Search Results (102)

Background/Objectives: Childhood obesity is a global epidemic. Addressing the modifiable risk factors with effective policies is crucial for both prevention and intervention. This scoping review aims to provide a situational analysis of childhood obesity in Greece by mapping the available evidence on the prevalence of obesity among Greek children and adolescents and exploring the existing policies implemented to address this issue. Methods: A systematic literature search was conducted on 15 September 2023, using the PubMed, Scopus, and IATROTEK-online databases to identify studies related to childhood obesity and policies in Greece. Keyword groups were developed for “childhood obesity,” “Greece,” and either “prevalence” or “policies”. Additional sources, including Google and Google Scholar, were screened to ensure comprehensiveness. Results: A total of 66 studies were included: 61 on obesity prevalence (≤18 years of age) and 5 on existing policies tackling childhood obesity, all in Greece. The collective prevalence was observed to lie within the subsequent range of values: 2.8–21.2%. Regarding both genders, the observed prevalence ranged from 2.8% to 26.7% in males, and between 1.3% and 33.7% in females. The policies adopted in Greece cover various domains (healthy nutrition, public preferences, physical activity, school policies, and programs related to childhood obesity). Conclusions: Childhood obesity in Greece is a major challenge. Greece currently uses some policies and strategies to combat childhood obesity. There is still work to be done: policies play a pivotal role as a key tool to influence lifestyle habits on a broad scale and exert a considerable impact on the reduction in this prevalent health concern. Full article

Background/Objectives: To develop a nomogram for predicting tumor aggressiveness and the presence of lymphovascular space involvement (LVSI) in patients with endometrial cancer (EC) using preoperative MRI and pathology–laboratory data. Methods: This IRB-approved, retrospective, multicenter study included 245 patients with histologically confirmed EC who underwent preoperative MRI and surgery at participating institutions between January 2020 and December 2024. Tumor type and grade, both from preoperative biopsy and surgical specimens, as well as preoperative CA125 and HE4 levels, were retrieved from institutional databases. A preoperative MRI was used to assess tumor morphology (polypoid vs. infiltrative), maximum diameter, presence and depth (< or >50%) of myometrial invasion, cervical stromal invasion (yes/no), and minimal tumor-to-serosa distance. The EC-to-uterus volume ratio was also calculated. Results: Among the 245 patients, 27% demonstrated substantial LVSI, and 35% were classified as aggressive on final histopathology. Multivariate analysis identified independent MRI predictors of LVSI, including cervical stromal invasion (OR = 9.06; p = 0.0002), tumor infiltration depth (OR = 2.09; p = 0.0391), and minimal tumor-to-serosa distance (OR = 0.81; p = 0.0028). The LVSI prediction model yielded an AUC of 0.834, with an overall accuracy of 78.4%, specificity of 92.2%, and sensitivity of 43.1%. For tumor aggressiveness prediction, significant predictors included biopsy grade (OR = 8.92; p < 0.0001), histological subtype (OR = 12.02; p = 0.0021), and MRI-detected serosal involvement (OR = 14.39; p = 0.0268). This model achieved an AUC of 0.932, with an accuracy of 87.0%, sensitivity of 79.8%, and specificity of 91.2%. Both models showed excellent calibration (Hosmer–Lemeshow p > 0.86). Conclusions: The integration of MRI-derived morphological and quantitative features with clinical and histopathological data allows for effective preoperative risk stratification in endometrial cancer. The two nomograms developed for predicting LVSI and tumor aggressiveness demonstrated high diagnostic performance and may support individualized surgical planning and decision-making regarding adjuvant therapy. These models are practical, reproducible, and easily applicable in standard clinical settings without the need for radiomics software, representing a step toward more personalized gynecologic oncology. Full article

The peritoneum is a thin membrane that lines the abdominal cavity and covers the abdominal organs. It serves as a conduit for the spread of various pathological processes, including gas and fluid collections, inflammation, infections, and neoplastic conditions. Peritoneal carcinomatosis is the most common and well-known pathology involving the peritoneum, typically resulting from the dissemination of gastrointestinal and pelvic malignancies. However, numerous benign and malignant peritoneal diseases can mimic the imaging appearance of peritoneal carcinomatosis. The aim of this review is to revisit the anatomy of peritoneal compartments and elucidate the patterns of peritoneal disease spread. Emphasis is placed on identifying the distinctive imaging features of both neoplastic and non-neoplastic peritoneal diseases that differ from peritoneal carcinomatosis. Full article

