Search Results (25,452)

Dermatomyositis is a rare autoimmune disease characterized by muscle weakness and skin rashes. Management typically involves high-dose cortisone treatment, which raises concerns about the feasibility and safety of aesthetic surgeries for affected individuals. This case report presents a successful outcome of an aesthetic surgery conducted on a dermatomyositis patient undergoing high-dose cortisone therapy. The patient, a 39-year-old female with a history of juvenile dermatomyositis, expressed a desire for aesthetic improvement, first in the periocular area and then in terms of the appearance of her breasts. Despite the challenges posed by the underlying condition and ongoing corticosteroid treatment, the patient underwent elective aesthetic surgeries with meticulous perioperative care and close collaboration between the surgical, anesthetic, and rheumatology teams. The successful outcome of the procedures enhanced the patient’s self-esteem and quality of life. This case underscores the importance of individualized treatment planning, interdisciplinary collaboration, and careful perioperative management for achieving favorable aesthetic outcomes for patients with dermatomyositis undergoing corticosteroid therapy for more than 20 years. Further research and awareness are warranted to guide the safe performance of aesthetic surgeries on this unique patient population. Full article

Agritourism and rural tourism represent an essential growing sector in certain EU regions, particularly in restructured and rebranded Central and Eastern European countries (CEECs) like Romania that display important rural areas and face important societal and economic changes. The rapid growth of rural tourism activities in the South Bukovina region (historically overlapping most of Suceava County) led, in the new legislative frame, to the establishment of the first regional Destination Management Organization (DMO) in Romania. By an exploratory qualitative, mixed-method case study approach, this study underscores important factors for tourism development in the region, outlining rural and agritourism variables integrated into the public authorities’ discourse. The paper innovatively focuses on the semantic analysis of online newspaper media texts and videos, complementarily analyzed by appropriate software solutions. The main results emphasize the factors for tourism development in the area through a dual cluster centered around the multilevel governance and tourism management structures represented by public authorities on the one hand and the projects, investments, and EU funding on the other. Key stakeholders’ opinion underscored public–private partnerships, supportive administrative structures, tourism events and various natural and cultural resources as sustainable elements that contribute to the successful development of tourism in the region. Full article

Background and Objectives: Although available therapies have changed the natural evolution of multiple sclerosis (MS), in time some patients assume a progressive course and no longer respond to treatment. There is no definitive clinical or laboratory parameter to certify MS progression from relapsing remitting MS (RRMS) to secondary progressive MS (SPMS) in early phases of transition. Our study aims to evaluate the value of clinical parameters and serum neurofilament light chain levels (sNfLs) as early warning signs of conversion to SPMS. Materials and Methods: The Expanded Disability Status Scale (EDSS), Nine-Hole Peg Test (9HPT), 25-foot walk test (25FWT) and Symbol Digit Modalities Test (SDMT) were evaluated at 12 months apart in a cohort of 83 RRMS treated patients. sNfLs were evaluated at the second time point. Results: sNfLs correlate with EDSS and SDMT, with EDSS change and disease duration. Clinical parameters correlate among themselves and perform well in supporting the diagnosis of SPMS in logistic regression and ROC curves analysis. Eighty percent of the RRMS patients in our study (of which 65% are treated with high-efficacy disease-modifying drugs) showed some type of progression independent of relapses (PIRA) after 12 months, with one in five patients experiencing isolated cognitive worsening and almost two-thirds some type of motor worsening. We found no differences in terms of progression between patients treated with platform drugs versus high-efficacy drugs. Conclusions: An elevated level of progression independent of relapses (PIRA) was found in our cohort, with high-efficacy drugs providing no supplementary protection. As sNfL levels were correlated with the progression of EDSS (the main clinical progression marker), they may be considered potential prognostic markers, but further studies are necessary to precisely define their role in this direction. The lack of early sensitive markers for risk of progression may contribute to therapeutic delay and failure. Full article

