudar a erradicar ou a pensar a erradicação da pobreza e da fome, garantir ou pensar a saúde e educação de qualidade, igualdade de género, a ecologia, a dignidade humana, as desigualdades, as cidades, a sustentabilidade, o valor da vida, a paz, a justiça e o lugar das instituições. Assim, as Humanidades serão estimuladas a contribuir para que seja dada uma resposta às interrogações mais prementes da atualidade. Para além disso, a mobilidade de investigadora/es em princípio de carreira na área das Humanidades será estimulada no seio da UE. Prevê-se que este concurso fomente a reabilitação de importantes momentos de uma época suprimida do conhecimento comum, dissipada pelo passado fora e abafada ao longo da Idade Moderna. A finalidade principal deste concurso consiste, portanto, em financiar um conjunto notável de investigadore/as talentosa/os empenhados na divulgação da vasta densidade da Idade Latina enquanto inexaurível fonte de orientação para fazer face, com um olhar voltado para o porvir, às inquietações da contemporaneidade. 3: Elegibilidade3.1: Candidata/osApesar deste concurso ser designado de "Concurso Europeu", apenas candidata/os nacionais dos 27 Estados-membros independentes da União Europeia poderão concorrer. No âmbito das candidaturas individuais será dada preferência a jovens investigadora/es talentosa/os em princípio de carreira que tenham concluído o Doutoramento no máximo há 3 anos, se bem que serão elegíveis toda/os a/os candidata/os que tenham concluído o Doutoramento há menos de 10 anos, i.e., no ano fiscal de 2011. A preferência dada a jovens investigadora/es talentosa/os em princípio de carreira que tenham concluído o Doutoramento no máximo há 3 anos materializa-se na limitação de 7 pacotes de financiamento individual a projetos apresentados por candidata/os que apresentem esse perfil. Serão elegíveis toda/os a/os candidata/os independentemente da sua proveniência e género, mas será estimulada a equidade e a interação, por via da atribuição de 7 pacotes de financiamento exclusivamente voltados para projetos mistos. Estes projetos devem ser mistos na medida em que as candidaturas devem ser apresentadas conjuntamente por uma investigadora e um investigador com diferentes nacionalidades e proveniências institucionais distintas.3.2: PropostasOs projetos devem enquadrar-se em alguma das áreas das humanidades ou nos seus cruzamentos. Será dada preferência a projetos que incluam ou se insiram no desenvolvimento de investigação sobre o período tardio da Idade Latina nas áreas da filosofia, da geografia, da história e da linguística, tal como a projetos que se debrucem sobre a contribuição de filósofas de qualquer proveniência, etnia, credo e cultura tal como da filosofia arábico-islâmico para a atualidade e o diálogo científico e cultural na Idade Latina. Os pacotes de financiamento são concedidos numa perspectiva do topo para a base, pois os projetos devem procurar contribuir para que os ODS da ONU sejam melhor compreendidos, transmitidos e alcançados. Serão imediatamente rejeitadas todas as propostas que não declarem expressamente a relação entre a investigação a desenvolver e os ODS da ONU. Os projetos individuais devem prever duas fases de desenvolvimento a serem levadas a cabo em duas instituições sediadas em países distintos daquele do qual a/o candidata/o provém. As candidaturas aos pacotes de financiamento para projetos mistos devem ser apresentadas por uma candidata e um candidato que pretendam levar a cabo, em conjunto, um projeto de investigação em duas fases, em instituições sediadas em dois países diferentes daqueles de onde a candidata e o candidato são provenientes. Todas as instituições envolvidas (de proveniência e de destino) devem estar sediadas num dos 27 Estados-membros da União Europeia (UE), podendo ser instituições de investigação públicas ou privadas. A duração dos projetos deverá ser superior a 32 meses e inferior a 37 meses, e deverão ter início dois meses após a publicação dos resultados da avaliação.4: FinanciamentoPrevê-se a atribuição de um total de 5.100.000€, distribuído em 27 pacotes de financiamento: 20 para candidaturas individuais (150.000€ para cada projeto financiado) e 7 para candidaturas mistas (300.000€ para cada projeto financiado). Caso não haja 7 candidaturas mistas acompanhadas de uma avaliação positiva, cada um dos pacotes de financiamento remanescentes será repartido em 2 pacotes de financiamento para projectos individuais e cada um dos pacotes de financiamento resultantes será atribuído a outros projectos individuais qualificados com uma avaliação positiva. Os pacotes de financiamento serão concedidos a/os investigadora/es diretamente mas de forma faseada, sendo o total do financiamento a atribuir dividido pelo número de meses da duração do projeto. No caso dos projetos mistos, o pacote de financiamento será concedido ao par mas adjudicado separadamente, pelo que cada participante do projeto receberá o valor correspondente ao de um pacote de financiamento para projetos individuais. Cada investigador/a poderá beneficiar de um financiamento suplementar de 1500€/ano para estadias e deslocações para qualquer país do mundo. A atribuição do subsídio para deslocações/estadia será feita na forma de reembolso e exigirá que o/a investigador/a apresente um requerimento para o efeito, acompanhado de uma justificação, a apresentar ao CEI nos meses de janeiro ou fevereiro do ano fiscal imediatamente a seguir ao da contração das despesas. Caso o painel de avaliação da CEI considere que a fundamentação carece de sentido, o requerimento será indeferido, sem possibilidade de recorrer da decisão do painel.5: Processos5.1: CandidaturaEsta é a primeira edição do Concurso Europeu na Área das Humanidades: a Idade Latina como Fonte de Respostas às Interrogações Prementes da Atualidade, que decorrerá anualmente por tempo indefinido. Para que a candidatura seja validamente lacrada, os formulários oficiais, o projeto de investigação e os documentos suplementares, que incluem a carta de aceitação das instituições-destino, a carta de motivação e todos os documentos pessoais listados no regulamento, deverão ser incluídos. A candidatura deverá ser lacrada até ao dia 31 de agosto, e os resultados serão publicados a 31 de outubro (validação das candidaturas) e 31 de dezembro (avaliação das candidaturas). As chamadas foram publicadas nesta página, na página do CCI, no