Search Results (2,340)

Corneal crosslinking (CXL) is a medical procedure used to treat keratoconus. CXL works by strengthening the collagen fibers of the cornea through the application of riboflavin (vitamin B2) and ultraviolet (UV) light, which helps to stabilize the cornea and prevent further deterioration. There is a recognized risk that CXL can trigger the reactivation of dormant herpes simplex virus (HSV), leading to herpetic keratitis even in patients with no history of herpetic disease. We examined the medical history of 52 patients who underwent CXL procedures due to previously diagnosed keratoconus. We reviewed the patient’s medical histories to assess whether there was a herpes labialis infection and/or herpetic keratitis. Altogether, 52 eyes (from 52 patients) were analyzed. Of those, four (7.69%) patients were diagnosed with epithelial herpetic keratitis on the 5–8th day after surgery. All four patients had a history of herpes labialis and no prior HSV keratitis infection. Two patients developed herpetic keratitis despite prophylactic therapy with acyclovir 5 days before surgery. A positive history of HSV lip infection before CXL was present in 18/52 (34.62%). During a one-year follow-up period, no patient experienced a recurrence. Close follow-up is crucial for diagnosing herpetic keratitis after corneal crosslinking. The use of prophylactic antiviral therapy in patients who are asymptomatic and have a history of recurrent herpes labialis does not guarantee the prevention of infection. Full article

Chronic antibody-mediated rejection in kidney transplantation is a common cause of graft loss in the late post-transplant period. In this process, the role of the classical complement activation pathway is crucial due to the formation of immune complexes between donor-specific antibodies (DSAs) and donor antigens and the attachment of the C1q complement fragment. This study aimed to determine the levels of circulating C1q immunocomplexes (CIC-C1q) and complement activation (CH50), in sensitized kidney transplant recipients (KTRs). In this cross-sectional study we used serum samples from KTRs with de novo or preformed DSAs (n = 14), KTRs without DSAs (n = 28), and 22 subjects with no history of chronic kidney disease (controls). C1q immunocomplexes and CH50 concentration in serum were measured with the enzyme immunoassay (EIA) kit MicroVue CIC-C1q (Quidel, Athens, OH, USA) and EIA kit MicroVue CH50 (Quidel, OH, USA), respectively. Higher concentrations of CIC-C1q was observed in KTRs with DSAs in comparison with controls and with KTRs with no DSAs (6.8 ± 2.7 and 4.8 ± 1.9 vs. 5.0 ± 1.2 μg Eq/mL, respectively, p < 0.01). We found no difference in CIC-C1q between KTRs with no DSAs and controls. CIC-C1q levels were positively correlated with DSA titer. CH50 levels were decreased in KTRs with DSAs in comparison with controls and KTRs with no DSAs (39 ± 15 vs. 68 ± 40 and 71 ± 34 U Eq/mL, respectively, p < 0.01). There was no difference in CH50 between DSA-negative KTRs and controls. Kidney transplant recipients with DSAs had increased serum levels of C1q immunocomplexes and increased classical pathway complement activation. Full article

This study reconstructs the recent history of Therasia by examining the interplay between traditional settlements and the island’s natural and agricultural landscape. Through an interdisciplinary approach that integrates spatial and architectural analysis, historical records, and NDVI-based vegetation mapping, this research highlights the significant impact of agrarian structures like dry-stone walls and terraces on the environment. The unique dry-stone wall and terrace system is shown to have been crucial for both spatial organization and the survival of Therasia’s inhabitants. This study also addresses the challenges of dating these structures, employing a relative dating methodology to establish a timeline of habitation from the late medieval period to the present. This research reconstructs the island’s recent history, from early seasonal settlements to the eventual decline of rural architecture in the 20th century. The findings indicate that settlement patterns were closely linked to environmental and geomorphological factors, with the evolution of these sites driven by agricultural practices and broader socio-economic changes. This research not only reconstructs Therasia’s past, but also proposes a novel methodological framework combining remote sensing with traditional historical analysis, offering new insights into the relationship between human settlements and the environment in the Aegean region. Full article

