Prevention of vitamin D deficiency in children. The state of the problem in the world and in Ukraine.

The article presents current data on the prevalence of vitamin D deficiency and criteria for its deficiency in children in different countries. Vitamin D is recognized as one of the most important vitamins involved in many biochemical processes in the body. Its active metabolites play a key role in calcium absorption, bone mineralization and promote phosphate and magnesium metabolism. At the same time, in addition to affecting mineral metabolism, there is a wide range of conditions in which vitamin D also plays a preventive role. Vitamin D has been shown to play a vital role in innate immunity maintenance and is important in prevention of several diseases, including infections, autoimmune diseases, certain forms of cancer, type 1 and 2 diabetes, and cardiovascular diseases. Vitamin D is of particular importance for newborns and young children. This vitamin is involved in important physiological regulatory processes such as bone metabolism, lung development, maturation of the immune system and differentiation of the nervous system. Vitamin D deficiency increases risks of neonatal sepsis, necrotizing enterocolitis, respiratory distress syndrome, and bronchopulmonary dysplasia. Adequate intake of vitamin D and calcium during childhood can reduce the risk of osteoporosis and other diseases associated with vitamin D deficiency in adults. Recently, vitamin D deficiency has shown to be a potential risk factor for COVID-19 propensity. It has been established that to date most scientific pediatric societies have recognized the need to prevent vitamin D deficiency in healthy children of all ages, but data on the dosage of vitamin D in its prophylactic use differ. Most scientific societies recommend an average of 400-600 IU per day of vitamin D for prophylactic purposes. The analysis of published data shows the need to follow a strategy based on an individual approach, taking into account physiological characteristics, individual requirements and lifestyle.Copyright © 2021 University of Tartu Press. All rights reserved.

RHEUMATOLOGISTS BEWARE OF LOW ALP: A CASE OF HYPOPHOSPHATASIA MISDIAGNOSED AS FIBROMYALGIA, CAUSING LONG DIAGNOSTIC DELAY

BackgroundHypophosphatasia(HPP), a rare, inherited metabolic disease featuring low serum alkaline phosphatase (ALP) activity due to ALPL (encoding tissue non-specific alkaline phosphatase) gene mutation[1,2]. A wide-ranging clinical spectrum is often seen due to defective mineralisation affecting teeth, bones, joints and muscles[1]. This disease has a prevalence of 1/6370 in Europe and is often misdiagnosed and underdiagnosed with a diagnostic delay of more than ten years[1] The treatment is often supportive for milder cases and enzyme replacement therapy in severe cases.ObjectivesTo share this case to raise awareness among Rheumatologists.MethodsThis 58-year-old Caucasian female had her first HPP symptom as early eruption of deciduous teeth, along with recurrent dental infections and gum problems. She was diagnosed with flat feet at age five, had a big toe fracture at sixteen, followed by a metatarsal fracture. She experienced leg muscle cramps and aches, affecting her performance in sport during school life.At the age of thirty she began noticing weakness in arms and legs, which progressed over the years. She faced significant early morning stiffness along with painful ribs, hips, knees, shoulders, and small joints of feet when walking.She was diagnosed with Fibromyalgia at the age of forty-four. The following ten years she met numerous specialists including rheumatologist, pain specialist and physiotherapists. She was also diagnosed with early osteoarthritis, pernicious anaemia, hyperlipidemia, functional neurological syndrome, and central sensitization syndrome. She had multiple trials of steroids and opioids, all of which were stopped either due to side effects or inefficiency.A major flare of symptoms five years ago rendered her bedbound for three months, following which a chemical pathologist noticed a persistent low ALP levels and decided to investigate for HPP. It took another four years to complete these investigations due to the coronavirus pandemic.Currently, she is unable to weight bear or climb stairs and must stay indoors or in bed during flareup. She moved into a ground floor flat at the age of 54 and use a walking stick occasionally. By 58, she is unable to work and had given up her own business due to pain, weakness, and disability.ResultsOn clinical assessment, her height is 160 cm, faced difficulty getting up from chair, has an antalgic waddling gait, with a 6-minute walking distance of 60 metre, stopped after three minutes, and had a Brief Pain Inventory pain severity score of 7/10. Her ALP level is 24 U/L and PLP/PA ratio is 18.8 (ref < 5), and genetic testing showed heterozygous missense variant of ALPL gene mutation.ConclusionIt took more than forty years to reach a conclusive diagnosis of childhood onset HPP. Low ALP level is a signature of HPP and warrants investigations. Diagnosis can be challenging due to the rareness and variable presentation, however recognition of HPP features is crucial for timely referral, optimal disease management and potential improvement in quality of life.References[1]Högler W, Langman C, Gomes da Silva H, Fang S, Linglart A, Ozono K, Petryk A, Rockman-Greenberg C, Seefried L, Kishnani PS. Diagnostic delay is common among patients with hypophosphatasia: initial findings from a longitudinal, prospective, global registry. BMC Musculoskelet Disord. 2019 Feb 14;20(1):80. doi:10.1186/s12891-019- 2420-8. PMID: 30764793;PMCID: PMC6376686.[2]Injean P, Lee S, Downey C. Hypophosphatasia May Be Misdiagnosed as Fibromyalgia: A Single Center Experience []. Arthritis Rheumatol. 2020;72 (suppl 10). https://acrs.org//hypophosphatasia-may-be-misdiagnosed-as- ibromyalgia-a-single-center-experience/. Accessed January 14, 2023.[3]Lefever E, Witters P, Gielen E, Vanclooster A, Meersseman W, Morava E, Cassiman D, Laurent MR. Hypophosphatasia in Adults: Clinical Spectrum and Its Association With Genetics and Metabolic Substrates. J Clin Densitom. 2020 Jul-Sep;23(3):340- 48. doi: 10.1016/j.jocd.2018.12.006. Epub 2018 Dec 21. PMID: 30655187.Acknowledgements:N L.Disclosure of InterestsNone Declared.