portal de Financiamento e Concursos da Comissão Europeia e enviadas por via eletrónica para todas as Unidades de I&D na área das Humanidades sediadas na UE. Candidata/os deverão ler a chamada atentamente e redigir uma proposta original. Não serão aceites projetos que se limitem a propôr um aprofundamento de temas já antes tratados por si ou por outrem, a não ser que o façam em resposta ao ODS número 4, procurando não só ir mais fundo na investigação mas também tornar os seus resultados acessíveis gratuitamente numa plataforma em linha num formato adequado para que constituam uma oferta de aprendizagem ao longo da vida ou voltada para crianças com menos de 12 anos de idade. Recomenda-se que a/os candidata/os se familiarizem atempadamente com o serviço para a submissão de propostas da UE e submetam as suas propostas tão cedo quanto lhes seja possível. Assim que o fizerem, será enviado um email para o endereço facultado no formulário com o documento unificado da candidatura que será apreciado pelo painel de avaliação, incluindo os anexos. Nenhuma proposta poderá ser apresentada ou alterada uma vez ultrapassada a data-limite; antes disso, as propostas submetidas poderão ser alteradas um número ilimitado de vezes por via do upload de um novo documento na secção "Projeto", o que levará à substituição do anterior documento pelo novo e ao envio de um novo email com o novo documento unificado da candidatura. No fim da fase de validação das candidaturas, o CEI informará toda/os a/os candidata/os sobre a validação ou não-validação das suas propostas, que poderão ou não avançar para a fase de avaliação das candidaturas por parte de um painel de especialistas externos ao CEI, recrutada/os por este. Apenas propostas validadas seguirão para o processo de avaliação por um painel de especialistas externos.5.2: AvaliaçãoAs propostas serão avaliadas por um painel internacional de especialistas externos ao CEI com base na excelência e na sua articulação com os ODS da ONU. O painel de avaliação irá apreciar e avaliar todas as propostas que passem da fase de validação de candidaturas. Na presente edição deste concurso, o orçamento e as tipologias dos pacotes de financiamento não sofrerão alterações, podendo ser alvo de aumento, decréscimo ou revisões em edições posteriores. A execução dos pacotes de financiamento fica-se pela atribuição dos mesmos, mas a não-execução dos projetos ou de parte destes levará à instauração de um processo visando a averiguação das causas. Em casos de não-execução parcial ou total dos projetos, poderá ser exigida ser exigida a devolução total ou parcial do financiamento por parte da/os candidata/os. O painel de avaliação será constituído por 54 membros, uma investigadora e um investigador especializada/os em temas da Idade Latina e provenientes de cada Estado-membro da UE, que serão selecionada/os pelo Conselho Científico da CEI com base na sua reputação científica. Os nomes dos membros do painel de avaliação serão tornados públicos na página Web da CEI apenas na data em que tenha sido dada resposta a todos os eventuais recursos.6: RecursoA/Os candidata/os dispõem da prerrogativa de interpor recurso perante as decisões tomadas pelo painel de avaliação nos casos do indeferimento imediato das propostas e na sequência dos resultados da avaliação. Para recorrer da decisão do painel de avaliação na fase de validação das candidaturas, a/os candidata/os deverão fazê-lo até 10 dias depois da publicação dos resultados, e receberão a resposta no decorrer dos 15 dias seguintes à interposição do recurso. O recurso na sequência dos resultados da avaliação deverão ser apresentados até 15 dias após a publicação dos resultados, e serão informados do resultado da apreciação do recurso no decorrer dos 20 dias após a interposição do mesmo. Todos os recursos serão apreciados por um painel de avaliação externo recrutado para o efeito pelo Centro Comum de Investigação (CCI). Por cada recurso, será enviado um despacho escrito para o CEI e para a/os candidata/os que apresentaram o respectivo recurso, a especificar e fundamentar a decisão, favorável ou não, do CCI. O CCI pode:i) considerar o recurso desprovido de mérito e sustentar a anterior decisão da CEI;ii) constatar que apenas erros irrelevantes ou inofensivos foram detectados no processo de atribuição de financiamento da CEI e, como tal, indeferir o recurso;iii) considerar o recurso meritório e poderáiii.i) proceder à inclusão da candidatura original, conforme apresentada, no processo de apreciação e avaliação da candidatura, sempre que esta tenha sido indeferida de imediato, o que não assegura a concessão do financiamento, antes permitindo que a proposta inicialmente indeferida seja novamente inscrita no processo de avaliação para efeitos de atribuição de financiamento;iii.ii) ou estipular as medidas necessárias, que poderão compreender, designadamente, a atribuição parcial dos fundos, uma nova avaliação das candidaturas ou quaisquer outras medidas previstas pelo CEI e pelo CCI para os casos de recursos meritórios apresentados posteriormente à publicação dos resultados da avaliação.7: BibliografiaEsta bibliografia não é uma lista de obras para a/os candidata/os do concurso, mas tão só a breve lista de obras que referi neste trabalho.Carvalho, Mário Santiago de. Falsafa. Breve introdução à filosofia arábico-islâmica. 2.a ed. eQuodlibet. Coimbra: Instituto de Estudos Filosóficos, 2020. https://doi.org/10.5281/zenodo.4420368.Deely, John. Four ages of understanding: the first postmodern survey of philosophy from ancient times to the turn of the twenty-first century. Toronto studies in semiotics. Toronto e Buffalo: University of Toronto Press, 2001. https://doi.org/10.3138/9781442675032.———. Medieval Philosophy Redefined as the Latin Age. 1st edition. South Bend, Indiana: St. Augustines Press, 2020. https://www.staugustine.net/our-books/books/medieval-philosophy-redefined-as-the-latin-age/.———. Medieval Philosophy Redefined: The Development of Cenoscopic Science, AD354 to 1644 (From the Birth of Augustine to the Death of Poinsot). Scranton, PA: University of Scranton Press, 2010. https://press.uchicago.edu/ucp/books/book/distributed/M/bo10192605.html.Lagerlund, Henrik, ed. Knowledge in Medieval Philosophy. The Philosophy of Knowledge: A History. London, New York, Oxford, New Delhi e Sydney: Bloomsbury Academic, 2019. http://dx.doi.org/10.5040/9781474258340.

