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Clinical,laboratory,and therapeutic differences between immunoglobulin E-mediated and non-immunoglobulin E-mediated cow’s milk protein allergy in children

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World Journal of Clinical Pediatrics 2025年第1期14卷 78-92页

作者： Hasan M Isa Marwa J Abdulnabi nawra S naser Fatema n Lahmda noor M AlAnsari Zahra H Isa Afaf M Mohamed Department of Pediatrics Salmaniya Medical ComplexManama 26671Bahrain Department of Pediatrics Arabian Gulf UniversityManama 26671Bahrain Faculty of Medicine Mansoura UniversityMansoura 35516Egypt Public Health Directorate Ministry of HealthManama 26671Bahrain

BACKGROUnD Although breast milk is ideal for newborns,in some cases,it is replaced with cow’s milk,which contains proteins that increase the risk of cow’s milk protein allergy(CMPA).AIM To evaluate CMPA prevalence in Bahrain and compare clinical characteristics of children with immunoglobulin E(IgE)-and non-IgE-mediated *** This retrospective cohort study examined children with CMPA diagnosed at the pediatric gastroenterology outpatient clinic of the Salmaniya Medical Complex,Bahrain,between 2014 and 2022,and assessed CMPA *** presentations,laboratory findings,dietary modifications,and outcomes were compared between children with IgE-mediated and non-IgE-mediated *** variables were compared using Fisher’s exact test or Pearson’sχ2 test,whereas continuous variables were compared using Student’s t-test or the Mann-Whitney U *** Of 8332 patients,6022(72.3%)adhered to their *** them,618(10.3%)were suggested of having CMPA and 595(96.3%)were included;CMPA prevalence was 2%.Most patients were Bahraini(93.8%)and males(55.3%).non-IgE-mediated type accounted for 77.3%cases and IgE-mediated type,22.7%.IgE-mediated CMPA presented more in boys(P=0.030),and later in life(5.1 months±4.5 months vs 4.2 months±4.2 months,P=0.016,95%CI:0.08-1.73),had more associated diseases(Pnd presented with more cutaneous(P=0.024)and respiratory(P=0.003)manifestations,severe symptoms[rash/dry skin(P=0.031),facial swelling/angioedema(P=0.003),failure to thrive(P=0.013),apparent life-threatening event(Pnd positive physical findings(P=0.002)than non-IgE-mediated *** patients were exclusively fed cow milk formula(50.3%).The amino acid-based formula(AAF)was most prescribed(60.5%)with no difference between the two types(P=0.173).Although breastfeeding was recommended to 49.6%,only 8.2%were exclusively ***-mediated CMPA was associated with a longer follow-up duration than non-IgE-mediated CMPA(17.3 months±14.0 mo

关键词： Children Milk allergy Immunoglobulin E Breastfeeding Infant formula Bahrain

Are urbanization, biotic and social factors associated with the song frequency and song entropy attributes of three urban syntopic passerines?

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Avian Research 2025年第01期 96-109页

作者： Xhareni Díaz-Lezama Alejandro Ariel Ríos-Chelén Jorge Castellanos-Albores Paula L.Enríquez Programa de Posgrado en Ciencias en Recursos naturales y Desarrollo Rural El Colegio de la Frontera Sur.Carr.Panamericana y Periférico Sur s/n Barrio Ma.Auxiliadora Centro Tlaxcala de Biología de la Conducta Universidad Autónoma de Tlaxcala Departamento Conservación de la Biodiversidad El Colegio de la Frontera Sur Carr.Panamericana y Periférico Sur s/n Barrio Ma.Auxiliadora