Background: Bronchiolitis accounts for a substantial number of pediatric hospitalizations and its epidemiology closely parallels that of respiratory syncytial virus (RSV), its principal etiological agent. International guidelines recommend supportive therapy based primarily on oxygen supplementation and hydration. Methods: This study aimed to assess, across three pediatric wards, the impact of internal monitoring and targeted educational interventions on adherence to bronchiolitis management guidelines. Focus was placed on evaluating the effectiveness of tailored strategies in enhancing the appropriateness of treatment practices. Each center independently developed an audit and feedback strategy aligned with local practices and available resources. In Center 1, monthly staff meetings included guideline refreshers throughout the epidemic season. Center 2 appointed two attending physicians to monitor treatment prescriptions and report deviations. Center 3 established an internal protocol through staff consensus, followed by monthly review sessions. In this retrospective analysis, all consecutive patients admitted with bronchiolitis during the winter seasons of 2022–2023 and 2023–2024 (Period 2) were compared with those admitted in 2021–2022 (Period 1). Results: A total of 623 infants under 24 months of age were included, 451 (72%) of whom tested positive for RSV. Their median length of hospital stay was 6 days; 26 infants (4%) required intensive care, and no deaths were recorded. A comparative analysis of the treatment modalities used—high-flow nasal cannula (HFNC) oxygen therapy, inhaled medications, corticosteroids, and antibiotics—revealed a reduced use of non-recommended therapies (e.g., nebulized β2-agonists, steroids, and antibiotics) in Period 2, alongside heterogeneous patterns in HFNC use. Center-specific strategies, tailored to team dynamics and resource availability, effectively promoted greater adherence to evidence-based guidelines. Conclusions: Our findings suggest that structured internal interventions can lead to more appropriate bronchiolitis management and the improved standardization of care. Full article

Background/Objectives: Parents/caregivers’ reports are valuable because they frequently play a crucial role in making decisions concerning a child’s health, and their perspectives can significantly impact treatment choices. Furthermore, negative effects of oral health issues extend beyond just the adolescent patient, having an impact on family life. The aim of this study is to explore the perception of parents/caregivers regarding their children’s oral-health-related quality of life (OHRQoL) and how the OHRQoL of adolescents impacts their family life. Methods: The Parental-Caregiver Perception Questionnaire-16 (P-CPQ-16) and the Family Impact Scale-8 (FIS-8) were administered to 160 parents/caregivers of adolescents aged 10–18 years old at the Dental Clinic of the University of Naples Federico II (Italy). Adolescents’ oral health status was recorded using the Decayed Missing and Filled Teeth (DMFT/dmft) index and Dental Aesthetic Index (DAI). Results: FIS-8 and P-CPQ-16 scores showed no significant differences across DAI and DMFT/dmft subgroups. However, regression analysis found a significant association between social well-being and total P-CPQ-16 scores with the DAI and DMFT index. Spearman’s correlation showed statistical significance only for the social well-being domain of P-CPQ-16 with respect to DAI scores. Conclusions: Parents/caregivers perceived a difference in their children’s OHRQoL according to different severities of malocclusion and dental caries; however, they did not report any impact on the family’s quality of life. Since adolescents often visit dentists due to parental influence, involving parents who perceive a lower quality of life in children with severe malocclusions or compromised oral health is crucial for effective care. Full article

In every era, climate variability and frequent food shortages have made it necessary to store harvested grains for more than one season. Underground grain storage has been used since ancient times throughout the world. Italy (Cerignola) and Malta (Valletta and Floriana) have preserved rare examples of more recent (from the 16th century onward) large concentrations of grain pits, capable of accumulating substantial reserves to cope with famine or siege. No longer in operation, they represent an important part of the cultural heritage of the agricultural economy. The purpose of this narrative review was, after a geographical framing of grain pits in the Eurasian and African macro-areas, to take the Italian and Maltese grain pits as historical case studies to draw attention to the reevaluation of underground grain storage in the context of climate change and food insecurity. Today, as in the past, grain reserves play a significant role in food security in developing countries and, due to climate change and geopolitical events that can cause disruptions in grain supplies, are also increasingly important for developed countries. A comparison of traditional and modern underground storage systems reveals the great flexibility of this technology, ranging from basic pits of different sizes to large underground granaries equipped with a support structure. The advantages of underground storage, such as environmental sustainability due to thermal insulation of the soil and airtight conditions that make high energy inputs for grain cooling and pesticide use unnecessary, are still useful today, perhaps more so than in the past. Prospects for development include technical solutions involving the application of innovative information technology-based monitoring systems and the use of modern materials to ensure the performance of waterproofing, seepage control, and static safety, all tools for further evolution of this ancient storage system. Full article