Background: Children with hematologic malignancies, especially those who receive intensive chemotherapy, are at high risk for invasive mold infections (IMI) that confer substantial mortality. Randomized controlled trials support the use of anti-fungal prophylaxis with anti-mold activity as an optimal strategy for risk reduction in this population, but studies outlining the practical application of evidence-based recommendations are lacking. Procedure: We conducted a 15-year, single-institution retrospective review of children with hematologic malignancies treated with chemotherapy to determine the incidence of proven or probable IMI diagnosed between 2006 and 2020 and to identify the host and disease factors associated with IMI risk. We then compared the incidence and type of IMI and related factors before and after 2016 implementation of an evidence-based, risk-adapted anti-fungal prophylaxis algorithm that broadened coverage to include molds in patients at highest risk for IMI. Multivariable linear regression was used to determine factors related to IMI risk. Results: We identified 61 cases of proven or probable IMI in 1,456 patients diagnosed with hematologic malignancies during the study period (4.2%). Implementation of an anti-fungal prophylaxis algorithm reduced the IMI incidence in this population from 4.8% to 2.9%. After multivariable analysis, both Hispanic ethnicity and cancer diagnosis prior to 2016 were significantly associated with risk for IMI. Conclusion: An evidence-based, risk-adapted approach to anti-fungal prophylaxis for children with hematologic malignancies is an effective strategy to reduce incidence of IMI.

