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Deep brain stimulation of the central thalamus (CT-DBS) has potential for modulating states of consciousness, but it can also trigger electrographic seizures, including poly-spike-wave trains (PSWT). To report the probability of inducing PSWTs during CT-DBS in awake, freely-moving mice. Mice were implanted with electrodes to deliver unilateral and bilateral CT-DBS at different frequencies while recording electroencephalogram (EEG). We titrated stimulation current by gradually increasing it at each frequency until a PSWT appeared. Subsequent stimulations to test arousal modulation were performed at the current one step below the current that caused a PSWT during titration. In 2.21% of the test stimulations (10 out of 12 mice), CT-DBS caused PSWTs at currents lower than the titrated current, including currents as low as 20 μ A. Our study found a small but significant probability of inducing PSWTs even after titration and at relatively low currents. EEG should be closely monitored for electrographic seizures when performing CT-DBS in both research and clinical settings. [ABSTRACT FROM AUTHOR]

• Older women with WC >93.5 cm had 3.30 greater chances of having FOF. • WC was not able to discriminate FOF in older men. • These results may help professionals to better control fear of falling. Fear of falling (FOF) is a prevalent condition among older adults and several variables have been pointed out as risk factors. To identify the cut-off point on waist circumference (WC), capable of discriminating between older adults with and without FOF, and to test the association between WC and FOF. A cross-sectional observational study was carried out with older adults of both sexes from Balneário Arroio do Silva, Brazil. We used Receiver Operating Characteristic (ROC) curves to determine the cut-off point on WC and logistic regression adjusted for potential confounding variables to test the association. Older women with WC >93.5 cm [area under the curve: 0.61 (95%CI 0.53; 0.68)] had 3.30 (95%CI 1.53; 7.14) greater chances of having FOF compared with older women with WC ≤93.5 cm. WC was not able to discriminate FOF in older men. WC values >93.5 cm are associated with higher chances of FOF in older women. [ABSTRACT FROM AUTHOR]

Obesity without metabolic alterations (Metabolically Healthy Obesity, MHO) is a condition with a risk of death and cardiovascular disease lower than that of obesity associated with metabolic alterations (Metabolically Unhealthy Obesity, MUO) and similar to that of healthy non obese individuals. Inflammation is considered as a key risk factor mediating the adverse health outcomes in obesity. We compared circulating levels of thirteen major cytokines and adipokines and the expression profiles of fifteen pro-inflammatory and two anti-inflammatory genes in visceral and subcutaneous adipose tissue in a series of 16 MHO patients and in 32 MUO patients that underwent bariatric surgery. MHO was defined according to the most applied definition in current literature. Serum levels of a large set of major cytokines and adipokines did not differ between MHO and MUO patients (p ≥ 0.15). Analyses of the expression profile of pro-inflammatory and anti-inflammatory genes in subcutaneous and visceral adipose tissue failed to show differences between MHO and MUO patients (p ≥ 0.07). Sensitivity analyses applying two additional definitions of MHO confirmed the results of the primary analysis. In a series of metabolically healthy obese patients neither circulating levels of major cytokines and adipokines nor the gene expression profile of a large set of pro-inflammatory and anti-inflammatory genes in subcutaneous and visceral fat differed from those in metabolically unhealthy obese patients. • Metabolically Healthy Obesity (MHO) is a condition with a risk of death and cardiovascular disease lower than that of obesity associated with metabolic alterations (Metabolically Unhealthy Obesity, MUO). • Inflammation is considered as a key risk factor mediating the adverse health outcomes in obesity. • In a series of MHO patients neither circulating levels of major cytokines and adipokines nor the gene expression profile of a large set of pro-inflammatory and anti-inflammatory genes in subcutaneous and visceral fat differed from those MUO patients. • The low risk of death and cardiovascular disease in metabolically healthy obese subjects reported in large epidemiological studies is unlikely to be explained by lower levels of inflammation. [ABSTRACT FROM AUTHOR]

Chest pain is a common and complex condition in emergency departments, often complicating the diagnostic process due to its wide range of potential causes. This case report presents a 72-year-old man with chest pain and ST-segment elevation on ECG, initially suggestive of acute coronary syndrom. AI-assisted ECG analysis reinforced this suspicion; however, angiography revealed patent coronary arteries. When his symptoms persisted, further investigation uncovered a pneumothorax. Additional evaluation identified a digitization error affecting the AI interpretation. This case underscores the importance of a comprehensive clinical approach for chest pain and highlights the need for quality data input and alternative imaging, such as thoracic ultrasound, for accurate and timely differential diagnoses. [ABSTRACT FROM AUTHOR]