Background/Objectives: Condylectomy is a delicate and intricate procedure commonly employed in the management of temporomandibular joint (TMJ) disorders, osteochondromas, condylar hyperplasia, hemimandibular hyperplasia, and other pathologies affecting the condylar region. The advent of surgical cutting guides has introduced a new dimension to condylectomy procedures as they enable surgeons to plan and execute precise cuts with a heightened level of accuracy. In the literature already exists cases of cutting guide-based condylectomy, but they only depend on the mere mirroring procedure in virtual planning, which has accuracy limitations because it does not consider asymmetry of peri-condylar structures at the level of the ramus, body, and mandibular angle. Methods: CAD-CAM orthodontic preparation through the NEMOFAB Software was performed to correct the canting of the occlusal plane, following the “orthodontic first” technique. The same software was used for VSP of the surgical cutting guide to perform the condylectomy, basing not to the mere mirroring of the opposite side but considering the whole condylar-TMJ-glenoid fossa structure. Results: At 6 months follow-up, the patient showed good occlusion and an almost totally recovered lower third symmetry as median-upper and lower interincisive lines coincide with each other and with the chin median. A good occlusal and masticatory outcome was obtained. The joint structure was preserved with remodeling of the glenoid cavity caused by the presence of the joint disc, which was preserved during surgery. Conclusions: The goal of this study is to propose a method of therapeutic management of condylar hyperplasia that benefits from accurate pre-operative orthodontic treatment (orthodontics first) to maximize the results of proportional condylectomy, reducing post-operative orthodontic care as well as any need for any adjuvant orthognathic surgery. A new virtual surgical planning method is also proposed for creating a cutting guide that not only takes advantage of the mirroring technique to accurately calculate the amount of condyle to be cut but also considers the entire condyle–TMJ complex to perform a condylectomy that is more precise. Full article

Hepatocellular carcinoma (HCC) is among the most aggressive and lethal human tumors. Many functional studies have demonstrated the role of non-coding RNAs (ncRNA), particularly microRNAs (miRNA), in the regulation of hepatocarcinogenesis driving pathways. MiR-125a-5p (miR-125a) has been consistently reported as an oncosuppressive miRNA, as demonstrated in vivo and in vitro. However, its HCC relevant targets and molecular mechanisms are still largely unknown. Here, a genome-wide perspective of the whole miR-125a targetome has been achieved. In particular, two different HCC cell lines were subjected to a miRNA boosting by mimic transfections, and consequently many genes were de-regulated, as observed by a transcriptomic approach. The merging of down-regulated genes with results from bioinformatic predictive tools yielded a number of candidate direct targets that were further experimentally validated by luciferase-based reporter assays. Different novel targets were found, in particular ARID3A, CCNJ, LIPA, NR6A1, and NUP210, oncogenes in various tumors and here also related to HCC through miR-125a regulation. The RNA interactions investigated in this work could pave the way to piece together the RNA regulatory networks governed by the miRNA impacting on hepatocarcinogenesis, and be exploited in the future for identifying novel biomarkers and therapeutic targets in HCC. Full article

Sepsis is a complex and potentially life-threatening syndrome characterized by an abnormal immune response to an infection, which can lead to organ dysfunction, septic shock, and death. Early diagnosis is crucial to improving prognosis and reducing hospital management costs. This narrative review aims to summarize and evaluate the current literature on the role of monocyte distribution width (MDW) as a diagnostic biomarker for sepsis, highlighting its advantages, limitations, and potential clinical applications. MDW measures the volumetric distribution width of monocytes, reflecting monocytic anisocytosis, and is detected using advanced hematological analyzers. In 2019, it was approved by the FDA as a biomarker for sepsis due to its ability to identify systemic inflammatory response at an early stage. Thirty-one studies analyzed by us have shown that an increased MDW value is associated with a higher risk of sepsis and that its combination with clinical parameters (such as qSOFA) and other biomarkers (CRP, PCT) can enhance diagnostic sensitivity and risk stratification capacity. Despite its high sensitivity, MDW has lower specificity compared to more established biomarkers such as procalcitonin, thus requiring a multimodal integration for an accurate diagnosis. The use of MDW in emergency and intensive care settings represents an opportunity to improve early sepsis diagnosis and critical patient management, particularly when combined with other markers and clinical tools. However, further studies are needed to define a universal cut-off and confirm its validity in different clinical contexts and pathological scenarios. Full article

