Pancreatic cancer is one of the most aggressive and lethal forms of cancer, with a five-year survival rate of less than 10%. Despite advances in treatment modalities, the prognosis for pancreatic cancer patients remains poor, highlighting the urgent need for innovative approaches for early diagnosis and targeted therapies. In recent years, there has been significant progress in understanding the molecular mechanisms underlying pancreatic cancer development and progression. This paper reviews the current knowledge of molecular targets for the diagnosis and treatment of pancreatic cancer.

Adaptive hyperactivity, characterized by increased activity levels and novelty-seeking traits without mood disorders, is prevalent among older adults in Sardinia's "blue zone," an area with high longevity. This study aims to evaluate the adaptive nature of hyperac-tivity concerning quality of life, social rhythms, and mood symptoms in individuals from this region, particularly among older adults over 80. Methods: This observational cross-sectional study included adults and older adults over 80 years from Sardinia's blue zone, recruited from the dermatology clinic at the University Hospital of Cagliari. Partici-pants underwent psychiatric interviews and completed the Mood Disorder Questionnaire (MDQ), Patient Health Questionnaire (PHQ-9), SF-12, and Brief Social Rhythm Scale (BSRS). Data were compared with national and regional normative data. Results: Older adults in the blue zone demonstrated higher MDQ positivity (22.58%) compared to na-tional averages (0.87%), without corresponding increases in dysregulated rhythms, de-pressive symptoms, or reduced quality of life. Younger elders (65-79 years) showed in-creased rhythm dysregulation (BSRS score: 20.64±7.02) compared to adults (17.40±6.09, p=0.040), but this trend was not observed in older elders (80+ years). No significant differ-ences were found in CH3SH and (CH3)2S levels between groups. Conclusions: Hyperactiv-ity observed in older adults from Sardinia's blue zone appears adaptive, not linked to so-cial rhythm dysregulation, depressive symptoms, or diminished quality of life, suggesting resilience factors that may contribute to longevity. These findings support the potential classification of such hyperactivity as beneficial rather than pathological, warranting fur-ther research into biomarkers and psychoeducational interventions to prevent the onset of bipolar disorders in predisposed individuals.

Background/Objectives Gastroparesis, a chronic digestive disorder characterized by delayed gastric emptying, often results from diabetes, post-surgical complications, autoimmune diseases, and neurological disorders. In approximately 50% of cases, the cause is idiopathic gastroparesis (IGD). Recent studies suggest a link between chronic enteroviral infections and persistent gas-trointestinal symptoms, including delayed gastric emptying. This study investigates the effects of a silydianin-rich extract from Silybum marianum seeds on enteroviral infections in vitro and the mitigation of delayed gastric emptying in mice. Silydianin, a key bioactive compound known for its liver-protective and antioxidant properties, has not been extensively studied for its impact on enteroviral infections and gastroparesis; Methods NMR spectroscopy (¹H, ¹³C, and DEPT) identi-fied silydianin as the primary compound, with minor flavonolignans and trace amounts of an oxidation product. The study assessed the cytotoxicity and antiviral activity of the extract at various stages of the viral life cycle, including virucidal activity, cell protection, and post-infection effects, using neutral red assays in RD cells, with results confirmed by real-time PCR. The viruses studied included Coxsackievirus B2, Coxsackievirus A10, Poliovirus SL-1, and Enterovirus EV71. The impact on delayed gastric emptying was evaluated in a mouse model of gastroparesis using doses of 100 and 200 mg/kg compared to a control; Results: The silydianin-rich extract exhibited con-sistent antiviral activity, with the highest selectivity index (SI) for EV71 (4.08) during virucidal activity. It provided moderate cell protection, with EC50 values ranging from 120.88 to 186.10 µg/mL and SI values from 2.20 to 3.39. Post-infection treatment showed varying efficacy, with Coxsackie A10 demonstrating the highest SI (3.90). In vivo, the extract at 200 mg/kg significantly improved gastric emptying to 96.47% and slightly increased gastrointestinal transit from 50.33% to 61.46%; Conclusions These results suggest that silydianin may be effective in treating enteroviral infections and enhancing intestinal function, making it a promising candidate for gastroparesis treatment and warranting further research.