Urban environments have challenging characteristics for bird acoustic communication. High levels of anthropogenic noise, as well as vegetation structure(e.g., in urban parks), can potentially affect the song frequency characteristics of several bird species. An additional factor such as the abundance of conspecific and heterospecific vocalizing birds may play an important role in determining the structure of bird songs. In this study, we analyzed whether noise levels, vegetation percentage, and abundance of conspecifics and heterospecifics influence the song characteristics of three syntopic songbird species: House Finch(Haemorhous mexicanus), Rufouscollared Sparrow(Zonotrichia capensis), and House Sparrow(Passer domesticus) living in urban sites. We recorded songs of these species and measured the peak frequency and entropy of their songs at 14 sites in the city of San Cristobal de Las Casas, Chiapas, Mexico. We found that the song peak frequency of House Finch and House Sparrow's songs was negatively related to the vegetation. The peak frequency of neither of the three species correlated with the average noise level. However, the abundances of conspecific and heterospecific were related to the peak frequency of the three species' songs. The entropy of the House Finch and House Sparrow songs was positively and negatively related, respectively, to noise levels. House Sparrow song entropy was negatively related to the percentage of vegetation. Song entropy of House Finches was negatively associated to conspecific and House Sparrow abundance. Song entropy of Rufous-collared Sparrows was positively related to conspecific abundance. In conclusion, the song peak frequency and song entropy of the three songbird species were differentially related to urban noise, vegetation, and conspecific and heterospecific abundance, suggesting these factors influence bird song characteristics.

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LSBSP: A Lightweight Sharding Method of Blockchain Based on State Pruning for Efficient Data Sharing in IoMT

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Computers, Materials & Continua 2025年第2期82卷 3309-3335页

作者： Guoqiong Liao Yinxiang Lei Yufang Xie neal n.Xiong College of Virtual Reality(VR)Modern Industry Jiangxi University of Finance and EconomicsNanchang330032China School of Computer Science Jiangxi University of Traditional Chinese MedicineNanchang330004China Jiangxi Tourism&Commerce Vocational College Nanchang330100China Department of Computer Mathematical and Physical SciencesSul Ross State UniversityAlpineTX 79830USA

As the Internet of Medical Things (IoMT) continues to expand, smart health-monitoring devices generate vast amounts of valuable data while simultaneously raising critical security and privacy challenges. Blockchain technology presents a promising avenue to address these concerns due to its inherent decentralization and security features. However, scalability remains a persistent hurdle, particularly for IoMT applications that involve large-scale networks and resource-constrained devices. This paper introduces a novel lightweight sharding method tailored to the unique demands of IoMT data sharing. Our approach enhances state bootstrapping efficiency and reduces operational overhead by utilizing a dual-chain structure comprising a main chain and a snapshot chain. The snapshot chain periodically records key blockchain states, allowing nodes to synchronize more efficiently. This mechanism is critical in reducing the time and resources needed for new nodes to join the network or existing nodes to recover from outages. Additionally, a block state pruning technique is implemented, significantly minimizing storage requirements and lowering transaction execution overhead during initialization and reconfiguration processes. This is crucial given the substantial data volumes inherent in IoMT ecosystems. By adopting an optimistic sharding strategy, our model allows nodes to swiftly join the snapshot shard, while full shards retain the complete ledger history to ensure comprehensive transaction verification. Extensive evaluations across diverse shard configurations demonstrate that this method significantly outperforms existing baseline models. It provides a comprehensive solution for IoMT blockchain applications, striking an optimal balance between security, scalability, and operational efficiency.

关键词： Internet of medical things blockchain sharding lightweight snapshot

Malpractice or masterful practice?navigating vicarious liability in healthcare

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World Journal of Clinical Cases 2025年第2期13卷 10-13页

作者： Satvik n Pai naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Department of Orthopaedics PES University Institute of Medical Sciences and ResearchBengaluru 560100KarnatakaIndia Department of Orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia Department of Orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia

In the intricate landscape of healthcare,vicarious liability looms large,shaping the responsibilities and actions of healthcare practitioners and administrators *** by a poignant scenario of a medication error,this article navigates the complexities of vicarious liability in *** explains the legal basis and ramifications of this theory,emphasizing its importance in fostering responsibility,protecting patient welfare,and easing access to *** paper explores the practical effects of vicarious responsibility on day-to-day operations,leadership practices,and decision-making processes via the eyes of senior consultants,junior doctors,and hospital *** comprehensive insights and real-world examples,it underscores the imperative of fostering a culture of accountability,communication,and quality care to navigate the intricate web of liabilities inherent in modern healthcare.