News & Views: Groundbreaking Discoveries in Immunology

Background: This longitudinal cohort study aimed to examine the impact of the first wave of the COVID-19 pandemic in Ireland on parents of children with externalising difficulties, in comparison to parents of children without such difficulties. Method: Parents of 159 children completed online self-report measures at three time points during the first wave of the COVID-19 pandemic; 1) Delay and Mitigation Phase (March 2020 - May 2020), 2) Reopening of Society Phase (June 2020 – July 2020), and 3) Wave 2 Case Acceleration Phase (September 2020 - October 2020). Participants were allocated to the Clinical group if they met the clinical cut off point on the Conduct or Hyperactivity/Inattention subscales of the Strengths and Difficulties Questionnaire at Time 1. Results: Parents of children with externalising difficulties experienced significantly higher levels of stress, lower levels of wellbeing, and engaged in higher levels of avoidant-focused coping strategies longitudinally. There was a significant difference between outcomes at the different phases of the COVID-19 pandemic, for stress related to parenting, personal/family stress related to the impact of the COVID-19, and type of coping strategies employed. Children with externalising difficulties, in comparison to children without externalising difficulties, showed significantly greater adjustment over time for behavioural and emotional difficulties. Conclusions: Results provide important information regarding the trajectory of psychological outcomes in parents of children with externalising difficulties over the first wave of the COVID-19 pandemic, highlighting the need for increased parental supports during, and after, the COVID-19 pandemic.

Objectives: Chemotherapy-induced nausea vomiting (CINV) is a troublesome side-effect of chemotherapy in pediatric patients undergoing Osteosarcoma treatment. The role of 5HT3 antagonists needs to be explored for the same. The study aims to evaluate the superiority of single-dose Palonosetron over Granisetron in pediatric patients undergoing moderate emetogenic therapy for osteosarcoma. Materials and Methods: In this double-blind, case-controlled, randomized study, pediatric patients were assessed for acute nausea and vomiting following moderate emetogenic chemotherapy for osteosarcoma. These children were assigned to group I (palonosetron) and group II (Granisetron) without other antiemetic prophylaxis. The primary objective variable was children’s segment with complete response during the acute phase of the first on-study chemotherapy cycle. Risk factors associated with the trial were analyzed. The patients were followed for the first 24 hours following chemotherapy. Results: A total number of 200 children were evaluated, and other factors which might alter the response were assessed into two groups. These 200 children underwent 604 blocks of chemotherapy. The complete responses (CR) were documented in 83% and 72% receiving palonosetron and Granisetron, respectively, during the acute phase. The only dexamethasone, used as rescue medication, was found to be a significant risk factor that predisposed the response (p<0.05) Conclusion: Palonosetron is an effective alternative to Granisetron as a single dose for preventing CINV in children receiving MEC for osteosarcoma.

