High directional emission and high radiative quantum efficiency are strongly needed when moving a single optical nano-emitter (such as a quantum dot) into the practical realm. However, a typical optical nano-emitter struggles to meet the requirements above, which limits its practical applications in next-generation nano-photonic devices such as single-photon sources. Here, to achieve these features simultaneously, we propose and theoretically investigate a composite plasmonic antenna consisting of a hemispherical solid immersion lens (SIL) and a bowtie plasmonic nano-antenna, wherein a high directional emission of 10° and 2.5 × 10³ of Purcell factor have both been enabled. Moreover, we find that directionality and the Purcell factor can be manipulated independently in our antenna, which provides a novel platform for the optimization of single-photon sources. Full article

Persistent human papillomavirus (HPV) infection is recognized as a major risk factor for cervical cancer. Women with persistent HPV and negative cytology are at greater risk of CIN2+ than women with negative infection. The diagnosis becomes more complicated when the woman has a type 3 transformation zone at colposcopy. The aim of this study was to determine the prevalence of CIN2+ in women with persistent HPV, negative cytology and TZ3; how to stratify the risk of CIN2+; and what the best diagnostic strategy is, given TZ3. Methods: In a multicenter retrospective cohort study, we enrolled women with negative cytology and TZ3 among the 213 women referred for colposcopy for persistent HPV. The average age of the women was 53 years; in particular, 83% were postmenopausal women. In the presence of a TZ3, the entire transformation zone cannot be explored, making colposcopy and targeted biopsy useless and inadequate, with great risks of underdiagnosis or missed diagnosis. Women with TZ3 underwent diagnostic LEEP to ensure correct diagnoses. Results: The study highlighted 19% (16/84) of CIN2+ lesions, a higher frequency of non-HPV 16/18 genotypes (76.2%), and 50% of CIN2+ lesions being due to non-HPV 16/18 genotypes. Furthermore, more than half of the women (80.9%) had normal histopathological results in the LEEP sample. Conclusion. Women with viral persistence, negative cytology, and TZ3 have a 19% risk of CIN2+; genotyping helps stratify risk, but extensive genotyping is necessary instead of partial genotyping (16/18), referring to a population of women over 50 years old in which the prevalence of genotypes 16,18 decreases and the prevalence of other genotypes increases; diagnostic LEEP is excessive (only 16 cases of CIN2+ out of 48 cases treated), even though 83% of women had viral clearance after LEEP; p16/Ki67 double staining could be a potential risk marker, which would only highlight women at risk of CIN2+ to undergo LEEP. To individualize the diagnostic workup and treatment and minimize the risk of under diagnosis and overtreatment, future studies should explore the use of extended genotyping and new biomarkers for individual risk stratification. Full article

This article highlights a dilemma that we face when we turn to new tools that promise to improve on law’s imperfect governance. On the one hand, our discontent with law’s governance is both broad and deep, and much of it is rooted in the human nature of the legal enterprise. Yet, we remain attached to the essentially human nature of law’s governance. On the other hand, we recognise the potential benefits in technological governance but not without some displacement of the human element. Caught on the horns of this dilemma, we attempt to limit the loss of the human element by insisting that governance must be compatible with human rights or human dignity, or, more directly, that governance must limit the applications of technology so that they remain human-centric. Given a demand for human-centric applications of technologies, we consider how far humans might, and should, go in deploying new tools with a view to improving law’s imperfect governance. Should these tools be limited to assisting humans? Or, might they replace humans? Or might we even govern by technological management of places, products, and processes so that reliance on both humans and rules is reduced? It is concluded that, in all spheres of governance and in all human communities, the one thing that is essential is that the applications of new technologies are controlled so that they do not undermine the generic conditions which are presupposed by viable groups of human agents. Full article