The ovary is the major determinant of female reproductive health. Ovarian functions are mainly related to the primordial follicle pool, which is gradually loss with aging. Ovarian aging and reproductive dysfunctions share oxidative stress as common underlying mechanism. ROS signaling is essential for normal ovarian processes yet can contribute to various ovarian disorders when disrupted. Therefore, balance in the redox system is crucial for proper ovarian functions. In the present study, by focusing on mRNAs and ncRNAs described in the ovary and taking into account only validated ncRNA interactions, we built up an ovarian antioxidant ceRNA network, namely OvAnOx ceRNA, composed of 5 mRNAs (SOD1, SOD2, CAT, PRDX3, GR), 10 miRNAs and 5 lncRNAs (XIST, FGD5-AS1, MALAT1, NEAT1, SNHG1). Our bioinformatic analysis indicated that the components of the OvAnOx ceRNA not only contribute to antioxidant defence, but are also involved in other ovarian functions. Indeed, antioxidant enzymes encoded by mRNA of OvAnOx ceRNA operate within a regulatory network that impacts ovarian reserve, follicle dynamics, and oocyte maturation in normal and pathological conditions. The OvAnOx ceRNA represents a promising tool to unravel the complex dialogue between redox potential and ovarian signalling pathways involved in reproductive health, aging and diseases.

Currently, obesity is a critical global public health burden. Numerous studies have demonstrated the regulation of the pathogenesis of obesity and metabolic abnormalities by the gut microbiota and microbial factors; however, their involvement in the various degrees of obesity is not yet understood well. Previously, obesity has been shown to be associated with decreased levels of vitamin B12. Considering exclusive microbial production of vitamin B12, we hypothesised that a decrease in cobalamin levels in obese individuals may be at least partially caused by its depleted production in the intestinal tract by the commensal microbiota. In the present study, our aim was to estimate the abundance of enzymes and metabolic pathways for vitamin B12 synthesis in the gut microbiota of mouse models of alimentary and genetically determined obesity, to evaluate the contribution of the obesogenic microbiome to vitamin B12 synthesis in the gut. We have defined a significantly lower representation of enzymes and metabolic pathways for vitamin B12 biosynthesis in obese mice compared to non-obese mice, wherein enzyme depletion was more pronounced in lepr(-/-) (db/db) mice, which developed severe obesity. The representation of enzymes involved in cobalamin synthesis is strongly correlated with representation of several microbes in high-fat diet fed mice, whereas there were almost no correlations in db/db mice. Therefore, the degree of obesity and the composition of the correspondent microbiota are the main contributors to the representation of genes and pathways for cobalamin biosynthesis in the mouse gut.

(1) Background: Sarcopenia, a condition characterized by a decrease in muscle mass and strength, is very common in patients with obesity and can be aggravated by bariatric surgery, potentially compromising the clinical results of surgery. There is increasing interest in pa-tient-reported outcome measures (PROMs) to assess results in other health variables that may be especially important for individual patients. The role of exercise in enhancing health-related quality of life (HRQoL) after surgery remains underexplored. This study investigated the impact of exercise on HRQoL in bariatric sarcopenic patients via the Sarcopenia Quality of Life (SarQoL) questionnaire. (2) Method: Candidates for surgery took part in the EXPOBAR program and were randomized into experimental and control groups. The intervention lasted 16 weeks, starting one month after surgery, and included combined aerobic and resistance exercise. Outcomes, including body composition and physical fitness parameters, were measured before and after the intervention. All participants underwent gastric bypass surgery (RYGB). (3) Results: The baseline characteristics of the participants were not significantly different between the two groups. All patients met the criteria for moderate/severe obesity and the EASO/ESPEN criteria for sarcopenia, namely, reduced muscle strength assessed by grip strength and reduced muscle mass assessed by the ASMM score/weight. After completing the study protocol, patients in both groups had increased HRQoL, but the increase was significantly greater in the intervention group than in the control group. (4) Conclusion: Our findings suggest that exercise plays a crucial role in improving both physical and psychological well-being in postbariatric patients, highlighting the need to integrate structured exercise programs in post-surgery care. This study was prospectively registered at Clinicaltrials.gov (NCT03497546).