Background: Limited data are currently available on the incidence rates and risk factors for bacterial sepsis and invasive fungal infections (IFIs) among neonates and infants undergoing major surgery.Aim: To assess the incidence of bacterial sepsis and IFI, fungal colonization, risk factors for sepsis, and mortality in neonates and infants aged <3 months undergoing major surgery.Methods: A multicentre prospective study was conducted involving 13 level-3 neonatal intensive care units in Italy, enrolling all infants aged ≤3 months undergoing major surgery.Findings: From 2018 to 2021, 541 patients were enrolled. During hospitalization, 248 patients had a bacterial infection, and 23 patients had a fungal infection. Eighty-four patients were colonized by fungal strains. Overall, in-hospital mortality was 2.8%, but this was higher in infected than in uninfected infants (P = 0.034). In multivariate analysis, antibiotic exposure before surgery, ultrasound-guided or surgical placement of vascular catheters, vascular catheterization duration, and gestational age ≤28 weeks were all associated with bacterial sepsis. The risk of IFI was markedly higher in colonized infants (odds ratio (OR): 8.20; P < 0.001) and was linearly associated with the duration of vascular catheterization. Fungal colonization in infants with abdominal surgery increased the probability of IFI 11-fold (OR: 11.1; P < 0.001).Conclusion: Preventive strategies such as early removal of vascular catheters and the fluconazole prophylaxis should be considered to prevent bacterial and fungal sepsis in infants undergoing abdominal surgery, and even more so in those with fungal colonization. [ABSTRACT FROM AUTHOR]

Traditional and complementary medicine constitutes an important, and often underestimated, source of healthcare for multiple diseases including cancer. However, little is known about the ethnomedical knowledge and practices in Northern Africa. The main objective of this study is to identify and analyze the variety of natural products used in Algerian ethnopharmacology for cancer therapy. For this purpose, semi-structured interviews with 225 traditional healers, herbalists and practitioners were realized in twelve locations in Algeria throughout field studies performed from June 2015 to July 2019. Interviews covered popular and vernacular names of the natural product, mode of use and administration, dose, period of treatment, toxicity and side effects among other data. The obtained results reveal the use of 113 medicinal plants (belonging to 53 families and 104 genera), 10 animal species and various products and by-products from different origins such as honey, olive oil, thorns, urine, milk, animal fat and the alkaline water of Zamzam. Basing on the frequency of citation (FC), use reports (UR) and use value (UV), the most used natural products for cancer treatment are honey (FC = 181, UR = 194, UV = 0.65), Nigella sativa L. (FC = 131, UR = 152, UV = 0.54), Aristolochia longa L. (FC = 118, UR = 144, UV = 0.51), Berberis vulgaris L. (FC = 111, UR = 142, UV = 0.51), Curcuma longa L. (FC = 107, UR = 121, UV = 0.43), Trigonella foenum - graecum L. (FC = 102; UR = 119, UV = 0.43), Citrus limon (L.) Obseck (FC = 97, UR = 120, UV = 0.43), Artemisia herba-alba Asso (FC = 92, UR = 115, UV = 0.41) and the holy water 'Zamzam' (FC = 110, UR = 110, UV = 0.43) respectively. Mixtures of two or more ingredients were frequently used. The use of Pelophylax saharicus skin' was reported for the first time for the treatment of visible tumors and skin cancer. This is the first study documenting the traditional uses of various natural products for cancer treatment in Algeria. Our findings are relevant to document the traditional uses of numerous natural products and to provide background basis to search for novel compounds for cancer therapy. [ABSTRACT FROM AUTHOR]

In this paper, crosstalk characterization results of single-photon avalanche diode (SPAD) arrays in CMOS 150 nm technology are reported and discussed. SPADs are implemented in two different sizes (15.6 and 25.6 μm pitch) and three guard ring widths (0.6, 1.1 and1.6 μm). A SPAD array is composed of 25 (5×5) devices, which can be separately activated. Measurement results show that total crosstalk probability is well below 1% for arrays with conservative guard ring SPADs, and decreases with distance between devices. We also observed crosstalk is dependent on geometry parameters of SPADs. [ABSTRACT FROM AUTHOR]