This paper proposes a multi-perspective adaptive examination cheating behavior detection method to meet the demand for automated monitoring throughout the entire process in paperless online exams. Unlike current dual-perspective cheating behavior detection methods, we expand the monitoring field of view by using three cameras with different perspectives: the overhead perspective, the horizontal perspective, and the face perspective. This effectively covers areas where cheating may occur. An adaptive cheating behavior detection system based on three perspectives is proposed, including a gaze direction recognition model based on Swin Transformer, a cheating tool detection model based on Lightweight-YOLOv5-Coordinate Attention, and a cheating behavior determination model based on Multilayer Perceptron. To reduce computational complexity and ensure efficient processing while expanding the monitoring field of view, the system uses the results of the gaze direction recognition model to adaptively select the cheating behavior detection model from different perspectives, reducing the three-perspective system to dual-perspective. In online simulation tests, our method achieves cheating behavior determination at 35 frames per second, with an average recognition rate of 95%. It has good real-time performance, accuracy, and a large monitoring range. Full article

Northwestern Morocco is characterized by highly anthropized landscapes under the combined effect of agricultural intensification, resource overexploitation, urbanization, and tourism, but also local reforestation. Reconstructing the recent changes in vegetation in the region of the lower valley of the Loukkos river near Larache and their relationship to the settlement history are particularly helpful for understanding the processes at work within the landscape construction. The geohistorical approach combines paleoenvironmental, documentary, and historical data. The last few centuries have seen the emergence of wooded stands, in which cork oaks are a structural element. As forests were retreating, parklands intended for agriculture, agroforestry, and herding, like the Spanish dehesa and Portuguese montado, began to emerge. Nearly all of them have disappeared today, but we can identify their legacy and evaluate their cultural significance through comparing them with their counterparts in the Iberian Peninsula, but also in other areas of Morocco. Their deep historical roots give this landscape an evolving heritage character that is directly linked to the communities’ lifestyles, culture, and history. Full article

Avian influenza viruses (AIVs) of the H5 subtype rank among the most serious pathogens, leading to significant economic losses in the global poultry industry and posing risks to human health. Therefore, rapid and accurate virus detection is crucial for the prevention and control of H5 AIVs. In this study, we established a novel detection method for H5 viruses by utilizing the precision of CRISPR/Cas12a and the efficiency of RT-RPA technologies. This assay facilitates the direct visualization of detection results through blue light and lateral flow strips, accurately identifying H5 viruses with high specificity and without cross-reactivity against other AIV subtypes, NDV, IBV, and IBDV. With detection thresholds of 1.9 copies/μL (blue light) and 1.9 × 10³ copies/μL (lateral flow strips), our method not only competes with but also slightly surpasses RT-qPCR, demonstrating an 80.70% positive detection rate across 81 clinical samples. The RT-RPA/CRISPR-based detection method is characterized by high sensitivity, specificity, and independence from specialized equipment. The immediate field applicability of the RT-RPA/CRISPR approach underscores its importance as an effective tool for the early detection and management of outbreaks caused by the H5 subtype of AIVs. Full article

In this study, a p-Si/ALD-Al₂O₃/Ti/Pt MOS (metal oxide semiconductor) device has been fabricated and used as a hydrogen sensor. The use of such a stack enables a reliable, industry-compatible CMOS fabrication process. ALD-Al₂O₃ has been chosen as it can be integrated into the back end of the line (BEOL) or in CMOS, post processing. The device response and recovery are demonstrated with good correlation between the capacitance variation and the hydrogen concentration. Detection down to 20 ppm at 140 °C was obtained and a response time of 56 s for 500 ppm was recorded. Full article

This study investigates the phase equilibria of the Al-Mo-Hf ternary system at 400 °C and 600 °C using X-ray diffraction (XRD) and electron probe microanalysis (EPMA/WDS) techniques. Seven three-phase and five two-phase regions were identified at 400 °C, while eight three-phase and four two-phase regions were identified at 600 °C. Despite variations in the solid solubility ranges of certain compounds, the distribution of phase zones in the isothermal cross-section remained consistent at both temperatures. Using the experimental results and logical deductions, isothermal cross-sections were constructed for the Al-Mo-Hf ternary system at 600 °C and 400 °C. Full article