The growing complexity of cities and the unprecedented pace of urbanisation create exposure and vulnerabilities to extreme events and crises that are difficult to manage and plan for as widely acknowledged by the existing literature. In this paper, three main challenges to be tackled are identified based on the selected literature according to the interpretation of the authors based on extended research in the field. Those challenges relate to the multi-risk environment characterising many contemporary cities, the need to overcome sectoral approaches towards increased alignment of emergency and spatial planning at different scales, and the opportunities that derive from integrated risk and resilience management. Such challenges are evidenced in the Pozzuoli case study, a densely inhabited municipality of the metropolitan city of Naples, placed into a volcanic caldera, that has been analysed in the light of the above challenges for an extended period of time of about fifty years. The in-depth assessment of the quality of urban development has been enabled by geospatial data management. Advanced geospatial information systems are not only instrumental in depicting the history of urban development in the period of consideration but also as an enabler to tackle the above-mentioned challenges. In fact, such systems permit a much more dynamic and updatable assessment of multirisk conditions and provide the basis for shared knowledge among the large number of stakeholders that are responsible for different sectoral and comprehensive urban and risk-related plans. Full article

Tetrodotoxin (TTX) is a potent marine neurotoxin found in several phylogenetically diverse organisms, some of which are sought as seafood. Since 2015, TTX has been reported in bivalve shellfish from several estuarine locations along the Mediterranean and European Atlantic coasts, posing an emerging food safety concern. Although reports on spatial and temporal distribution have increased in recent years, processes leading to TTX accumulation in European bivalves are yet to be described. Here, we explored the hypothesis that the ribbon worm species Cephalothrix simula, known to contain high levels of TTX, could play a role in the trophic transfer of the toxin into shellfish. During a field study at a single location in southern England, we confirmed C. simula DNA in seawater adjacent to trestle-farmed Pacific oysters Magallana gigas (formerly Crassostrea gigas) with a history of TTX occurrence. C. simula DNA in seawater was significantly higher in June and July during the active phase of toxin accumulation compared to periods of either no or continually decreasing TTX concentrations in M. gigas. In addition, C. simula DNA was detected in oyster digestive glands collected on 15 June 2021, the day with the highest recorded C. simula DNA abundance in seawater. These findings show evidence of a relationship between C. simula and TTX occurrence, providing support for the hypothesis that bivalves may acquire TTX through filter-feeding on microscopic life forms of C. simula present in the water column at particular periods each year. Although further evidence is needed to confirm such feeding activity, this study significantly contributes to discussions about the biological source of TTX in European bivalve shellfish. Full article

Remote Sensing (RS) and Geographic Information Science (GIS) techniques are powerful tools for spatial data collection, analysis, management, and digitization within cultural heritage frameworks. Despite their capabilities, challenges remain in automating data semantic classification for conservation purposes. To address this, leveraging airborne Light Detection And Ranging (LiDAR) point clouds, complex spatial analyses, and automated data structuring is crucial for supporting heritage preservation and knowledge processes. In this context, the present contribution investigates the latest Artificial Intelligence (AI) technologies for automating existing LiDAR data structuring, focusing on the case study of Sardinia coastlines. Moreover, the study preliminary addresses automation challenges in the perspective of historical defensive landscapes mapping. Since historical defensive architectures and landscapes are characterized by several challenging complexities—including their association with dark periods in recent history and chronological stratification—their digitization and preservation are highly multidisciplinary issues. This research aims to improve data structuring automation in these large heritage contexts with a multiscale approach by applying Machine Learning (ML) techniques to low-scale 3D Airborne Laser Scanning (ALS) point clouds. The study thus develops a predictive Deep Learning Model (DLM) for the semantic segmentation of sparse point clouds (<10 pts/m²), adaptable to large landscape heritage contexts and heterogeneous data scales. Additionally, a preliminary investigation into object-detection methods has been conducted to map specific fortification artifacts efficiently. Full article

The Bee Cosmetic Surgery Scale (BCSS) is a novel clinical tool designed to assess the psychopathological, psychosocial, and decision-making factors involved in accepting cosmetic procedures. This prospective, multicenter study aimed to propose and validate the BCSS, which considers aesthetic aspects, personal pathological history, and psychopathological implications leading to the acceptance of invasive or non-invasive aesthetic interventions. The study included 281 participants aged 18–66 years, divided into three groups: non-invasive cosmetic surgery (NICS), invasive and non-invasive cosmetic surgery (INICS), and individuals who had not undergone cosmetic surgery (NCS). Participants were randomly selected from patients visiting plastic surgery services and various medical services in Oradea, Romania, between October 2022 and March 2024. The BCSS comprises 20 items with Likert-type responses, ranging from one to five. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support. The BCSS aims to elucidate the patient’s desire for aesthetic procedures, whether it stems from an impulsive act, warrants a longer decision-making period, or necessitates addressing psychological or psychiatric conditions before scheduling the procedure. The scale enables cosmetic surgeons to assess whether the patient has been adequately informed and understands the risks and complications associated with the cosmetic surgical procedure. Full article