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias of clinical relevance and a major cause of cardiovascular morbidity and mortality. Following a diagnosis of AF, patients are directed towards therapy with anticoagulant drugs to reduce the thromboembolic risk and antiarrhythmics to control their cardiac rhythm, with periodic follow-up checks. Despite the great ease of handling these drugs, we soon realized the need for follow-up models that would allow the appropriateness and safety of these pharmacological treatments to be monitored over time. This pilot study was conducted at a rural pharmacy. The study comprised 47 patients (average age 71.22 years) with nonvalvular atrial fibrillation (68% being paroxysmal) on NOACs. Twenty percent of the enrolled subjects lived alone and fifty-four percent of the participants stated that they were not independent in managing their treatment. The primary aim was to describe the implementation and the outcomes of an innovative smart clinic model in which a local trained pharmacist is a case manager, and the patient carries out the required checks via telemedicine and point-of-care testing systems (POCT) under the service pharmacy regime; the results of the checks could be shared in real time with the attending general practitioner and the relevant specialist. The secondary aims of this study were to evaluate adherence to the planned controls, the prescriptive appropriateness of the dosages and drugs and adherence to the prescribed therapy, the occurrence of pharmacological problems linked to drug type interactions, the occurrence of hemorrhagic and/or thromboembolic complications, the acceptance by the general practitioners and/or the specialists of the reports made by the pharmacist on the subsequent actions undertaken, the economic and social impact of this model on the National Health Service and on the patient, and the impact on the quality perceived by the patients involved in this innovative monitoring process. Compliance with the planned checks was 93%. The dosage of the anticoagulant drug during enrollment was found to be inappropriate, without apparent clinical reasons, in 11% of the sample. Adherence to the anticoagulant therapy was found to be 98%. In total, 214 drug–drug interactions of varying clinical relevance were detected. No embolic events were detected; however, 13% of the sample reported a major hemorrhagic event, which came to light thanks to the close monitoring of hemoglobinemia. A total of 109 reports were made to the patients’ referring doctors in relation to the summarized anomalies, and 84% were accepted by the referring clinicians. Therefore, community pharmacists and pharmacy services represent ideal actors and contexts that, when integrated into the care network, can really favor individual care plan adherence and achieve daily morbidity reductions and cost savings through proper disease control and the early diagnosis of complications. Full article

Light pollution has become an increasingly knotty environmental management problem, but little has been done to review and compare light pollution controls across the world. To address this research gap, a comparative review study has been undertaken. Among the light pollution laws of the most light-polluted regions, those pertaining to Shanghai, New York, Hong Kong, Seoul, London and Valletta were examined. We systematically evaluate the impact of legal systems, regulatory approaches and control parameters on light pollution regulation. The findings reveal that civil law jurisdictions, such as Shanghai and Seoul, typically adopt dedicated legislation while common law jurisdictions, like New York and London, often rely on bolt-on regulations to broader environmental laws. The study also finds that jurisdictions employing dedicated legislation and a metrics-based system offer a more comprehensive and preemptive solution to light pollution challenges. However, certain exceptions are noted, and the balance between regulatory certainty and flexibility is highlighted. The nuanced relationship between environmental protection and legal instruments is discussed, and the potential for unintended consequences of stringent regulation is acknowledged. The paper closes with a call for ongoing research and iterative regulatory reviews, emphasizing the need to incorporate scientific advancements and stakeholder interests into regulatory updates. Full article

Objective: The aim of this study was to develop quantitative structure–pharmacokinetics relationship (QSPKR) models for a group of xanthine derivatives with proven pharmacological activity and to investigate its applicability for the prediction of the pharmacokinetics of these compounds. Methods: The SYBYL-X, KowWin, and MarvinSketch programs were employed to generate a total of fourteen descriptor variables for a series of new compounds: 7- and 7,8-substituted theophylline derivatives (GR-1–GR-8) and three well-known methylxanthines. Pharmacokinetic profiles of all compounds were determined after intravenous administration of studied compounds to cannulated male rats. Pharmacokinetic parameters were calculated using noncompartmental analysis. Results: Multiple linear regression revealed that logD was the main determinant of the variability in V_ss, λ_z, and CL of the studied compounds. Moreover, λ_z and CL depended on LUMO and HEFO, while for V_z COAR was the only explanatory variable. The developed QSPKR models accounted for most of the variation in V_ss, λ_z, CL, and fraction unbound (f_u) (R² ranged from 0.68 to 0.91). Cross-validation confirmed the predictive ability of the models (Q² = 0.60, 0.71, 0.34, and 0.32 for V_ss, λ_z, CL, and f_u, respectively). Conclusions: The multivariate QSPKR models developed in this study adequately predicted the overall pharmacokinetic behavior of xanthine derivatives in rats. Full article