Excessive blood loss could lead to pathological conditions such as tissue necrosis, organ failure, and death. The limitations of recently developed hemostatic approaches, such as their low mechanical strength, inadequate wet tissue adhesion, and weak hemostatic activity, pose challenges for their application in controlling visceral bleeding. In this study, a novel hydrogel (CT) made of collagen and tannic acid (TA) was proposed. By altering the proportions between the two materials, the mechanical properties, adhesion, and coagulation ability were evaluated. Compared to commercial hydrogels, this hydrogel has shown reduced blood loss and shorter hemostatic time in rat hepatic and cardiac bleeding models. This was explained by the hydrogel’s natural hemostatic properties and the significant benefits of wound closure in a moist environment. Better biodegradability was achieved through the non-covalent connection between tannic acid and collagen, allowing for hemostasis without hindering subsequent tissue repair. Therefore, this hydrogel is a new method for visceral hemostasis that offers significant advantages in treating acute wounds and controlling major bleeding. And the production method is simple and efficient, which facilitates its translation to clinical applications. Full article

In this study, we introduce an innovative methodology for the detection of helmet usage violations among motorcyclists, integrating the YOLOv8 object detection algorithm with deep convolutional generative adversarial networks (DCGANs). The objective of this research is to enhance the precision of existing helmet violation detection techniques, which are typically reliant on manual inspection and susceptible to inaccuracies. The proposed methodology involves model training on an extensive dataset comprising both authentic and synthetic images, and demonstrates high accuracy in identifying helmet violations, including scenarios with multiple riders. Data augmentation, in conjunction with synthetic images produced by DCGANs, is utilized to expand the training data volume, particularly focusing on imbalanced classes, thereby facilitating superior model generalization to real-world circumstances. The stand-alone YOLOv8 model exhibited an F1 score of 0.91 for all classes at a confidence level of 0.617, whereas the DCGANs + YOLOv8 model demonstrated an F1 score of 0.96 for all classes at a reduced confidence level of 0.334. These findings highlight the potential of DCGANs in enhancing the accuracy of helmet rule violation detection, thus fostering safer motorcycling practices. Full article

In order to optimize sealing performance, a novel labyrinth seal with semi-elliptical teeth (SET) structure is proposed in this paper, which includes semi-elliptical teeth and a series of cavities. The simulation results calculated by the numerical methods are compared with the experimental and theoretical results, and static and dynamic characteristics of the novel SET structure are further investigated. The numerical simulations of labyrinth seals with the SET structure demonstrate high accuracy and reliability, with a maximum relative error of less than 6% as compared to experimental results, underscoring the validity of the model. Notably, leakage rates are directly influenced by pressure drop and axial offset, with optimal sealing achieved at zero axial displacement. The direct damping coefficient increases as the pressure drop increases while the other dynamic coefficients decrease. Additionally, the stability results show that the novel SET structure exhibits higher stability for positive axial offsets. The novel model and corresponding results can provide a meaningful reference for the study of sealing structure and coupled vibration in the field of fluid machinery. Full article