Background and aims Pro-inflammatory molecules produced by adipose tissue have been implicated in the risk of cardiovascular (CV) disease in obesity. We investigated the expression profile of 19 pro-inflammatory and seven anti-inflammatory genes in subcutaneous adipose tissue (SAT) and in visceral adipose tissue (VAT) in 44 severely obese individuals who underwent bariatric surgery. Methods and results SAT and VAT expressed an identical series of pro-inflammatory genes. Among these genes, 12 were significantly more expressed in SAT than in VAT while just one (IL18) was more expressed in VAT. The remaining genes were equally expressed. Among pro-inflammatory cytokines, both IL6 and IL8 were about 20 times more intensively expressed in SAT than in VAT. The expression of nine genes was highly associated in SAT and VAT. Only for three pro-inflammatory cytokines (IL8, IL18, SAA1) in SAT the gene expression in adipose tissue associated with the circulating levels of the corresponding gene products while no such an association was found as for VAT. Conclusions The expression of critical pro-inflammatory genes is substantially higher in SAT than in VAT in individuals with morbid obesity. The variability in circulating levels of pro-inflammatory cytokines is, in small part and just for three pro-inflammatory cytokines, explained by underlying gene expression in SAT but not in VAT. These results point to a compartment-specific adipose tissue contribution to inflammation in obesity and indicate that abdominal SAT contributes more than VAT to the pro-inflammatory milieu associated with severe obesity. [ABSTRACT FROM AUTHOR]

Abstract: Malignant pleural mesothelioma (MPM) is a relevant public health issue. A large amount of data indicate a relationship between mesothelioma and asbestos exposure. MPM incidence has considerably and constantly increased over the past two decades in industrialized countries and is expected to peak in 2010–2020. In Italy, the standardized incidence rate in 2008 was 3.6 and 1.3 per 100,000 in men and women respectively, with wide differences from one region to another. The approach to this disease remains difficult and complex in terms of pathogenic mechanism, diagnosis, staging and treatment thus an optimal strategy has not yet been clearly defined. The Second Italian Multidisciplinary Consensus Conference on Malignant Pleural Mesothelioma was held in Turin (Italy) on November 24–25, 2011: recommendations on MPM management for public health institutions, clinicians and patients are presented in this report. [Copyright &y& Elsevier]

Background: Over the years, several modifications of the Scopinaro biliopancreatic diversion (BPD) have been proposed. This retrospective study reported the results of 15 years of follow-up after open BPD coupled with a type of transient gastroplasty (TG) and duodenal switch (DS), termed BPD-TG with DS. Methods: Data were analyzed for 874 patients operated on between January 1993 and May 2010 in 3 different surgical departments. Results: The median preoperative body mass index (BMI) was 52 kg/m² (range, 35–63). Comorbidities present were hypertension (57%), hypercholesterolemia (87%), hypertriglyceridemia (53%), type 2 diabetes (35%), and obstructive sleep apnea syndrome (OSAS; 9%). The mean follow-up was 11.9 ± 3.1 years. The median BMI decreased to 33.9 after 1 year from bariatric surgery, 31.1 after 2–5 years, 30.9 after 5–10 years, and 31.2 kg/m² after 10–15 years. Overall, 67% of diabetic patients were able to stop insulin and 97% were able to stop oral hypoglycemic drugs within 1 year. Blood pressure, triglyceride levels, and cholesterol levels became normal in >96% of patients within 1 year. OSAS was resolved within 8 months in all cases. One year postoperatively, but absent thereafter, we observed severe hypoalbuminemia (serum albumin <3 g/dL) in 1.7% of patients and severe iron-deficiency anemia in 1.9%. Incisional hernias were recorded in 30% and anastomotic ulcers in 2.4% of cases. Mortality was null. Conclusion: Our results suggest considering BPD-TG with DS as a viable bariatric operation, with its excellent long-term outcome in terms of weight loss, improvement of obesity-related diseases, and quality of life. [ABSTRACT FROM AUTHOR]

Abstract: Context and Objective: Despite the differences in the main characteristics between the autosomal dominant form of GH deficiency (IGHD II) and the bioinactive GH syndrome, a common feature of both is their impact on linear growth leading to short stature in all affected patients. Design: The index patient, a boy, was referred for assessment of his short stature (−2.54 SD score) and a delayed bone age of 5.9yrs at the chronological age of 7.7yrs. The GHD was confirmed by standard GH provocation tests, which revealed modestly reduced GH and IGF-I concentrations. Further genetic analysis of GH-1 gene identified heterozygosity for GH-P59L mutation. The secretion of the GH-P59L following stimulation with forskolin was investigated and compared to that of the wt-GH after expression of both GH variants in AtT-20 cells. Based on the position of P59L mutation that lies within a patch of residues composing the GH binding site 1 for GHR, we performed the analysis of GH-P59L binding to GHR by in silico mutagenesis and molecular dynamics simulations, which suggested possible problems in correct binding of GH-P59L to the GHR. Therefore, the functional characterization of this GH mutant was assessed through studies of GHR binding and activation of Jak2/Stat5 signaling pathway. Results: In line with the clinical data of the patient GH deficiency is suggested, underlined by GH-secretion studies revealing a moderate difference in secretion between GH-P59L and wt-GH. In addition, further functional characterization of the GH-P59L by studies of GH-receptor binding and activation of Jak2/Stat5 pathway presented with a reduced binding affinity of GH-P59L for GHR and decreased bioactivity compared to the wt-GH. Conclusions: The clinical data of the patient combined with the laboratory data support the diagnosis of partial IGHD type II. Since the GH deficiency was not total, additional binding and signaling studies were performed, which revealed that the GH-P59L variant displays some of the common features of bioinactive GH syndrome. Taken together, in this study we report a patient suffering from the combination of two growth disorders (alteration of secretion as well as bioactivity) caused by a GH-1 gene alteration highlighting the necessity of functional analysis of any GH variant, despite the presence of obvious clinical features of IGHD type II. [Copyright &y& Elsevier]