Despite the lack of evidence that suggests hemodiafiltration (HDF) offers a better survival outcome than standard hemodialysis (HD), the number of patients initiating HDF in Japan continues to rise. This study examined the temporal change in the number of HDF incidents, evaluated factors associated with all-cause mortality, and compared the mortality risk and survival time of patient on HDF with patients receiving standard HD in three sets of 2-year cohorts. The primary analyses included the insurance claims data of 460 HDF patients and propensity score-matched 903 standard HD patients who initiated dialysis therapy between April 1, 2012 and March 31, 2018. Patient follow-up was censored at the time of death or the end of the 2-year study period. The influence of comorbidities on all-cause mortality was investigated, and the survival outcomes between HDF and standard HD patient groups throughout cohorts were compared. The number of HDF patients was increasing throughout cohorts, but the proportions of mortality cases across cohorts slowly decreased. Dementia status increases the mortality risk of patients regardless of dialysis modality. The mortality risk among HDF patients with dementia was more significant than HD patients. Adjusting for all covariates, we observed that HDF patients had a reduced mortality risk and longer survival time than patients on standard HD. This study supports the notion that HDF reduces all-cause mortality compared with standard HD in an incident dialysis population in Fukuoka Prefecture, Japan.

Growth hormone therapy (GHT) can improve growth velocity and final height but can also accelerated the process of bone growth, which is related to structural bone modelling, both in formation and resorption. The study evaluated the capacity of bone turnover markers to predict early growth response to one year GHT in short stature children born as small for gestational age (SGA). 25 prepubertal SGA children were included. We have estimated P1NP (N-terminal procollagen type 1), CTX (C-terminal telopeptide of collagen type I), P3NP (N-terminal procollagen type III), NT-pro-CNP (amino-terminal C-type natriuretic peptide) and Ca-P metabolism using standard ECLIA, IRA and ELISA methods. A statistically significant increase in bone resorption markers (Ctx ) was found both at 6 and 12 months. P1NP bone markers increased at 6 months and after 12 months of therapy. The P3NP marker of collagen synthesis also increased after 12 months of therapy. We obtained significant increases in phosphorus levels at 6 and 12 months and similarly ALP. We have found a significant correlation between height (cm) and Ctx after 6 -12 months as well as P1NP / height (SD) after 12 months. Calcium levels significantly correlated with height (SD) after 12 months. We find a strong reaction of bone resorption and bone formation markers during growth hormone therapy that may determine their selection as prediction of GH treatment outcome in SGA children. However, the issue requires further research.

The kynurenine pathway (KP) and the endocannabinoid system (ECS) are known to be deregulated in depression and obesity; however, it has been recognized that acute physical exercise has an important modulating role inducing changes in the mobilization of their respective metabolites -endocannabinoids (eCB) and kynurenines (KYN)- which overlap at some points, acting as im-portant antidepressant, anti-nociceptive, anti-inflammatory, and antioxidant biomarkers. There-fore, the aim of this review is to analyze and discuss some studies performed recently to investigate the potential interactions between both systems, particularly, those related with exercise-derived endocannabinoidome and kynurenine mechanisms and to elucidate how, the prescription of physical exercise could represent a new approach for the clinical manage of these two conditions.