Background: The antimicrobial resistance (AMR) of Klebsiella pneumoniae recorded a steep upward trend over the last two decades, among which carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most concerning strains considering the development and spread of AMR. The aim of this study was to analyze the evolution of AMR for Klebsiella pneumoniae and to describe the risk factors of AMR for Klebsiella pneumoniae, including the COVID-19 pandemic. Methods: We conducted a retrospective study on Klebsiella pneumoniae non-duplicative isolates collected from patients admitted to a tertiary hospital in Bucharest, Romania, from January 2019 to December 2021. We evaluated AMR changes by comparing resistance between 2019 and the mean of 2020–2021. Results: The rates of AMR increased for third-generation cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and colistin and decreased for trimethoprim/sulfamethoxazole (TMP/SMX), 45.7% in 2019 vs. 28.3% in 2021. A longer length of hospital stay (ꭓ² = 49.68, p < 0.01); recent antibiotic consumption, RR = 1.38, 95% CI [1.21, 1.57]; and recent contact with hospital settings, RR = 1.54, 95% CI [1.32, 1.8] were risk factors for multidrug-resistant (MDR) Klebsiella pneumoniae. Conclusions: The AMR of Klebsiella pneumoniae increased during 2020–2021 for most of the potential active antibiotics; only TMP/SMX resistance decreased, and it may represent a treatment option for CRKP or MDR Klebsiella pneumoniae infections. Decreasing the excessive use of antibiotics and the implementation of prevention and control measures in healthcare settings are mandatory for avoiding further increases in the AMR rate of Klebsiella pneumoniae. Full article

The lifetime risk of silicosis associated with low-level occupational exposure to respirable crystalline silica remains unclear because most previous radiographic studies included workers with varying exposure concentrations and durations. This study assessed the prevalence of silicosis after lengthy exposure to respirable crystalline silica at levels ≤ 0.10 mg/m³. Vermont granite workers employed any time during 1979–1987 were traced and chest radiographs were obtained for 356 who were alive in 2017 and residing in Vermont. Work history, smoking habits and respiratory symptoms were obtained by interview, and exposure was estimated using a previously developed job-exposure matrix. Associations between radiographic findings, exposure, and respiratory symptoms were assessed by ANOVA, chi-square tests and binary regression. Fourteen workers (3.9%) had radiographic evidence of silicosis, and all had been employed ≥30 years. They were more likely to have been stone cutters or carvers and their average exposure concentrations and cumulative exposures to respirable crystalline silica were significantly higher than workers with similar durations of employment and no classifiable parenchymal abnormalities. This provides direct evidence that workers with long-term exposure to low-level respirable crystalline silica (≤0.10 mg/m³) are at risk of developing silicosis. Full article

The imperative reduction of carbon dioxide into valuable fuels stands as a crucial step in the transition towards a more sustainable energy system. Perovskite oxides, with their high compositional and property adjustability, emerge as promising catalysts for this purpose, whether employed independently or as a supporting matrix for other active metals. In this study, an A-site-deficient La_0.9FeO₃ perovskite underwent surface decoration with Ni, Cu or Ni + Cu via a citric acid-templated wet impregnation method. Following extensive characterization through XRD, N₂ physisorption, H₂-TPR, SEM-EDX, HAADF STEM-EDX mapping, CO₂-TPD and XPS, the prepared powders underwent reduction under diluted H₂ to yield metallic nanoparticles (NPs). The prepared catalysts were then evaluated for CO₂ reduction in a CO₂/H₂ = 1/4 mixture. The deposition of Ni or Cu NPs on the perovskite support significantly enhanced the conversion of CO₂, achieving a 50% conversion rate at 500 °C, albeit resulting in only CO as the final product. Notably, the catalyst featuring Ni-Cu co-deposition outperformed in the intermediate temperature range, exhibiting high selectivity for CH₄ production around 350 °C. For this latter catalyst, a synergistic effect of the metal–support interaction was evidenced by H₂-TPR and CO₂-TPD experiments as well as a better nanoparticle dispersion. A remarkable stability in a 20 h time-span was also demonstrated for all catalysts, especially the one with Ni-Cu co-deposition. Full article