Reproductive success largely defines the fitness of plant species. Understanding how heat and drought affect plant reproduction will thus be key to predicting future plant fitness under rising global temperatures. Recent work suggests reproductive tissues are highly vulnerable to water stress in perennial plants where reproductive sacrifice could preserve plant survival. However, most crop species are annuals where such a strategy would theoretically reduce fitness. We examined the reproductive strategy in tomato (Solanum lycopersium) to determine whether water supply to fruits was prioritized above vegetative tissues during drought. Using optical methods, we map xylem cavitation and tissue shrinkage in vegetative and reproductive organs during dehydration to determine the priority of water flow under acute imposed water stress. Stems and peduncles of tomato showed significantly greater resistance to xylem cavitation than vegetative tissues. This prioritization of reproductive water supply enabled tomato fruit to continue expanding during acute water stress, utilising xylem water made available by capacitance and cavitation of vegetative tissues. Here, tomato plants prioritize water supply to reproductive tissues, maintaining fruit development in drought conditions. These results emphasize the critical role of water transport in shaping tomato life history and suggest a broad relevance of hydraulic prioritization in plant ecology.

Glomus tumors are exceedingly rare tumors arising from the normal glomus body. Only a very few cases located in the small intestine were reported to date. Here, we present a case of glomus tumor of the jejunum in a 30-year-old female patient, and discuss its clinical, imaging, and pathologic features.

ABSTRACT BACKGROUND: Back pain amongst children is on the rise exponentially. Hamstring tightness is known to have cause/effect relationship with low back pain. Presence of hamstring tightness is also associated with increase in risk of muscular strains. The purpose of this study was to assess the prevalence of hamstring tightness in school going children in the United Arab Emirates. To our knowledge, this is the first such reported study in the Middle East. METHODS: All children of a school based in Dubai, UAE from grade 2 to grade 10 aged 7-15 years were assessed by a team of 5 physiotherapists. Hamstring tightness was evaluated by standard active knee extension [AKE] test in the school medical department. A total of 317 children were assessed [634 limbs] by two observers and any inability to actively extend the knee completely while the hip being at 90-degree flexion was considered as hamstring tightness. RESULTS: Out of 317 subjects, 287 [90.53%] were found to have at least some hamstring tightness. There was a statistically significant difference between genders: boys showing more prevalence. All age groups across the school showed similar pattern. This may be the highest ever recorded prevalence of hamstring tightness in school children in any reported study in English literature. CONCLUSION: An alarming proportion of children in a Dubai based school have hamstring tightness. Wider studies with larger numbers should be undertaken so as to ascertain if this is in some way related to lack of active lifestyle in the UAE where gadget-dependency of younger generation as well as prolonged sitting might be a causative factor. Whether such high prevalence is pathological or physiological also needs to be addressed. School authorities and parents in UAE should engage the children in regular stretching programs.

Background: Diabetes is a chronic condition that requires lifelong treatment with anti-diabetic medications to achieve optimum blood sugar level and to prevent complications associated with it but medication non-adherence becomes a major barrier in attaining good glycemic control. Aim: The study was designed to determine the adherence rate to anti-diabetic medications and factors associated with medication non-adherence amongst diabetic patients in Punjab. Materials & Methods: A cross-sectional study was carried out for 3 months on 138 diabetic patients who were using at least one hypoglycemic agent or were on insulin therapy. Hill-Bone Medication Adherence Scale (HB-MAS) - a 9 item questionnaire was used to measure adherence rate. Results: Medication adherence in the study population was above average. 89(64.5%) had high adherence followed by 41(29.7%) having moderate and 8(5.8%) having low adherence. Factors associated with medication non-adherence were age group 18-30 years, male, unmarried, and had a family monthly income < Rs 5000. Conclusion: The factors which affect medication adherence need to be evaluated at the constant interval for an individual patient. Patients must be educated about the disease and the benefits of adhering to their treatment regimen, which eventually improves the quality of life.