A versatile and popular Cucurbitaceous vegetable, pumpkin has recently gained much attention because of its variety of phytochemicals and health advantages. Pumpkins are a type of winter squash, traditionally with large, spherical, orange fruits and a highly nutrient food. Pumpkin by-products comprise various parts, such as seeds, peels, and pulp residues, with their bioactive composition and many potential benefits poorly explored by the food industry. Pumpkin and their by-products contain a wide range of phytochemicals, including carotenoids, polyphenols, tocopherols, vitamins, minerals, and dietary fibers. These compounds in pumpkin by-products exhibit antioxidant, anticancer, anti-inflammatory, anti-diabetic, and antimicrobial properties and could reduce the risk of chronic diseases. This comprehensive review aims to provide a detailed overview of the phytochemicals found in pumpkin and its by-products, along with their extraction methods, health benefits, and diverse food and industrial applications. This information can offer valuable insights for food scientists seeking to reevaluate pumpkin’s potential as a functional ingredient. Reusing these by-products would support integrating a circular economy approach by boosting the market presence of valuable and sustainable products that improve health while lowering food waste. Full article

(1) Background: Despite the recognized importance of the patient–doctor relationship (PDR) for pediatric diabetes management, the literature presents diverse and emerging findings regarding its impact on treatment outcomes for children with type 1 diabetes (T1D). (2) Methods: Using a meta-analytic approach, a comprehensive search for relevant studies was conducted across major databases, from the earliest study to June 2024. Inclusion criteria were studies on PDR and T1D outcomes in underaged individuals, providing quantitative results. (3) Results: Fifteen reports were included, showing a small but significant overall effect size (r = 0.165, p < 0.05) of PDR on T1D outcomes. Moderator analyses revealed significant associations from elements of PDR, duration of diagnosis, outcome assessment methods, information reporters, and being Caucasian. Demographic variables like gender, age, not being Caucasian, and caregiver’s marital status did not significantly impact the association. Specific elements of PDR, such as clinician’s objectives, communication, partnership, respect, and supportive care, showed significant positive effect sizes, while telecommunication did not. (4) Conclusions: A strong PDR is essential for managing diabetes in children, particularly in the early years of diagnosis. Future studies should use quantitative designs and include diverse demographics to better understand PDR’s connection to T1D outcomes. Full article

Background and Objectives: Typically, the vertebral arteries (VAs) enter the posterior fossa through dural rings and further unite, forming the basilar artery. The posterior inferior cerebellar artery (PICA) is usually a branch of the V4 segment of the VA (intradural origin). It may also leave the V3 suboccipital segment of the VA (extradural origin). The transdural origin of the PICA within the VA’s dural ring has been consistently overlooked. A study was designed to determine the topographical patterns of the PICA’s origin. Materials and Methods: Determinations were performed in a retrospective sample of 225 computed tomography angiograms. Four types of PICA origin were documented: type 0, absent PICA; type 1, the extradural origin of the PICA from the V3 segment of the VA; type 2, the transdural origin of the PICA within the dural ring; and type 3, the intradural origin of the PICA from the V4 segment of the VA. The bilateral symmetry of types was also investigated. Results: Out of 450 VAs, type 0 (absent PICA) was found in 36%, type 1 (extradural) in 0.44%, type 2 (transdural) in 5.56%, and typical type 3 in just 58%. In types 1 and 2, the PICA entered the posterior fossa through the dural ring and the marginal sinus. In the overall group (N = 225), the type combinations 1_1, 1_2 and 1_3 were not found. Bilaterally absent PICAs occurred in 18.67%. The bilateral combinations 0_1/0_2/0_3/2_2/2_3/3_3 were found, respectively, in 0.89%/3.11%/30.67%/1.78%/4.44%/40.44%. Four of the seventy-eight PICAs opposite to an absent one, three intradural and one transdural, were true bihemispheric PICAs. Conclusions: The PICAs with extradural or transdural origins are facultative contents of the dural ring and are at risk during neurosurgical approaches in the foramen magnum. Rare bihemispheric PICAs could originate either intradurally or within the dural ring. Full article