Tumoral calcinosis is an extremely rare genetic disease caused by mutations in three genes, GALNT3, FGF23, and KL, which disrupt phosphorus metabolism. The hallmark of this condition is the formation of tumors in the soft tissues around the joints. Other phenotypic features of tumoral calcinosis are dental involvement and brain and vascular calcifications. The clinical case reported herein presents for the first time to the scientific community the c.202A>G (p.Thr68Ala) mutation of the FGF23 gene, associated with a hyperphosphatemic variant of tumoral calcinosis and multiple severe vascular aneurysms. A female patient underwent multiple surgeries for tumor formations in her soft tissues that first appeared at the age of 12 months. On this occurrence, the patient was found to have hyperphosphatemia, low phosphate clearance, increased tubular reabsorption with normal levels of total and ionized calcium, vitamin D3, and parathyroid hormone, and no effect of treatment with sevelamer hydrochloride and a low-phosphate diet. At the age of 39, the patient underwent imaging studies due to edema and a pulsating formation in the neck area, which revealed multiple vascular aneurysms with thrombosis, for which she received operative and interventional treatment. In this connection, and because of the established phosphorus metabolism disturbance, a genetic disease was suspected. The sequence analysis and deletion/duplication testing of the 358 genes performed on this occasion revealed that the woman was homozygous for a variant of the c.202A>G (p.Thr68Ala) mutation of the FGF23 gene. The established mutation is not present in population databases. The presented clinical case is the first and only one in the world to demonstrate the role of this type of FGF23 gene mutation in the development of a hyperphosphatemic variant of tumoral calcinosis characterized by aggressive formation of multiple vascular aneurysms. Full article

The purpose of this study was to evaluate the repair process in rat calvaria filled with synthetic biphasic bioceramics (Plenum^® Osshp-70:30, HA:βTCP) or autogenous bone, covered with a polydioxanone membrane (PDO). A total of 48 rats were divided into two groups (n = 24): particulate autogenous bone + Plenum^® Guide (AUTOPT+PG) or Plenum^® Osshp + Plenum^® Guide (PO+PG). A defect was created in the calvaria, filled with the grafts, and covered with a PDO membrane, and euthanasia took place at 7, 30, and 60 days. Micro-CT showed no statistical difference between the groups, but there was an increase in bone volume (56.26%), the number of trabeculae (2.76 mm), and intersection surface (26.76 mm²) and a decrease in total porosity (43.79%) in the PO+PG group, as well as higher values for the daily mineral apposition rate (7.16 µm/day). Histometric analysis presented material replacement and increased bone formation at 30 days compared to 7 days in both groups. Immunostaining showed a similar pattern between the groups, with an increase in proteins related to bone remodeling and formation. In conclusion, Plenum^® Osshp + Plenum^® Guide showed similar and sometimes superior results when compared to autogenous bone, making it a competent option as a bone substitute. Full article

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder characterized by renal tubular cystic dilatations. The cysts can develop anywhere along the nephron, and over time the cystic dilatation leads to kidney enlargement. On the other hand, the cysts begin to reduce the number of functional nephrons as a consequence of cystic expansion that further contributes to the decline in renal function over the years. The pressure exerted by the dilated cysts leads to compensatory mechanisms that further contribute to the decline in renal function. These structural changes are responsible of glomerular hyperfiltration states, albuminuria, proteinuria, and hematuria. However, the presentation of ADPKD varies in children, from a completely asymptomatic child with incidental ultrasound detection of cysts to a rapidly progressive disease. There have been reports of early onset ADPKD in children younger than 2 years that showed a more rapid decline in renal function. ADPKD is caused by a mutation in PKD1 and PKD2 genes. Today, the PKD1 gene mutation seems to account for up to 85% of the cases worldwide, and it is associated with worse renal outcomes. Individuals with PKD2 gene mutation seem to present a milder form of the disease, with a more delayed onset of end-stage kidney disease. The cardinal sign of ADPKD is the presence of renal cysts during renal ultrasound. The current guidelines provide clinicians the recommendations for genetic testing in children with a positive family history. Given that the vast majority of children with ADPKD present with normal or supra-normal kidney function, we explored the glomerular filtration rates dynamics and the renal ultrasound-adjusted percentiles. In total, 14 out of 16 patients had kidney percentiles over 90%. The gene mutations were equally distributed among our cohort. In addition, we compared the modified Schwartz formula to the quadratic equation after adjusting the serum creatinine measurements. It seems that even though children with ADPKD have enlarged kidneys, the renal function is more likely normal or near normal when the quadratic estimation of glomerular filtration rate is used (qGFR tended to be lower, 111.95 ± 12.43 mL/min/1.73 m² when compared to Schwartz eGFR 126.28 ± 33.07 mL/min/1.73 m², p = 0.14). Also, when the quadratic equation was employed, not even a single patient reached the glomerular hyperfiltration threshold. The quadratic formula showed that glomerular filtration rates are linear or slightly decreasing after 1 year of follow-up (quadratic ΔeGFR = −0.32 ± 5.78 mL/min/1.73 m²), as opposed to the Schwartz formula that can falsely classify children in a hyperfiltration state (ΔeGFR = 7.51 ± 19.46 mL/min/1.73 m²), p = 0.019. Full article