Objectives. Whole blood viscosity (WBV) may promote endothelial shear stress, endothelial inflammation, and vascular remodeling, and can accelerate the atherosclerotic process. We aimed to evaluate the relationship between WBV and Aortic Stenosis (AS). Methods. The study population included 209 participants of which 49 patients with severe AS, 98 patients with mild-to-moderate AS and 62 patients as control. The WBV calculated with a formula from Hct and total plasma protein (TP) for wall shear stress. WBV was cal-culated for both low shear rate (LSR) (0.5 s–1) and high shear rate (HSR) (208 s–1) from Hct and TP protein concentration using a validated formula. Results. WBV values were significantly higher for HSR (p = 0.001) and for LSR (p=0.002) in severe aortic stenosis group than mild-to-moderate aortic stenosis group. HSR and LSR were correlated with mean systolic transaortic gradient (p<0.001 and p<0.001, respectively). WBV for both LSR and HSR were found to be independent predictors for the aortic stenosis severity (β=0.265;p=0.034 and β=0.237;p=0.049, respectively). Hypertension independently associated with the aortic stenosis severity (p<0.05). Conclusion. We found a significant relationship between WBV and AS

A document by Fatma Uğuz Selçuk. Click on the document to view its contents.

Objective: Pulmonary embolism (PE) is usually a complication of deep vein thrombosis and is an important cause of mortality and morbidity. Vascular endothelial growth factor D (VEGF-D) is a secretory protein that plays a role in the remodeling of blood vessels and the lymphatic system. This study aimed to determine the relationship between VEGF-D level and clinical risk scoring in patients with PE. Methods: The study included 117 patients admitted for PE that were divided into 4 groups: high-risk patients (n=35), high-intermediate-risk patients (n=30), low-intermediate-risk patients (n=24), and low-risk patients (n=28). Plasma VEGF-D was measured from peripheral venous blood samples (5 cc) using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Pulmonary Artery Obstruction Index (PAOI) was calculated from CT angiography imaging. Results: VEGF-D levels in the low-risk PE group differed significantly from those in the high-intermediate and high-risk groups (p=0.001 for both) but not from that in the low-intermediate-risk PE group (p=0.155). There was no significant difference in troponin-I and NT-proBNP levels between the high-intermediate-risk and high-risk PE patients, whereas VEGF-D levels differed significantly (p=0.134, p=0.146, p=0.016). VEGF-D level was moderately correlated with mean pulmonary artery pressure and PAOI (r=0.481, p=0.01; r=0.404, p=0.01). In ROC curve analysis, a cut-off of 370.1 pg/ml for VEGF-D had 91.4% sensitivity and 67.4% specificity in the differentiation of high-intermediate-risk and high-risk PE patients. Conclusion: This study showed that plasma VEGF-D level was more reliable than troponin-I and NT-proBNP in clinical risk scoring and demonstrating thrombus burden. VEGF-D can be used as a biomarker in clinical risk scoring and estimation of thrombus burden in patients with acute PE.

Hemophagocytic lymphohistiocytosis is a rare condition, characterized by excessive cytokine release and inflammatory response. HLH can be primary or secondary to infections, neoplasm or autoimmune conditions. Management includes immunosuppressive agents. Diagnosis of HLH is difficult in the setting of sepsis. We report a case of Klebsiella pneumonia complicated by HLH.

Background The coronavirus disease 2019 (COVID-19) pandemic has given rise to the need to develop a vaccine as quickly as possible. As pregnant women are at increased risk of contracting severe COVID-19, with higher mortality, it is essential to assess the safety of the vaccines administered during pregnancy. Methods The aim of this study was to determine the titer of specific maternal and cord antibodies against severe acute respiratory syndrome coronavirus 2 S protein after antenatal vaccination. The secondary objective was to evaluate the ratio of the umbilical cord to the maternal antibody titers. Patients included in the study were enrolled after undergoing voluntary vaccination against COVID-19 during pregnancy at different weeks of gestation. Their decision concerning vaccination was independent of the decision to participate in the present study. All patients analyzed in our initial study were vaccinated with the BNT162b2 mRNA COVID-19 vaccine. Results The results of the current study document high anti-S total antibody titers in cord serum at birth in all mother-infant pairs analyzed. Conclusions Our study suggests that maternal immunization may provide neonatal protection through transplacental transfer of antibodies.

Intraprocedural transesophageal echocardiography (TEE) guidance plays an essential role in transcatheter repair therapy of the tricuspid valve (TV). So far, several different imaging concepts are in use. However, an imaging protocol that fully addresses the morphological complexity of the TV and further offers efficacious workarounds for the frequently occurring restrictions of TV imaging is still missing. As a tertiary referral center with a large experience of more than 250 cases of transcatheter edge-to-edge repair (TEER) of the TV performed at the Heart Valve Center in Mainz/Germany, we have constantly adapted our periinterventional echocardiographic approach to accomplish both. As a key measure for success, we intensely rely on the transgastric acoustic windows that not only delivers high-resolution information on the morphology of the TV and all relevant procedural steps but also help to avoid the frequent shadowing artefacts experienced in transesophageal imaging.