Appropriate nutrition during pregnancy and the post-partum period is vital to both the parent and their offspring. Both under- and over-nourished status may have important microbial implications on the parental and infant gut microbiomes. Alterations to the microbiome can have implications for a person’s risk of obesity and metabolic diseases. In this review, we examine alterations in the parental gut, vaginal, placental, and milk microbiomes in the context of pre-pregnancy BMI, gestational weight gain, body composition, gestational diabetes, and parental diet. We also investigate how the infant gut microbiome may be altered by these different parameters. Many of the microbial changes seen in under- and over-nourished states in birthing parents may result in long-term implications to the health of offspring. Differences in diet appear to be a major driver of the parental, and subsequently milk and offspring microbiomes. Further prospective longitudinal cohort studies are needed examining nutrition and the microbiome to better understand its implications. Additionally, trials involving dietary interventions in child-bearing age adults should be explored to improve the parent and child’s risks for metabolic diseases.

In the past thirty years, childhood obesity rates have risen significantly worldwide, affecting over 340 million children in affluent nations. This surge is intricately tied to metabolic disorders, notably insulin resistance, type 2 diabetes mellitus (T2DM), and the continually evolving spectrum of metabolic-associated (dysfunction) steatotic liver disease (MASLD). This review underscores the alarming escalation of childhood obesity and delves comprehensively into the evolving and dynamic changes of nomenclature surrounding diverse conditions of hepatic steatosis, from the initial recognition of non-alcoholic fatty liver disease (NAFLD) to the progressive evolution into MASLD. Moreover, it emphasizes the crucial role of pediatric endocrinologists in thoroughly and accurately investigating MASLD onset in children with T2DM where each condition influences and exacerbates the progression of the other. The review critically highlights the inadequacies of current screening strategies and diagnosis, stressing the need for a paradigm shift. A proposed solution involves the integration of hepatic magnetic resonance imaging assessment in the diagnostic arsenal for children showing insufficient glycaemic control and weight loss post-T2DM diagnosis, thereby complementing conventional liver enzyme testing. This holistic approach aims to significantly enhance diagnostic precision, fostering improved outcomes in this vulnerable high-risk pediatric population.

This study aimed to investigate the knowledge of patients with hypertension about their condition, adherence to antihypertensive medication, and the factors influencing it. A cross-sectional study was conducted in two cardiology outpatient clinics of two tertiary hospitals, in Greece. The study included 188 patients diagnosed with hypertension. The patient’s knowledge about their disease and adherence to medication were assessed by using the HK-LS and A-14 scales, respectively. Patients had sufficient knowledge levels about their disease, but significantly low levels of adherence to medication. Patients with higher knowledge levels were more adherent to medications [r(188) = 0.885, p < 0.001]. By using multivariate analysis, higher age (p = 0.018), residence in a more populous area (p = 0.041), more years with the disease (p = 0.012), and a lower number of medications (p = 0.03) were associated with higher levels of knowledge. Conversely, younger age (p = 0.036), lower educational levels (p = 0.048), fewer years with the disease (p = 0.001), and a higher number of medications (p = 0.003) were associated with lower adherence to medication. The Greek patients' hypertension knowledge was sufficient, however, adherence to medication was significantly low. Healthcare managers could utilize our findings to design targeted interventions for improving adherence to medication for these patients.

A vast amount of non-biodegradable waste is generated during mining and processing operations of dimensional stones such as marble. This, over the years has become a global nuisance by damaging the environment through means of more than one. Therefore it has become necessary to find a technique to safely dispose or reuse marble waste. This paper reviews the impact of replacement of the conventional materials by marble waste was studied in terms of fresh, mechanical and durability properties of concrete. The air pollution caused by the dust generated in the process of crushing and extracting marble can cause serious problems to the general physiological functions of plants and it affects human life as well. Therefore, the objectives of this study were to assess the air quality of areas with marble factories and areas without marble factories, where the concentration of particulate matter in terms of total suspended particles (TSP) was determined. This paper also reviews some eco-innovation options considering the pollution caused, consumption of water and electricity and the disposal of marble waste and their waste.