Macerated stillbirth

Stillbirth is defined as the birth of a viable baby without signs of life. They account for more than 2.5 million intrauterine deaths per year worldwide and are associated with a number of risk factors, the most important of which are maternal and placental factors. Autopsy provides information that may be of use in determining time since death, gestational age of the fetus, mode of death, cause of fetal demise, and the likelihood of recurrence. The format of the autopsy is guided by parental consent, but even when consent is limited, valuable information may be obtained by careful consideration of antemortem test results, imaging, and genetic testing. Where there is a delay between death and delivery, fetuses are affected by maceration, which may increase the technical complexity of the autopsy and impart a number of artefactual changes, which should not be misinterpreted as genuine pathology. The most common pathologies encountered at autopsy are placental abnormalities, changes related to maternal disorders, malformations, and central nervous system pathology. © Springer Nature Switzerland AG 2022. All rights reserved.

EMPHASIZING SOME CHARACTERISTICS OF NATURAL SALTED WATERS' AREAS, USED FOR PUBLIC HEALTH IMPROVEMENT

In recent years, more and more data has become available about the benefits of green in and around cities. Vegetation helps people to recover faster from illness;this reduces costs of healthcare and improves the patients ' quality of life. In highly urbanized locations, the design of green elements requires special attention. Our paper presents a multidisciplinary study of areas located near the old salt mines and their use by entering in the spa and leisure circuit. Specific components were monitored, like the salted waters quality in lakes and/or springs and the identification of different plant species adapted to high salinity of the soil and able to enrich a green zone. In recent years, the continuous degradation of environmental quality due to factors such as air pollution, noise, chemical compounds, the pandemic state due to COVID-19 and disappearance of natural areas, in combination with lifestyle changes led to the emergence of a growing number of diseases such as different forms of diabetes, cardiovascular and nervous system disorders and cancer.

Virus Management Using Metal-Organic Framework-Based Technologies.

The eradication and isolation of viruses are two concurrent approaches to protect ourselves from viral infections and diseases. The quite versatile porous materials called metal-organic frameworks (MOFs), have recently emerged as efficient nanosized tools to manage viruses, and several strategies to accomplish these tasks have been developed. This review describes these strategies employing nanoscale MOFs against SARS-CoV-2, HIV-1, tobacco mosaic virus, etc., which include the sequestration by host-guest penetration inside pores, mineralization, design of a physical barrier, controlled delivery of organic and inorganic antiviral drugs or bioinhibitors, photosensitization of singlet oxygen, and direct contact with inherently cytotoxic MOFs.