Background: Pneumomediastinum (PNM) is a severe complication in COVID-19 patients, potentially exacerbating morbidity and requiring heightened clinical attention. This study aims to identify risk factors, clinical characteristics, and outcomes associated with PNM in COVID-19 patients hospitalized for respiratory failure in our institution. Methods: Among 4513 patients admitted in our institution and testing positive for COVID-19 infection during the peak of the COVID-19 pandemic in Italy (1 March 2020 to 31 July 2020), we conducted a single-center, retrospective case–control study focusing our analysis on those with severe disease (respiratory failure). The cohort included a total of 65 patients (32 with PNM and 33 without PNM in the same period). Data were retrospectively collected from hospital records, including demographics, comorbidities, smoking history, clinical and laboratory findings, and imaging results. Statistical analyses were performed using Fisher’s exact test and Student’s t-test, with significance set at α = 0.05. Results: Patients with PNM were significantly younger (54.9 ± 18.5 vs. 65.4 ± 14.3 years, p = 0.0214) and exhibited higher inflammatory markers, particularly white blood cells count (WBC) at admission (11.4 ± 5.4 vs. 6.5 ± 4.1, p < 0.0001). Although smoking status, body mass index (BMI), and major comorbidities did not differ significantly between groups, COPD was more prevalent in the PNM group (46.9% vs. 15.1%, p = 0.0148). Radiologically, ground-glass opacities (GGOs) and consolidations were more frequent in PNM patients (93.7% vs. 51.5%, p = 0.0002; 78.1% vs. 42.2%, p = 0.0051, respectively). PNM was associated with longer hospital stays (28.5 ± 14.9 vs. 12.0 ± 7.2 days, p < 0.0001) and a higher need for invasive mechanical ventilation (53.1% vs. 30.3%, p = 0.0619). However, mortality rates did not differ significantly between groups. Conclusions: PNM in patients with severe COVID-19 infection is associated with younger age, elevated inflammatory markers, and extensive lung involvement, contributing to increased morbidity and prolonged hospitalization. Early detection and tailored management strategies, including optimized respiratory support and aggressive anti-inflammatory therapies, are crucial in mitigating the adverse outcomes associated with PNM. Further research is needed to validate these findings and improve clinical protocols for managing this complication. Full article

This study aims to analyse two trials involving magic, superstition, exorcism, and witchcraft, which were held in 1713 in the Diocese of Vieste (present-day Apulia), Kingdom of Naples. It aims to illuminate the dynamics between the Church, magical practices, and the territorial context, providing insights into this less-explored period in inquisition history when the Catholic Church’s fight against superstition was beginning to wane. The first trial against Rita di Ruggiero is very rich in detail, giving us a clear vision of which magical practices were used during the Modern Age. Additionally, it touches, albeit only marginally, on a theme that will be crucial for the duration of these practices in the Kingdom of Naples: the complex interactions between state and ecclesiastical authorities. The second 1713 trial involving Elisabetta Del Vecchio explores accusations of bewitchment, contributing to our understanding of witchcraft paradigms. Full article

The Ahdeb oil field is located in the southwestern part of the Zagros fold deformation zone. The study of the model of the formation of the oil reservoir in this field will be helpful to deepen the pattern of hydrocarbon distribution in this zone. In this paper, we use the seismic data of the Ahdeb oil field to recover the tectonic evolution history of the field. Under neotectonic movement, the oil field formed in the early stage, migrated to the high point in the late stage, and finally entered the present formation. From here, for the oil-bearing inclusions within the reservoir, the photometric absorption values of the organic matter groups were measured by infrared spectroscopy. Their ratios were used to evaluate the maturity, thus discovering two phases of oil charging. Finally, using the hydrocarbon generation history and tectonic evolution history, combined with the oil and gas transportation periods in the reservoir, we deduce that the reservoir formation mode in the area is a two-phase gathering and final adjustment formation mode. This understanding of the hydrocarbon formation patterns will promote oil and gas exploration in this zone. Full article