The intensity gradient is a new cutpoint-free metric that was developed to quantify physical activity (PA) measured using accelerometers. This metric was developed for use with the ENMO (Euclidean norm minus one) metric, derived from raw acceleration data, and has not been validated for use with count-based accelerometer data. In this study, we determined whether the intensity gradient could be reproduced using count-based accelerometer data. Twenty participants (aged 7–22 years) wore a GT1M, an ActiGraph (count-based), and a GT9X, ActiGraph (raw accelerations) accelerometer during both in-lab and at-home protocols. We found strong agreement between GT1M and GT9X counts during the combined in-lab activities (mean bias = 2 counts) and between minutes per day with different intensities of activity (e.g., sedentary, light, moderate, and vigorous) classified using cutpoints (mean bias < 5 min/d at all intensities). We generated bin sizes that could be used to generate IGs from the count data (mean bias = −0.15; 95% LOA [−0.65, 0.34]) compared with the original IG. Therefore, the intensity gradient could be used to analyze count data. The count-based intensity gradient metric will be valuable for re-analyzing historical datasets collected using older accelerometer models, such as the GT1M. Full article

Midwifery practices are defined as the level of midwifery care in which midwives use their expertise, management, and clinical leadership to provide personalized, evidence-based care to women independently and autonomously. Midwifery care includes antepartum, intrapartum, and postpartum care, which are defined by the WHO as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for the mother and baby during the antepartum, intrapartum and postpartum period. The aim of this study was to evaluate midwifery practices among registered midwives in selected hospitals in Limpopo Province, South Africa. The quantitative, descriptive, and cross-sectional research design was used to assess and describe midwifery practices among registered midwives in selected hospitals in Limpopo Province, South Africa. The population size was 100 registered midwives in the selected hospitals. The sample size of 80 registered midwives was determined using the Slovin formula. Simple random sampling was used to select the sample. A self-developed questionnaire was tested and validated prior to conducting the main study. The findings of the pilot study were used to refine the questionnaire before being used for the main study. Reliability and validity were ensured. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27 with the assistance of a statistician. The study revealed inadequate provision of midwifery care during antepartum, intrapartum, and postpartum periods due to lack of resources and equipment. The shortage of midwives and the shorter experience in the clinical setting within the midwifery environment were overwhelming. The study concluded that the practices of registered midwives were inadequate due to some challenges they faced during the provision of midwifery care. Inadequate midwifery practices have serious implications for the health and well-being of mothers and newborns. These practices were influenced by various factors, such as inadequate material and human resources and lack and malfunctioning of available equipment. The study recommended that women have access to a variety of pain relief options during labor, including both pharmacological and non-pharmacological methods. In addition, the study recommended implementation of the presence of doulas during labor and childbirth. Full article