Amyloid beta (Aβ of Alzheimer’s disease) and α-synuclein (α-Syn of Parkinson’s disease) form large fibrils. Evidence is increasing however that much smaller oligomers are more toxic and that these oligomers can form transmembrane ion channels. We have proposed previously that Aβ42 oligomers, annular protofibrils, and ion channels adopt concentric β-barrel molecular structures. Here we extend that hypothesis to the superfamily of α, β, and γ-synucleins. Our models of numerous Synuclein oligomers, annular protofibrils, tubular protofibrils, lipoproteins, and ion channels were developed to be consistent with sizes, shapes, molecular weights, and secondary structures of assemblies as determined by EM and other studies. The models have the following features: 1) all subunits have identical structures and interactions; 2) they are consistent with conventional β-barrel theory; 3) the distance between walls of adjacent β-barrels is between 0.6 and 1.2 nm; 4) hydrogen bonds, salt bridges, interactions among aromatic side-chains, burial and tight packing of hydrophobic side-chains, and aqueous solvent exposure of hydrophilic side-chains are relatively optimal; and 5) residues that are identical among distantly related homologous proteins cluster in the interior of most oligomers whereas residues that are hypervariable are exposed on protein surfaces. Atomic scale models of some assemblies were developed.

Porcine circoviruses are important pathogens of production swine. Porcine circovirus type 1 (PCV1) is non-pathogenic, and discovered as a contaminant of a porcine kidney cell line, PK-15. The discovery of pathogenic variant, PCV2, occurred in the late 90’s in association with post-weaning multi-systemic wasting disease syndrome (PMWS), which is characterized by wasting, respiratory signs and lymphadenopathy in weanling pigs. A new PCV type, designated as PCV3, was discovered in 2016, in pigs manifesting porcine dermatitis and nephropathy syndrome (PDNS), respiratory distress and reproductive failure. Pathological manifestations of PCV3 Infections include systemic inflammation, vasculitis and myocarditis. A 4 th PCV type, PCV4, was identified in 2020 in pigs with PDNS, respiratory and enteric signs. All the pathogenic PCV types are detected in both healthy and morbid pigs. They cause chronic, systemic infections with various clinical manifestations. Dysregulation of the immune system homeostasis is a pivotal trigger for pathogenesis in porcine circoviral infections. While the study of PCV3 immunobiology is still in its infancy lessons learned from PCV2 and other circular replication-associated protein (Rep)-​encoding single stranded(ss) (CRESS) DNA viruses can inform the field of exploration for PCV3. Viral interactions with the innate immune system, interference with dendritic cell function coupled with the direct loss of lymphocytes compromises both innate and adaptive immunity in PCV2 infections. Dysregulated immune responses leading to the establishment of a pro-inflammatory state, immune complex associated hypersensitivity, and the necrosis of lymphocytes and immune cells are key features of PCV3 immunopathogenesis. A critical overview of the comparative immunopathology of PCV2 and PCV3/4, and directions for future research in the field are presented in this review.

Over winter freeze-thaw events are notoriously difficult to represent in hydrologic models and have serious implications for the hydrologic function of intermittently freezing regions. With changing climate leading to higher variability in observed weather patterns, it is anticipated that mid-winter thaw events may become more numerous, especially in cold regions. Midwinter thaw events are often the cause of flooding due to the coupled impact of rain-on-snow, and limited soil infiltrability. A numerically efficient, semi-analytical coupled thermal and mass transport model is presented that is capable of representing the ice content of near-surface soil. This model allows for rapid and stable prediction of the ice content of frozen or partially frozen soil without having to solve a discrete form of the coupled partial differential equations. The model tracks pore ice formation and soil cold content in terms of enthalpy. It is tested against data collected in Southern Saskatchewan and is shown to reproduce field observations. This model is efficient enough to be incorporated as a module into existing regional hydrologic models and is expected to improve predictions of over-winter streamflow and flooding potential.