TiO2 based Photocatalysis membranes: An efficient strategy for pharmaceutical mineralization.

Among the various emerging contaminants, pharmaceuticals (PhACs) seem to have adverse effects on the quality of water. Even the smallest concentration of PhACs in ground water and drinking water is harmful to humans and aquatic species. Among all the deaths reported due to COVID-19, the mortality rate was higher for those patients who consumed antibiotics. Consequently, PhAC in water is a serious concern and their removal needs immediate attention. This study has focused on the PhACs' degradation by collaborating photocatalysis with membrane filtration. TiO2-based photocatalytic membrane is an innovative strategy which demonstrates mineralization of PhACs as a safer option. To highlight the same, an emphasis on the preparation and reinforcing properties of TiO2-based nanomembranes has been elaborated in this review. Further, mineralization of antibiotics or cytostatic compounds and their degradation mechanisms is also highlighted using TiO2 assisted membrane photocatalysis. Experimental reactor configurations have been discussed for commercial implementation of photoreactors for PhAC degradation anchored photocatalytic nanomembranes. Challenges and future perspectives are emphasized in order to design a nanomembrane based prototype in future for wastewater management.

Effectiveness of Different Methods in Removing Dentin Caries of Primary Teeth: Micro-CT and SEM Evaluation.

OBJECTIVES: With the recent improvements in technology, the expectation of minimal invasion and maximal comfort in caries removal techniques is increasing. This study aims to examine the effectiveness of six caries removal methods in primary teeth. STUDY DESIGN: Sixty primary molars (10 teeth in each groups) were used. The groups were: Group I (Tungsten Carbide Bur), Group II (Sono abrasion), Group III (Air abrasion), Group IV (Carisolv), Group V (Er:YAG Laser), Group VI (ART). In micro-CT scanning, mineral density at the cavity floor was examined before and after caries removal. After caries removal, the patency of the dentinal tubules was examined in two teeth from each group on SEM images. Statistical analyses were performed using Kruskal-Wallis, Wilcoxon tests. RESULTS: For six different caries removal methods, tooth mineral (inorganic, total) densities at cavity floors were compared among the groups after the procedures, and no statistically significant difference was found (p>0.05). On the SEM images, it was seen that the dentinal tubules were exposed and no smear layer was formed in the Carisolv group. Significant rough surfaces were exposed in the laser group. CONCLUSION: It was observed that alternative caries removal methods are at least as effective as the traditional method in primary teeth for clinical applications.

Current CO2 Capture and Storage Trends in Europe in a View of Social Knowledge and Acceptance. A Short Review

Carbon dioxide (CO2) has reached a higher level of emissions in the last decades, and as it is widely known, CO2 is responsible for numerous environmental problems, such as climate change. Thus, there is a great need for the application of CO2 capture and storage, as well as of CO2 utilization technologies (CCUS). This review article focuses on summarizing the current CCUS state-of-the-art methods used in Europe. Special emphasis has been given to mineralization methods/technologies, especially in basalts and sandstones, which are considered to be suitable for CO2 mineralization. Furthermore, a questionnaire survey was also carried out in order to investigate how informed about CO2 issues European citizens are, as well as whether their background is relative to their positive or negative opinion about the establishment of CCUS technologies in their countries. In addition, social acceptance by the community requires contact with citizens and stakeholders, as well as ensuring mutual trust through open communication and the opportunity to participate as early as possible in the development of actions and projects related to CO2 capture and storage, at all appropriate levels of government internationally, as citizens need to understand the benefits from such new technologies, from the local to the international level.

Ni-Co Bearing Laterites from Halmahera Island (Indonesia)