Anyone specialising in Islamic theology at a Western university is aware of the fact that their teaching and research will either be recognised by the institution as falling under the category of “Islamic Studies” or “Divinity”. In the first case, Islam is predominantly considered a cultural phenomenon and studied as such. In the second case, for reasons that have to do with what Marianne Moyaert in her latest book Christian Imaginations of the Religious Other has conceptualised as “Christian normativity” and the “religionisation” of other faiths, Islamic theology is de facto understood as Islamic speculative theology (kalām). In both cases, the understanding of how Islam theorises and practices theology is significantly restricted, when not altogether ignored. This article unpacks the genealogy of the secular version of a Christian epistemic framework that dominates the study of Islamic theology in the West and engages with the issues related to its application in the field of Islamic theology. In doing so, it opens a critical space for the investigation of Islamic literary productions as both dissensual and consensual theological terrains, through the analysis of the poetry of two theologians and polymathic scholars from two different periods of Islamic history, namely Ibn al-Fāriḍ (d. 632/1235) and Sidi Muḥammad Ibn al-Ḥabīb (d. 1390/1971). Full article

Literature on African urbanism has generally lacked insight into the significant roles of hunters and fishers as city founders. This has resulted in a knowledge gap regarding the cultural foundation of the cities that could enhance policy frameworks for sustainable urban governance. This article examines corollaries related to the complementarities of hunting and urbanism with case studies from the ethno-linguistic Yoruba region in southwestern Nigeria. Through qualitative methodologies involving ethnography and the (oral) history of landscapes of hunting from the pre-colonial and (British) colonial periods, as well as tracing the current cultural significance of hunting in selected Yoruba cities, the article reveals data that identify hunters and fishers as city founders. It shows that hunting, as a lived heritage, continues to be interlaced with cultural urban practices and Yoruba cosmology and that within this cultural imagery and belief, hunters remain key actors in nature conservation, contributing to socio-cultural capital, economic sustainability, and urban security structures. The article concludes with recommendations for strategies to reconnect with these value systems in rapidly westernizing urban Africa. These reconnections include the re-sacralization of desacralized landscapes of hunting, revival of cultural ideologies, decolonization from occidental conceptions, and re-definition of urbanism and place-making in light of African perspectives despite globalization. In doing so, the article contributes to a deeper understanding of the interconnections between the environmental and societal components of sustainability theory, agenda, and practice in urban contexts; underscores the societal value of lived heritage, cultural heritage, and cultural capital within the growing literature on urban social sustainability; and sheds more light on southern geographies within the social sustainability discourse, a field of study that still disproportionately reflects the global northwest. Full article

Background: During the coronavirus disease (COVID)-19 pandemic several drugs were used to manage the patients mainly those with a severe phenotype. Potential drugs were used off-label and major concerns arose from their applicability to managing the health crisis highlighting the importance of clinical trials. In this context, we described the mechanisms of the three repurposed drugs [Ivermectin-antiparasitic drug, Chloroquine/Hydroxychloroquine-antimalarial drugs, and Azithromycin-antimicrobial drug]; and, based on this description, the study evaluated the clinical efficacy of those drugs published in clinical trials. The use of these drugs reflects the period of uncertainty that marked the beginning of the COVID-19 pandemic, which made them a possible treatment for COVID-19. Methods: In our review, we evaluated phase III randomized controlled clinical trials (RCTs) that analyzed the efficacy of these drugs published from the COVID-19 pandemic onset to 2023. We included eight RCTs published for Ivermectin, 11 RCTs for Chloroquine/Hydroxychloroquine, and three RCTs for Azithromycin. The research question (PICOT) accounted for P—hospitalized patients with confirmed or suspected COVID-19; I—use of oral or intravenous Ivermectin OR Chloroquine/Hydroxychloroquine OR Azithromycin; C—placebo or no placebo (standard of care); O—mortality OR hospitalization OR viral clearance OR need for mechanical ventilation OR clinical improvement; and T—phase III RCTs. Results: While studying these drugs’ respective mechanisms of action, the reasons for which they were thought to be useful became apparent and are as follows: Ivermectin binds to insulin-like growth factor and prevents nuclear transportation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), therefore preventing cell entrance, induces apoptosis, and osmotic cell death and disrupts viral replication. Chloroquine/Hydroxychloroquine blocks the movement of SARS-CoV-2 from early endosomes to lysosomes inside the cell, also, this drug blocks the binding between SARS-CoV-2 and Angiotensin-Converting Enzyme (ACE)-2 inhibiting the interaction between the virus spike proteins and the cell membrane and this drug can also inhibit SARS-CoV-2 viral replication causing, ultimately, the reduction in viral infection as well as the potential to progression for a higher severity phenotype culminating with a higher chance of death. Azithromycin exerts a down-regulating effect on the inflammatory cascade, attenuating the excessive production of cytokines and inducing phagocytic activity, and acts interfering with the viral replication cycle. Ivermectin, when compared to standard care or placebo, did not reduce the disease severity, need for mechanical ventilation, need for intensive care unit, or in-hospital mortality. Only one study demonstrated that Ivermectin may improve viral clearance compared to placebo. Individuals who received Chloroquine/Hydroxychloroquine did not present a lower incidence of death, improved clinical status, or higher chance of respiratory deterioration compared to those who received usual care or placebo. Also, some studies demonstrated that Chloroquine/Hydroxychloroquine resulted in worse outcomes and side-effects included severe ones. Adding Azithromycin to a standard of care did not result in clinical improvement in hospitalized COVID-19 participants. In brief, COVID-19 was one of the deadliest pandemics in modern human history. Due to the potential health catastrophe caused by SARS-CoV-2, a global effort was made to evaluate treatments for COVID-19 to attenuate its impact on the human species. Unfortunately, several countries prematurely justified the emergency use of drugs that showed only in vitro effects against SARS-CoV-2, with a dearth of evidence supporting efficacy in humans. In this context, we reviewed the mechanisms of several drugs proposed to treat COVID-19, including Ivermectin, Chloroquine/Hydroxychloroquine, and Azithromycin, as well as the phase III clinical trials that evaluated the efficacy of these drugs for treating patients with this respiratory disease. Conclusions: As the main finding, although Ivermectin, Chloroquine/Hydroxychloroquine, and Azithromycin might have mechanistic effects against SARS-CoV-2 infection, most phase III clinical trials observed no treatment benefit in patients with COVID-19, underscoring the need for robust phase III clinical trials. Full article