In response to global urbanization and economic development, urban surface water pollution has become a universal challenge and particularly affects densely populated megacities, and Dhaka is no exception. The discharge of 98% of untreated domestic sewage and massive volumes of industrial wastewater from over 7000 industries escalate surface water crises. This study investigates microbial and fecal contamination with particular emphasis on Cryptosporidium in surface water, known for causing waterborne diseases, such as cryptosporidiosis. Findings reveal high Cryptosporidium oocyst concentrations and fecal contamination in various water bodies in Dhaka City. Among the investigated water bodies, the Buriganga River exhibits the highest Cryptosporidium oocyst concentration (46%), while the Balu River, Turag River, Shitalakkhya River, Dhanmondi Lake, Gulshan Lake, Banani Lake, Ramna Lake, and Crescent Lake also present high levels of oocyst concentrations ranging from 21–40%. This study also calculated infection risks and found that the infection risk of swimming is highest during the wet season and is (3.9 ± 2.2 (95% CI: 3.0–5.0)) × 10⁻² per swimming event, whereas it is approximately (2.4 ± 1.9 (95% CI: 1.6–3.3)) × 10⁻² during the dry season. Annual diving risks are approximately (1.2 ± 0.6 (95% CI: 0.9–1.4)) × 10⁻², indicating considerably high risks. Most of the sampling sites generally show significantly higher risks than other study areas like the Mymensingh and Kushtia Districts. In light of these results, we strongly recommend immediate measures to address water quality issues and mitigate the risks associated with Cryptosporidium contamination in Dhaka’s surface water. Full article

Inflammatory bowel disease (IBD) represents a heterogenous and complex group of idiopathic chronic inflammatory conditions affecting the gastrointestinal tract and other extraintestinal systems with rising global incidences. The interplay of genetic predisposition and environmental factors contributes to its pathogenesis. Among the key cytokines implicated in IBD molecular alterations, IL-33 stands out for its multifaceted roles in both pathogenesis and repair mechanisms. IL-33, known for its action in initiating immune responses, is closely associated with Th2 immunity and is considered a potent inflammatory factor with dual functions, acting both as a pro-inflammatory cytokine and a transcriptional regulator. Primarily expressed by non-hematopoietic cells in the gastrointestinal tract, IL-33 interacts with its receptor, ST2, to modulate immune responses. In IBD, dysregulated IL-33 expression exacerbates mucosal inflammation, compromising barrier integrity and promoting tissue damage and fibrosis. Additionally, IL-33 plays a complex role in IBD-related colorectal cancer (CRC), affecting tumor progression and angiogenesis. This review summarizes the multifaceted roles of IL-33 in gastrointestinal health and disease, emphasizing its significance in the pathogenesis of IBD and CRC. Moreover, we thought it of interest to provide new insights into potential therapeutic avenues targeting IL-33 signaling for the management of these debilitating conditions. Full article

Background: No actual data on spinal fusion and management of osteoporosis in Japan have been reported. The aim of the survey was to investigate pre- and post-operative management of osteoporosis, including testing and prescription, in elderly patients undergoing spinal fusion in Japan. Methods: Medical data on patients aged 65 years or older undergoing spinal fusion from April 2018 to March 2022 were extracted from the medical data vision (MDV) database containing health insurance claims data from Japanese acute care hospitals to investigate fusion area, pre- and post-operative osteoporosis tests (bone mineral density and osteoporosis markers), prescriptions of osteoporosis medications, and other information. Results: The analysis set consisted of 26,959 patients. Annual pre-operative BMD testing rates and osteoporosis markers testing rates were higher than the post-operative rates without significant annual changes. The post-operative prescription rate of osteoporosis medications throughout the target period was approximately two times higher than the preoperative rate. The drug with highest pre- and post-operative prescription rates was teriparatide (TPTD) followed by bisphosphonates, showing that the prescription rate of TPTD proportionally increased with the length of fusion area. Conclusions: It was suggested that patients aged 65 years or older undergoing spinal fusion might receive insufficient osteoporosis tests. Despite no trend in the testing rate with the length of fusion area, some tendency was observed in the selection of osteoporosis medications. In patients with osteoporosis undergoing spinal fusion, early examination, diagnosis, and therapeutic intervention may improve the prognoses, and solid testing and prescriptions are therefore expected. Full article