Eastern Indonesia, including the island of Halmahera, is a region with a high mineral potential, particularly Ni-Co, Au-Cu, and Ag ores, which are a globally important and critical source of raw materials (CRMs). The research was conducted within the framework of scientific cooperation between the Faculty of Geology, University of Warsaw (Poland), and PT Halmahera Resources Percasa Ltd. (Jakarta, Indonesia) Between the years of 2009 and 2011, 42 boreholes were drilled using an impact system (up to 15 m below surface) and 3 test pits (up to 8 m below surface). The presence of a laterite deposit containing Ni-Co mineralization was identified on the license area. The resources estimated in accordance with JORC Code, with a cut-off grade Ni ≥ 0.5%, equaling 185,510 t Ni and 17,747 t Co, with the stock of raw material amounting to 14.8 million t and with an average content of 1.00% Ni and 0.13% Co. The ore in the deposit has mixed character. To date, studies have shown the dominance of oxide ore, but saprolite composed of magnesium silicates was also identified in significant amount. The Ni mineralization in oxide ore (limonite) is bound to goethite and manganese minerals, while in the case of silicate (saprolite) ore, it occurs locally in the form of veins as well as zonally in the weathered serpentinites. Cobalt mineralization is almost entirely related to the Mn minerals that occur in the lower oxide zone. It has been found that both serpentinites and harzburgites (and possibly locally lherzolite) are the parent rocks for laterite deposit.

SARS-CoV-2 pharmaceutical drugs: a critical review on the environmental impacts, chemical characteristics, and behavior of advanced oxidation processes in water.

This review summarizes research data on the pharmaceutical drugs used to treat the novel SARS-CoV-2 virus, their characteristics, environmental impacts, and the advanced oxidation processes (AOP) applied to remove them. A literature survey was conducted using the electronic databases Science Direct, Scopus, Taylor & Francis, Google Scholar, PubMed, and Springer. This complete research includes and discusses relevant studies that involve the introduction, pharmaceutical drugs used in the SARS-CoV-2 pandemic: chemical characteristics and environmental impact, advanced oxidation process (AOP), future trends and discussion, and conclusions. The results show a full approach in the versatility of AOPs as a promising solution to minimize the environmental impact associated with these compounds by the fact that they offer different ways for hydroxyl radical production. Moreover, this article focuses on introducing the fundamentals of each AOP, the main parameters involved, and the concomitance with other sources and modifications over the years. Photocatalysis, sonochemical technologies, electro-oxidation, photolysis, Fenton reaction, ozone, and sulfate radical AOP have been used to mineralize SARS-CoV-2 pharmaceutical compounds, and the efficiencies are greater than 65%. According to the results, photocatalysis is the main technology currently applied to remove these pharmaceuticals. This process has garnered attention because solar energy can be directly utilized; however, low photocatalytic efficiencies and high costs in large-scale practical applications limit its use. Furthermore, pharmaceuticals in the environment are diverse and complex. Finally, the review also provides ideas for further research needs and major concerns.

Emerging Pollutants in Wastewater, Advanced Oxidation Processes as an Alternative Treatment and Perspectives

Emerging pollutants are present in wastewaters treated by conventional processes. Due to water cycle interactions, these contaminants have been reported in groundwater, surface water, and drinking waters. Since conventional processes cannot guarantee their removal or biotransformation, it is necessary to study processes that comply with complete elimination. The current literature review was conducted to describe and provide an overview of the available information about the most significant groups of emerging pollutants that could potentially be found in the wastewater and the environment. In addition, it describes the main entry and distribution pathways of emerging contaminants into the environment through the water and wastewater cycle, as well as some of the potential effects they may cause to flora, fauna, and humans. Relevant information on the SARS-CoV-2 virus and its potential spread through wastewater is included. Furthermore, it also outlines some of the Advanced Oxidation Processes (AOPs) used for the total or partial emerging pollutants removal, emphasizing the reaction mechanisms and process parameters that need to be considered. As well, some biological processes that, although slow, are effective for the biotransformation of some emerging contaminants and can be used in combination with advanced oxidation processes. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Diabetic Covid-19 severity: Impaired glucose tolerance and pathologic bone loss.