Cameroon introduced the malaria vaccine in its routine immunization programme on 22 January 2024, in the 42 districts out of 200, among the most at risk of malaria. A cross-sectional analysis of data on vaccine key events in the introduction roadmap and vaccine uptake during the first 30 days was conducted. In addition to available gray literature related to the introduction of the malaria vaccine, data on malaria vaccine uptake by vaccination session, collected through a digital platform, were analyzed. A total of 1,893 reports were received from 22 January 2024 to 21 February 2024 from 766 health facilities (85% of overall completeness). Two regions out of 10 recorded less than 80% of completeness. As of 21 February 2024, 13,811 children have received the first dose of the malaria vaccine, including 7,124 girls (51.6%) and 6,687 boys (48.4%). Thirty six percent of children were vaccinated through outreach sessions versus 61.5% through sessions in fixed posts. The overall monthly immunization coverage with the first dose was 37%. Early results have shown positive attitudes towards and acceptance of malaria vaccines. Suboptimal completeness of data reporting and low coverage highlight persistent gaps and challenges in vaccine rollout.

To investigate the impact of electrode structure on Electrical Stimulation Therapy (EST) for chronic wound healing, this study designed three variants of flexible microelectrodes (FMs) with Ag-Cu coverings (ACCs), each exhibiting distinct geometrical configurations: hexagonal, cross-shaped, and serpentine. These were integrated with PPY@PDA/PANI (3/6) hydrogel dressings. Comprehensive animal studies, coupled with detailed electrical and mechanical modeling and simulations, were conducted to assess their performance. Results indicated that the serpentine-shaped FM outperformed its counterparts in terms of flexibility and safety, exhibiting minimal thermal effects and a reduced risk of burns. Notably, FMs with metal coverings under 3% demonstrated promising potential for optoelectronic self-powering capabilities. Additionally, simulation data highlighted the significant influence of hydrogel non-uniformity on the distribution of electrical properties across the skin surface, providing critical insights for optimizing EST protocols when employing hydrogel dressings.

Background: The purpose of this review is to clarify the natural course of Benign Paroxysmal Torticollis (BPT) and to update the relationship of this disorder with migraine. BPT belongs to a group of “episodic syndromes that may be associated with migraine” and is diagnosed when according to diagnostic criteria of the International Classification of Headache Disorders, 3rd edition. It is present in infants and young children and it is an underdiagnosed manifestation, because it is not well recognized and in most cases with a benign evolution, but requires careful differential diagnosis. It was first described by Snyder in 1969 as a movement disorder, a cervical dystonia consequent to labyrinthic disorder.Materials and methods: The PubMed and Web of Science databases were consulted from 1968 to 2024, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines ,2020.( PRISMA)Results: 113 articles were identified, 86 selected and 20 considered for the purpose of this review. The clinical studies were considered in relation to evolution, cognitive and motor development, to genetic and not genetic etiology, to the relationship with migraine with and without aura, vestibular migraine, hemiplegic migraine, and paroxysmal vertigo.

Malaria remains a public health challenge in low- and middle-income countries (LMICs). Despite gains from strategies like Insecticide Treated Nets (ITNs) and Intermittent Preventive Treatment during pregnancy (IPTp), significant socioeconomic inequalities persist, particularly among pregnant women and children under five. This study analysed temporal and socioeconomic inequalities in malaria prevention in sub-Saharan Africa (SSA). Methods: Nationally representative Demographic Health Surveys from 10 SSA countries were used, comparing two time periods. Changes in ITN use by pregnant women and children under five, as well as IPTp coverage, were assessed. Inequalities based on socioeconomic status (SES) and residence were analysed using the Erreygers Normalized Concentration Index and Theil index.. Results: Results revealed significant variability in ITN use and IPTp coverage between and within countries. Eight countries showed improvements in ITN use during pregnancy, with Nigeria seeing a 173.9% increase over five years. Burkina Faso and Tanzania consistently reported high ITN use (~87%) in children under five. IPTp coverage increased in all countries except Kenya. Decomposition using the Theil index indicated that within-group inequalities, particularly based on SES and residence, were the primary drivers of disparities. Conclusion: To ensure progress toward universal health coverage, malaria prevention programs must prioritize vulnerable populations and be continuously evaluated.