Soil nematodes are a foremost component of terrestrial biodiversity, they display the whole gamut of trophic guilds and life strategies, and by their activity, affect major ecosystem processes, such as organic matter degradation and carbon cycling. Based on nematodes’ functional types, nematode community indices have been developed and can be used to link variation in nematode community composition and ecosystem processes. Yet, the use of these indices has been mainly restricted to anthropogenic stresses. In this study, we propose to expand the use of nematodes’ derived ecological indices to link soil and climate properties with soil food webs, and ecosystem processes that all vary along steep elevation gradients. For this purpose, we explored how elevation affects the trophic and functional diversity of nematode communities sampled every 300 m, from about 1000 m to 3700 m above sea level, across four transects in the lesser Himalayan range of Jammu and Kashmir. We found that (1) the trophic and functional diversity of nematodes increases with elevation; (2) differences in nematodes communities generate habitat-specific functional diversity; (3) the sigma maturity index, the channel index, and the metabolic footprint of nematodes increase with elevation, indicating less mature and less productive ecosystems, enhanced fungal-based energy flow, and a predominant role of nematodes in generating carbon influxes at high elevation sites, respectively. We thus conclude that the functional contribution of soil nematodes to belowground ecosystem processes, including carbon and energy flow, is stronger at high elevation. Overall, this study highlights the central importance of nematodes in sustaining soil ecosystems and brings insights into their functional role, particularly in alpine and arctic soils.

Background: The aim of the study was to determine the effectiveness of tocilizumab treatment in patients with COVID-19. Methods: 60 patients infected with SARS-CoV-2 were enrolled in the study. The patients were divided into two groups according to whether they treated with tocilizumab or did not. Demographic and clinical features of the patients, laboratory findings, treatments, and clinical outcome were evaluated. Results: The mean age of 30 patients in group 1 was 63.6±16.3 years and male/female ratio was 3.2, whereas the mean age of 30 patients in group 2 was 59.4±11 years and male/female ratio was 2.7 (P=0.244 and P=0.766, respectively). pO2/FiO2 and lymphocyte count at baseline, 2nd day and 7th day were significantly lower in group 1 treated with standard treatment without tocilizumab than group 2 additionally treated with tocilizumab (P<0.05). D-dimer level at 7th day, ferritin and CRP levels at 2nd and 7th day were significantly higher in group 1 than group 2 (P=0.015, P<0.001, P<0.001, P<0.001, P<0.001, respectively). The patients in group 1 had higher intensive care unit need and mortality rate than the patients in tocilizumab group (P=0.015). 28-day survival was lower in group 1 than tocilizumab group (P=0.024). Conclusions: We observed clinical improvement and lower mortality rate in hospitalized patients with severe COVID-19 with tocilizumab treatment.

Agricultural drainage networks increase hydrological connectivity from the field to the receiving environments. The response to the issue of surface water quality therefore implies an understanding of the hydrological processes related to drainage, particularly at the field scale. Drainage by tile drains and drainage ditch are the two most studied types at the plot scale. They can be complemented by temporary surface drains to improve the removal of surface runoff. The hydrological processes and functioning of tile-drained fields have been extensively studied at the event scale. However, few studies have been conducted over a full hydrological year and the description of water pathways in the soil generally relies on either exogenous tracer monitoring or irrigation experiments. In addition, only a few studies have been conducted on fields combining tile drainage and temporary surface drainage. In this study, high temporal resolution quantification of runoff from surface and subsurface drainage was conducted for a full year to establish one of the first water balances for a surface and subsurface drained field. Soil water pathways were studied under dry and saturated soil conditions tracing water by measuring stable isotope concentrations (18O and 2H) on rainwater, soil water, and surface and subsurface runoff. Runoff quantifications showed that surface drainage and subsurface drainage respectively evacuate 41% and 32% of the annual cumulated effective rainfall. The water balance highlights the importance of infiltrations to the deep horizons: 46% of the water transferred to the soil is not captured by the subsurface drains. Water tracing showed that rainwater was directly transferred to subsurface drains on dry soil, likely through macropores. On saturated soil, soil water present before the rain remains the main source of water to the subsurface drains, but event-rainwater also reaches the subsurface drains and can constitute up to 25% of the subsurface runoff volume.