关键词： Vicarious liability Healthcare Responsibility Litigation Patient welfare

Current considerations for the management of liver echinococcosis

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World Journal of Gastroenterology 2025年第10期31卷 159-163页

作者： Efstathios T Pavlidis Ioannis n Galanis Theodoros E Pavlidis The 2nd Department of Propaedeutic Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Echinococcosis or hydatid disease is induced mainly by Echinococcus granulosus and occasionally by Echinococcus multilocularis(alveolaris)and affects the liver *** alveolar echinococcosis is similar to carcinoma in appearance,and without treatment,it can lead to *** is based on current imaging *** management is the cornerstone of *** removal of the cyst(total pericystectomy or hepatectomy)ensures a permanent cure and should be the first-choice treatment for cystic *** evacuation,partial cystectomy,and drainage or omentoplasty,may be alternative choices in difficult ***,mebendazole and praziquantel are options for treating small cysts and preventing recurrence after *** the efforts,alveolar echinococcus is not usually amenable to surgical management,except in the early stage,which is less common,and management by albendazole is ***,there are few recent reports of major operations(ex-vivo hepatectomy,autotransplantation and vascular reconstruction)in advanced stages.

关键词： Hepatic echinococcosis Hydatid disease Echinococcus granulosus Echinococcus alveolaris Hepatectomy for parasite diseases Pericystectomy

Current opinions on the use of prophylactic antibiotics in patients undergoing laparoscopic cholecystectomy

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World Journal of Gastrointestinal Surgery 2025年第3期17卷 427-430页

作者： Efstathios T Pavlidis Ioannis n Galanis Theodoros E Pavlidis The Second Department of Propaedeutic Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Inappropriate use of antibiotics leads to microbial ***-dose antibio-tic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk patients despite some conflicting ***-risk patients are those who are older than 70 years,have diabetes mellitus,whose operation time exceeded 120 minutes,have acute cholecystitis,experienced iatrogenic intraoperative gallbladder perforation resulting in bile or gallstone spillage,suffered from obstructive jaundice,or were deemed *** gallbladder perforation,one dose of antibiotic prophylaxis is ***,guidelines are needed and must be strictly ***-lactic treatment is not needed for patients at low risk of developing sepsis fo-llowing elective laparoscopic cholecystectomy,although the opposite is ***,superficial surgical infections are related to low *** without risk factors have a very low risk of ***,the routine use of anti-biotic prophylaxis in elective laparoscopic cholecystectomy is not recommended.

关键词： Prophylactic antibiotics Gallstone disease Laparoscopic cholecystectomy Acute cholecystitis Skin incision infection Septic complications

Site index determination using a time series of airborne laser scanning data

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Forest Ecosystems 2025年第01期 93-103页

作者： Maria ?snes Moan Ole Martin Bollands?s Svetlana Saarela Terje Gobakken Erik n?sset Hans Ole ?rka Lennart noordermeer Faculty of Environmental Sciences and natural Resource Management Norwegian University of Life Sciences

Site index (SI) is determined from the top height development and is a proxy for forest productivity,defined as the expected top height for a given species at a certain index *** norway,an index age of 40 years is *** using bi-temporal airborne laser scanning (ALS) data,SI can be determined using models estimated from SI observed on field plots (the direct approach) or from predicted top heights at two points in time (the height differential approach).Time series of ALS data may enhance SI determination compared to conventional methods used in operational forest inventory by providing more detailed information about the top height *** used longitudinal data comprising spatially consistent field and ALS data collected from training plots in 1999,2010,and 2022 to determine SI using the direct and height differential approaches using all combinations of years and performed an external *** also evaluated the use of data *** of root mean square error obtained from external validation were in the ranges of 16.3%–21.4%and 12.8%–20.6%of the mean fieldregistered SI for the direct approach and the height differential approach,*** were no statistically significant effects of time series length or the number of points in time on the obtained *** assimilation did not result in any substantial improvement in the obtained *** a time series of ALS data did not yield greater accuracies compared to using only two points in time,a larger proportion of the study area could be used in ALS-based determination of SI when a time series was *** was because areas that were unsuitable for SI determination between two points in time could be subject to SI determination based on data from another part of the time series.