Objectives: Coronary artery fistulas (CAFs) are rare congenital anomalies with an occurrence rate of 0.002–0.3%. The right coronary artery (RCA) is reportedly the most common site of origin of CAFs, but fistulas draining to the left atrium (LA) are rare. We presented a three-year-old boy with a symptomatic congenital RCA-to-LA fistula, which was successfully percutaneously occluded with an Amplatzer vascular plug 4 (AVP4). Case report: The diagnosis was made by echocardiography when he was two months old. During the follow-up period of 2 years, a progressive dilatation of the RCA and enlargement of the left ventricle was detected, so treatment for congestive heart failure was initiated. At the age of three, the patient presented with a history of occasional mild central chest pain and discomfort and mild dyspnea on exertion. On a 24 h ECG Holter monitor, the depression of ST segments was registered. CT angiography highlighted a large type B RCA fistula to the LA, which extended along the atrioventricular sulcus. The proximal RCA diameter was 7 mm. The fistula was tortuous, with segmental narrowing and three curves. Cardiac catheterization was performed across the right femoral artery on the three-year-old boy (body weight: 13 kg). Across the 4F Judkins right guiding catheter, an AVP4 of 5 mm was placed in the distal part of the CAF connected with the delivery cable. After 15 min, ECG changes were not registered, so the device was released. Immediate post-deployment angiography demonstrated complete CAF occlusion, with satisfying flow in the distal coronary artery. The patient was discharged after four days. In the short-term follow-up period, the boy was symptom-free. Conclusions: In our experience, given the existence of the left-to-left shunt and the more pronounced exercise-induced coronary steal phenomenon that occurs in medium-sized and large CAFs, occlusion is necessary to prevent the further progression of clinical signs and symptoms. Full article

This Gulf of Manfredonia has, for millennia, been the primary water feature of the coastal wetland of Northern Apulia, Italy, although modern reclamation works make writing its long-term history challenging. Our recent paleoenvironmental research has reconstructed the evolution of the southern half of this lagoon since the Neolithic period. Here, we write a history of water management and environmental change in this landscape from the perspective of two key urban sites: pre-Roman Salpia vetus and Roman Salapia. The Roman architectural historian Vitruvius recounts the abandonment of Salpia vetus and the refoundation of Salapia. We employ his narrative as a frame for a more complex environmental history, starting from a historiography of this landscape’s study and a summary of our interdisciplinary research agenda, which unifies environmental, topographical, remote sensing, and archaeological approaches. Resilience in this changeable wetland environment was only possible through an integrated and intentional management of water among rivers, the lagoon, and the Adriatic Sea. While Salpia vetus exploited this wetland and thrived for centuries, the settlement eventually collapsed due to human and environmentally impelled factors. Roman Salapia subsequently emerged with a different approach, new infrastructure, and a new location. This blueprint would sustain urban life in this wetland for six centuries and lay the groundwork for the Medieval town. Full article