Diabetes mellitus (DM), hypertension, and cardiovascular diseases (CVDs) are the leading chronic comorbidities that enhance the severity and mortality of COVID-19 cases. However, SARS-CoV-2 mediated deregulation of diabetes pathophysiology and comorbidity that links the skeletal bone loss remain unclear. We used both streptozocin-induced type 2 diabetes (T2DM) mouse and hACE2 transgenic mouse to enable SARS-CoV-2-receptor binding domain (RBD) mediated abnormal glucose metabolism and bone loss phenotype in mice. The data demonstrate that SARS-CoV-2-RBD treatment in pre-existing diabetes conditions in hACE2 (T2DM + RBD) mice results in the aggravated osteoblast inflammation and downregulation of Glucose transporter 4 (Glut4) expression via upregulation of miR-294-3p expression. The data also found increased fasting blood glucose and reduced insulin sensitivity in the T2DM + RBD condition compared to the T2DM condition. Femoral trabecular bone mass loss and bone mechanical quality were further reduced in T2DM + RBD mice. Mechanistically, silencing of miR-294 function improved Glut4 expression, glucose metabolism, and bone formation in T2DM + RBD + anti-miR-294 mice. These data uncover the previously undefined role of SARS-CoV-2-RBD treatment mediated complex pathological symptoms of diabetic COVID-19 mice with abnormal bone metabolism via a miRNA-294/Glut4 axis. Therefore, this work would provide a better understanding of the interplay between diabetes and SARS-CoV-2 infection.

Use of Passive and Grab Sampling and High-Resolution Mass Spectrometry for Non-Targeted Analysis of Emerging Contaminants and Their Semi-Quantification in Water

Different groups of organic micropollutants including pharmaceuticals and pesticides have emerged in the environment in the last years, resulting in a rise in environmental and human health risks. In order to face up and evaluate these risks, there is an increasing need to assess their occurrence in the environment. Therefore, many studies in the past couple of decades were focused on the improvements in organic micropollutants’ extraction efficiency from the different environmental matrices, as well as their mass spectrometry detection parameters and acquisition modes. This paper presents different sampling methodologies and high-resolution mass spectrometry-based non-target screening workflows for the identification of pharmaceuticals, pesticides, and their transformation products in different kinds of water (domestic wastewater and river water). Identification confidence was increased including retention time prediction in the workflow. The applied methodology, using a passive sampling technique, allowed for the identification of 85 and 47 contaminants in the wastewater effluent and river water, respectively. Finally, contaminants’ prioritization was performed through semi-quantification in grab samples as a fundamental step for monitoring schemes.

Compostable Packaging Waste Management—Main Barriers, Reasons, and the Potential Directions for Development

The paper aims to identify the main reasons for the low level of compostable packaging waste management and to propose potential directions for development. Based on qualitative research (individual in-depth interviews and focus group discussions using the Social Innovation Lab), these are: (1) the lack of uniform and transparent regulations regarding the planning and organization of a closed-loop system for compostable packaging, (2) insufficient communication between the private and public sectors on how to increase the use of compostable packaging, (3) poorly developed infrastructure for compostable waste recycling, and (4) a lack of financial incentives to support activities for the circular economy of composting packaging at the communal level. Moreover, the portfolio of bottom-up (initiated by consumers, educational institutions, and NGOs) and bottom-down dimension (national, regional programs) proposals are presented. The diagnosis of different view perspectives of the supply chain underlines the crucial role of stakeholder cooperation improvement.

Voltammetric determination of heavy metals in honey bee venom using hanging mercury drop electrode and PLA/carbon conductive filament for 3D printer.

A new method for determination of selected heavy metals (Cd, Pb, Cu, Zn, and Ni) in honey bee venom was developed. Heavy metals are metabolized and incorporated into bee products, including honey and honey bee venom (apitoxin). Their composition reflects contamination of "bee environment", providing information about heavy metal contamination in the neighborhood of human dwellings. Moreover, assessment of bee products contamination is relevant for medicine, as they are a tool for promising therapeutic and chemoprophylactic strategies against COVID-19 (SARS-CoV-2). Owing to the complicated matrix, the developed method consists of wet mineralization with sulfuric acid, nitric acid, under increased temperature, and pressure and subsequent repeated boiling with concentrated nitric acid. Determination of the selected metals was carried out by anodic or cathodic stripping voltammetry on two types of electrodes: pen-type hanging mercury drop electrode (HMDE) and PLA filament with carbon conductive admixture (PLA-C) for 3D printer. Contents of lead and cadmium in all analyzed bee venom samples were on the level of mg kg-1, of nickel and copper about ten times higher, and of zinc on the level of g kg-1. The results achieved using HMDE were recorded with average relative standard deviation (RSD) 5.4% (from 3.2% to 8.6%) and using PLA-C 11.8% (from 6.5% to 18.0%). The results achieved using both electrodes proved to be equivalent with statistical probability higher than 95%.