Nowadays the computational fluid dynamics (CFD) simulation represents an important tool for the performance analysis of the local exhaust ventilation (LEV) systems. In this paper air velocity field in the proximity of a free-standing flanged slot having a 6:1 aspect ratio is investigated by such an approach. Numerically calculated velocities both in centreline and off the hood axis are compared with the velocities obtained by the most popular experimental and theoretical formulas available in literature. Simple equations are with a common mathematical structure, which are provided for all the numerically simulated velocity trends. [Copyright &y& Elsevier]

Highlights: [•] Philosophy of mind offers a new philosophical foundation for authenticity. [•] Philosophy of mind studies mental states, whose defining property is intentionality. [•] Intentionality is an essential trait in any characterization of authenticity. [•] Experiencing authenticity is a mental state. [•] Authenticity’s role as a theoretical construct is strengthened and amplified. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2012; 18: E63-E65 Abstract We report data concerning the detection of fungal DNA directly from lysis-centrifugation blood culture to assess its value in the detection of fungaemia in 86 of the 347 patients admitted to the neonatal intensive-care unit between January 2009 and December 2010. The sensitivity and specificity of the PCR were 87.5% and 98.5%, respectively, with a positive predictive value of 93.3% and a negative predictive value of 97.1%. Detection of fungal DNA directly from blood culture Isolator 1.5 microbial tubes, without prior cultivation, is a promising approach for the rapid detection of Candida spp. in neonates with suspected candidaemia. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit.Study Design: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants. Inhibitors of gastric acidity were used at the recommended dosages/schedules based on the clinical judgment of attending physicians. The distribution of days of inhibitors of gastric acidity exposure between infants with and without LOS/NEC was assessed. The mutually adjusted effects of birth weight, gestational age, duration of inhibitors of gastric acidity treatment, and exposure to BLF were controlled through multivariable logistic regression. Interaction between inhibitors of gastric acidity and BLF was tested; the effects of any day of inhibitors of gastric acidity exposure were then computed for BLF-treated vs -untreated infants.Results: Two hundred thirty-five of 743 infants underwent treatment with inhibitors of gastric acidity, and 86 LOS episodes occurred. After multivariate analysis, exposure to inhibitors of gastric acidity remained significantly and independently associated with LOS (OR, 1.03; 95% CI, 1.008-1.067; P = .01); each day of inhibitors of gastric acidity exposure conferred an additional 3.7% odds of developing LOS. Risk was significant for Gram-negative (P < .001) and fungal (P = .001) pathogens, but not for Gram-positive pathogens (P = .97). On the test for interaction, 1 additional day of exposure to inhibitors of gastric acidity conferred an additional 7.7% risk for LOS (P = .003) in BLF-untreated infants, compared with 1.2% (P = .58) in BLF-treated infants.Conclusion: Exposure to inhibitors of gastric acidity is significantly associated with the occurrence of LOS in preterm VLBW infants. Concomitant administration of BLF counteracts this selective disadvantage.Trial Registration: isrctn.org: ISRCTN53107700. [ABSTRACT FROM AUTHOR]

This preliminary study evaluated the use of the Platelia Candida antigen kit for the diagnosis of invasive candidosis in 70 of 184 pre-term infants admitted to a neonatal intensive care unit between March 2004 and March 2006. The frequency of confirmed candidaemia was 6.5%. The sensitivity and specificity of the assay were 94.4% and 94.2%, respectively, with a positive predictive value of 85% and a negative predictive value of 98%. These results suggest that the inclusion of regular serological surveillance for mannanaemia in some pre-term infants would complement blood cultures for the early detection of candidosis. [ABSTRACT FROM AUTHOR]