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Brain-derived neurotrophic factor signaling in the neuromuscular junction during developmental axonal competition and synapse elimination

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neural Regeneration Research 2025年第2期20卷 394-401页

作者： Josep Tomàs Víctor Cilleros-Mañé Laia Just-Borràs Marta Balanyà-Segura Aleksandra Polishchuk Laura nadal Marta Tomàs Carolina Silvera-Simón Manel M.Santafé Maria A.Lanuza Unitat d’Histologia i neurobiologia(UHneurob) Facultat de Medicina i Ciències de la SalutUniversitat Rovira i VirgiliReusSpain

During the development of the nervous system,there is an overproduction of neurons and *** competition between neighboring nerve endings and synapses performing different activity levels leads to their elimination or *** have extensively studied the involvement of the brain-derived neurotrophic factor-Tropomyosin-related kinase B receptor neurotrophic retrograde pathway,at the neuromuscular junction,in the axonal development and synapse elimination process versus the synapse *** purpose of this review is to describe the neurotrophic influence on developmental synapse elimination,in relation to other molecular pathways that we and others have found to regulate this *** particular,we summarize our published results based on transmitter release analysis and axonal counts to show the different involvement of the presynaptic acetylcholine muscarinic autoreceptors,coupled to downstream serine-threonine protein kinases A and C(PKA and PKC)and voltage-gated calcium channels,at different nerve endings in developmental *** dynamic changes that occur simultaneously in several nerve terminals and synapses converge across a postsynaptic site,influence each other,and require careful studies to individualize the mechanisms of specific *** describe an activity-dependent balance(related to the extent of transmitter release)between the presynaptic muscarinic subtypes and the neurotrophin-mediated TrkB/p75nTR pathways that can influence the timing and fate of the competitive interactions between the different axon *** downstream displacement of the PKA/PKC activity ratio to lower values,both in competing nerve terminals and at postsynaptic sites,plays a relevant role in controlling the elimination of supernumerary ***,calcium entry through L-and P/Q-subtypes of voltage-gated calcium channels(both channels are present,together with the n-type channel in developing nerve terminals)contributes to red

关键词： acetylcholine release adenosine receptors axonal competition brain-derived neurotrophic factor calcium channels motor end-plate muscarinic acetylcholine receptors postnatal synapse elimination serine kinases tropomyosin-related kinase receptorB

A novel Reliable and Trust Objective Function for RPL-Based IoT Routing Protocol

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Computers, Materials & Continua 2025年第2期82卷 3467-3497页

作者： Mariam A.Alotaibi Sami S.Alwakeel Aasem n.Alyahya Department of Computer Engineering College of Computer ScienceKing Saud UniversityRiyadh11543Saudi Arabia Department of Computer Science and Information Technology Shaqra UniversityShaqra11961Saudi Arabia

The Internet of Things (IoT) integrates diverse devices into the Internet infrastructure, including sensors, meters, and wearable devices. Designing efficient IoT networks with these heterogeneous devices requires the selection of appropriate routing protocols, which is crucial for maintaining high Quality of Service (QoS). The Internet Engineering Task Force’s Routing Over Low Power and Lossy networks (IETF ROLL) working group developed the IPv6 Routing Protocol for Low Power and Lossy networks (RPL) to meet these needs. While the initial RPL standard focused on single-metric route selection, ongoing research explores enhancing RPL by incorporating multiple routing metrics and developing new Objective Functions (OFs). This paper introduces a novel Objective Function (OF), the Reliable and Secure Objective Function (RSOF), designed to enhance the reliability and trustworthiness of parent selection at both the node and link levels within IoT and RPL routing protocols. The RSOF employs an adaptive parent node selection mechanism that incorporates multiple metrics, including Residual Energy (RE), Expected Transmission Count (ETX), Extended RPL node Trustworthiness (ERnT), and a novel metric that measures node failure rate (nFR). In this mechanism, nodes with a high nFR are excluded from the parent selection process to improve network reliability and stability. The proposed RSOF was evaluated using random and grid topologies in the Cooja Simulator, with tests conducted across small, medium, and large-scale networks to examine the impact of varying node densities. The simulation results indicate a significant improvement in network performance, particularly in terms of average latency, packet acknowledgment ratio (PAR), packet delivery ratio (PDR), and Control Message Overhead (CMO), compared to the standard Minimum Rank with Hysteresis Objective Function (MRHOF).

关键词： IoT LLns RPL objective function OF MRHOF OF0 routing metrics reliability trustworthiness