Atherosclerosis is a chronic inflammatory condition marked by endothelial dysfunction, lipid accumulation, inflammatory cell infiltration, and extracellular matrix (ECM) remodeling within arterial walls, leading to plaque formation and potential cardiovascular events. Key players in ECM remodeling and inflammation are matrix metalloproteinases (MMPs) and CD147/EMMPRIN, a cell surface glycoprotein expressed on endothelial cells, vascular smooth muscle cells (VSMCs), and immune cells, that regulates MMP activity. Hydrogen sulfide (H₂S), a gaseous signaling molecule, has emerged as a significant modulator of these processes including oxidative stress mitigation, inflammation reduction, and vascular remodeling. This systematic review investigates the mechanistic pathways through which H₂S influences MMPs and CD147/EMMPRIN and assesses its impact on atherosclerosis progression. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases, focusing on studies examining H₂S modulation of MMPs and CD147/EMMPRIN in atherosclerosis contexts. Findings indicate that H₂S modulates MMP expression and activity through transcriptional regulation and post-translational modifications, including S-sulfhydration. By mitigating oxidative stress, H₂S reduces MMP activation, contributing to plaque stability and vascular remodeling. H₂S also downregulates CD147/EMMPRIN expression via transcriptional pathways, diminishing inflammatory responses and vascular cellular proliferation within plaques. The dual regulatory role of H₂S in inhibiting MMP activity and downregulating CD147 suggests its potential as a therapeutic agent in stabilizing atherosclerotic plaques and mitigating inflammation. Further research is warranted to elucidate the precise molecular mechanisms and to explore H₂S-based therapies for clinical application in atherosclerosis. Full article

A paramagnetic A₃B-type Mn(III)-porphyrin was synthesized and characterized by physical–chemical methods (UV-Vis, FT-IR, ¹H-NMR spectroscopy). The obtained compound was tested as a sensitive material for the spectrophotometric and potentiometric detection of iodine species. Using UV-Vis spectroscopy, the triiodide anions could be detected with high precision in the concentration interval of 1.02 × 10⁻⁵ to 2.3 × 10⁻⁵ M, with an LOD of 9.44 × 10⁻⁶ M. The PVC-based electrode using DOP as a plasticizer showed a sensitivity toward iodide in a wide concentration range of 1.0 × 10⁻⁵ to 1.0 × 10⁻¹ M, with an LOD of 8.0 × 10⁻⁶ M. Both methods are simple, low-cost, and efficient for the detection of iodine species in synthetic samples and pharmaceuticals. Full article

Background and Objectives: This research was aimed at constructing a complete automated temporomandibular joint disc position identification system that could assist with magnetic resonance imaging disc displacement diagnosis on oblique sagittal and oblique coronal images. Materials and Methods: The study included fifty subjects with magnetic resonance imaging scans of the temporomandibular joint. Oblique sagittal and coronal sections of the magnetic resonance imaging scans were analyzed. Investigations were performed on the right and left coronal images with a closed mouth, as well as right and left sagittal images with closed and open mouths. Three hundred sagittal and coronal images were employed to train the artificial intelligence algorithm. Results: The accuracy ratio of the completely computerized articular disc identification method was 81%. Conclusions: An automated and accurate evaluation of temporomandibular joint disc position was developed by using both oblique sagittal and oblique coronal magnetic resonance imaging images. Full article

In this article, for the first time by using Caputo-type fractional derivatives, we introduce three new subclasses of bi-univalent functions associated with bounded boundary rotation in an open unit disk to obtain non-sharp estimates of the first two Taylor–Maclaurin coefficients, |a2| and |a3|. Furthermore, the famous Fekete–Szegö inequality is obtained for the newly defined subclasses of bi-univalent functions. Several consequences of our results are pointed out which are new and not yet discussed in association with bounded boundary rotation. Some improved results when compared with those already available in the literature are also stated as corollaries. Full article

In this article, we analytically investigate the isothermal magnetohydrodynamic axial symmetric flows of ordinary and fractional incompressible Oldroyd-B fluids through a porous medium in an annular channel. The fluid’s motion is generated by an outer cylinder, which moves along its symmetry axis with an arbitrary time-dependent velocity Vh(t). Closed-form expressions are established for the dimensionless velocity fields of both kinds of fluids, generating exact solutions for any motion of this type. To illustrate the concept, two particular cases are considered, and the velocity fields corresponding to the flow induced by the outer cylinder are presented in simple forms, with the results validated graphically. The motion of fractional and ordinary fluids becomes steady over time, and their corresponding velocities are presented as the sum of their steady and transient components. Moreover, the steady components of these velocities are identical. The influence of magnetic fields and porous media on the flow of fractional fluids is graphically depicted and discussed. It was found that a steady state is reached earlier in the presence of a magnetic field and later in the presence of a porous medium. Moreover, this state is obtained earlier in fractional fluids compared with ordinary fluids. Full article