Recently, the quest for high-Tc superconductors has evolved from the trial-and-error methodology to the growth of nanostructured artificial high-Tc superlattices (AHTSs) with tailor-made superconducting functional properties by quantum design. Here, we report the growth by molecular beam epitaxy (MBE) of a superlattice of Mott insulator metal interfaces (MIMIs) made of nanoscale superconducting layers of quantum confined-space charge in the Mott insulator La₂CuO₄ (LCO), with thickness L intercalated by normal metal La_1.55Sr_0.45CuO₄ (LSCO) with period d. The critical temperature shows the superconducting dome with Tc as a function of the geometrical parameter L/d showing the maximum at the magic ratio L/d = 2/3 where the Fano–Feshbach resonance enhances the superconducting critical temperature. The normal state transport data of the samples at the top of the superconducting dome exhibit Planckian T-linear resistivity. For L/d > 2/3 and L/d < 2/3, the heterostructures show a resistance following Kondo universal scaling predicted by the numerical renormalization group theory for MIMI nanoscale heterostructures. We show that the Kondo temperature, T_K, and the Kondo scattering amplitude, R_0K, vanish at L/d = 2/3, while T_K and R_0K increase at both sides of the superconducting dome, indicating that the T-linear resistance regime competes with the Kondo proximity effect in the normal phase of MIMIs. Full article

Biodiversity is a characteristic of ecosystems that plays a crucial role in the study of their evolution, and to estimate it, the species of all plants need to be determined. In this study, we used Unmanned Aerial Vehicles to gather RGB images of mid-to-high-altitude ecosystems in the Zao mountains (Japan). All the data-collection missions took place in autumn so the plants present distinctive seasonal coloration. Patches from single trees and bushes were manually extracted from the collected orthomosaics. Subsequently, Deep Learning image-classification networks were used to automatically determine the species of each tree or bush and estimate biodiversity. Both Convolutional Neural Networks (CNNs) and Transformer-based models were considered (ResNet, RegNet, ConvNeXt, and SwinTransformer). To measure and estimate biodiversity, we relied on the Gini–Simpson Index, the Shannon–Wiener Index, and Species Richness. We present two separate scenarios for evaluating the readiness of the technology for practical use: the first scenario uses a subset of the data with five species and a testing set that has a very similar percentage of each species to those present in the training set. The models studied reach very high performances with over 99 Accuracy and 98 F₁ Score (the harmonic mean of Precision and Recall) for image classification and biodiversity estimates under 1% error. The second scenario uses the full dataset with nine species and large variations in class balance between the training and testing datasets, which is often the case in practical use situations. The results in this case remained fairly high for Accuracy at 90.64% but dropped to 51.77% for F₁ Score. The relatively low F₁ Score value is partly due to a small number of misclassifications having a disproportionate impact in the final measure, but still, the large difference between the Accuracy and F₁ Score highlights the complexity of finely evaluating the classification results of Deep Learning Networks. Even in this very challenging scenario, the biodiversity estimation remained with relatively small (6–14%) errors for the most detailed indices, showcasing the readiness of the technology for practical use. Full article

Background: To achieve a successful result, the orthodontist must use a systematic approach to plan the orthodontic treatment. Defining the correct position of the upper and lower incisors and evaluating their relationship with intermaxillary discrepancy and facial divergence have been recognized as the starting point for the diagnostic decision regarding extractions and anchorage requirements. The aim of our study was to analyze the relationship between intermaxillary discrepancy (ANPg^), mandibular inclination (SN^GoGn), lip incompetence, and the positioning of the upper and lower incisors (UIPs and LIPs) in a group of orthodontic patients. This retrospective study included 290 lateral cephalograms in 122 males (42.1%) and 168 females (57.9%) aged 8 to 53 years (median 14; interquartile range IQR 12–17). Data were analyzed by means of one-way Analysis of Variance (ANOVA) and linear regression analysis. Results: This study showed a statistically significant increase in LIP values in patients with lip incompetence (p < 0.001). Moreover, the distribution of LIPs in groups with various SN^GoGn and ANPg^ angles was significantly different (p < 0.001). The regression analysis also showed a positive association between the LIP and SN^GoGn and between the LIP and ANPg^. Conclusion: The LIP presented a statistically significant difference in patients with and without lip incompetence, which varied significantly in subjects with different sagittal malocclusions and vertical face patterns. Full article