Consumer demand for food and drink products with special nutritional properties is constantly increasing. To respond to new consumption trends, research in winemaking focuses on optimizing the technological process to increase quality while preserving the traditional character and typicality of the product. Lately, winemakers are implementing a range of physical non-thermal (ultrasound technology and cold plasma technology) and thermal (microwave treatment) processes to streamline and optimize winemaking technologies, reduce costs, speed up production, and improve sustainability. This study examines the existing literature regarding the effects of various physical approaches on the quality of wines. Scientific articles are concentrating on enhancing the extraction of phenolic compounds and other active compounds—especially those that contribute positively to wine quality. The reviewed literature only offers a limited amount of information on this subject; further investigation is required to determine the significance, applicability, and efficacy of thermal and non-thermal procedures in the wine industry. Full article

This paper discusses impulsive effects on fractional differential equations. Two approaches are taken to obtain our results: either with fixed or changing lower limits in Caputo fractional derivatives. First, we derive an existence result for periodic solutions of fractional differential equations with periodically changing lower limits. Then, the impulsive effects are modeled for fractional differential equations regarding the nonlinearities rather than the initial value conditions. The proposed impulsive model differs from common discontinuous and nonsmooth dynamical systems. Full article

Cholangiocarcinomas (CCAs), a heterogeneous group of challenging malignant tumours which originate from the biliary epithelium, are associated with an alarming increasing incidence during recent decades that varies between different regions of the globe. Thus, awareness represents the key operating factor. Our purpose was to overview the field of CCAs following a double perspective: the constellation of the risk factors, and the presence of the paraneoplastic syndromes, emphasizing the endocrine features amid the entire multidisciplinary panel. This is a narrative review. A PubMed-based search of English-language original articles offered the basis of this comprehensive approach. Multiple risk factors underlying different levels of statistical evidence have been listed such as chronic biliary diseases and liver conditions, inflammatory bowel disease, parasitic infections (e.g., Opisthorchis viverrini, Clonorchis sinensis), lifestyle influence (e.g., alcohol, smoking), environmental exposure (e.g., thorotrast, asbestos), and certain genetic and epigenetic interplays. With regard to the endocrine panel, a heterogeneous spectrum should be taken into consideration: non-alcoholic fatty liver disease, obesity, type 2 diabetes mellitus, and potential connections with vitamin D status, glucagon-like peptide 1 receptor, or the galanin system, respectively, with exposure to sex hormone therapy. Amid the numerous dermatologic, hematologic, renal, and neurologic paraneoplastic manifestations in CCAs, the endocrine panel is less described. Humoral hypercalcaemia of malignancy stands as the most frequent humoral paraneoplastic syndrome in CCAs, despite being exceptional when compared to other paraneoplastic (non-endocrine) manifestations and to its reported frequency in other (non-CCAs) cancers (it accompanies 20–30% of all cancers). It represents a poor prognosis marker in CCA; it may be episodic once the tumour relapses. In addition to the therapy that targets the originating malignancy, hypercalcaemia requires the administration of bisphosphonates (e.g., intravenous zoledronic acid) or denosumab. Early detection firstly helps the general wellbeing of a patient due to a prompt medical control of high serum calcium and it also provides a fine biomarker of disease status in selected cases that harbour the capacity of PTHrP secretion. The exact molecular biology and genetic configuration of CCAs that display such endocrine traits is still an open matter, but humoral hypercalcaemia adds to the overall disease burden. Full article

Spinal muscular atrophy (SMA), identified over a century ago, is characterized by severe muscle wasting and early mortality. Despite its rarity, the high carrier frequency of the responsible genetic mutations and the variability in its manifestations make it a significant research focus. This prospective cross-sectional descriptive study evaluated health-related quality of life (HRQoL) across eight health domains in 43 Romanian SMA patients treated with nusinersen, using the SF-36 questionnaire to analyze influencing factors. The survey was conducted online with informed consent, and the data were analyzed using MedCalc software, employing both parametric and non-parametric statistical tests for accurate interpretation. The results revealed significant variations in HRQoL. Most patients were non-ambulatory (74.4%), reflecting SMA’s impact on mobility. Urban residents reported better outcomes, particularly in physical functioning (p = 0.014), which may be attributed to improved access to healthcare services. Younger participants (under 14), represented by proxy responses, noted better general health (p = 0.0072) and emotional well-being (p = 0.0217) compared to older participants. These findings suggest that younger patients or their proxies perceive a better health status, highlighting the need for age-specific approaches in SMA management and the potential optimistic bias associated with proxy reporting on perceived health outcomes. Full article