The immune response is crucial in Pregnancy Loss (RPL), which affects 1-2% of women. In RPL, peripheral blood lymphocytes and local immune cells are activated with a concomitant decrease in the leukocyte tolerogenic response in the uterus and decidua. IL-17 plays an essential role in T cell activation, weakening tolerogenic responses of the T cells. The report aims to analyze the IL-17 genetic polymorphism, circulating IL-17 lymphocyte populations, the reaction upon lymphocyte priming, the amount of cytokine in serum, and the number of T-reg cells in a group of 50 RPL and 50 normal women from the admixed Venezuelan population. No differences were observed in the genetic polymorphisms rs2275913 and rs763780. A significant decrease (P<0.001) was observed in RPL patients compared to controls in the IL-17+ cell populations CD3+, CD8+, CD56+, and CD4CD25 FoxP3, but not in the CD4IL17+ cells. The response upon cell priming was significantly decreased (P<0.001) in all subpopulations of RPL as compared to controls. It is concluded that despite the increase in IL-17A in the serum of patients, the number of circulating IL-17 cells and the lymphocyte response to stimulation was significantly decreased (p<0.001). No differences in the genetic polymorphism compared to controls suggest that biological factors influence IL-17 levels in RPL patients, which must be carefully studied.

To evaluate the effectiveness of a dual approach involving time-restricted eating (TRE) at different times-of-day combined with physical activity (PA) on functional capacity and metabolic health in overweight or obese women. Random allocation of sixty-one participants into four groups: early time-restricted eating plus physical activity (ETRE-PA, n=15, 31.8±10.56 years, 89.68±10.56 kg, 33.5±5.53 kg/m²), late time-restricted eating with physical activity (LTRE-PA, n=15, 30.60±7.94 years, 94.45±15.36 kg, 34.37±7.09 kg/m²), late time-restricted eating only (LTRE, n=15, 27.93±9.79 years, 88.32±10.36 kg, 32.71±5.15 kg/m²) and a control group (CG, n=15, 36.25±11.52 years, 89.01±11.68 kg, 33.66±6.18 kg/m²). The intervention lasted 12 weeks for all groups. Both ETRE-PA and LTRE-PA groups engaged in a rigorous combined aerobic and resistance-training program. Significant reductions in body weight and body mass index were observed in ETRE-PA and LTRE-PA compared to CG and LTRE groups in post-intervention (p<0.0005). Only ETRE-PA group exhibited a significant decrease in fat mass (p=0.02), low-density lipoprotein cholesterol (p=0.01) and aspartate aminotransferase (p=0.002). Significant reductions in alanine aminotransferase levels were observed in ETRE-PA (p=0.004) and LTRE-PA (p=0.02) groups. These two latter groups achieved higher performances in the 6-min walking test, bench press, 30-second squat, crunch test, vertical jump (p<0.0005 for both) and leg extension (p<0.02 for both) when compared to LTRE and CG groups. In conclusion, the integration of TRE with PA leads to greater improvements in body composition, lipid profile, and physical performance with no significant differences between ETRE-PA and LTRE-PA approaches. This combined strategy offers a promising solution in overweight or obese women.

To advance probiotic research, a comprehensive understanding of bacterial interactions with human physiology at the molecular and cellular levels is fundamental. Lacticaseibacillus rhamnosus LGG® is a bacterial strain that has long been recognized for its beneficial effects on human health. Probiotic effector molecules derived from LGG®, including secreted proteins, surface-anchored proteins, polysaccharides, and lipoteichoic acids, that interact with host physiological processes have been identified. In vitro and animal studies have revealed that specific LGG® effector molecules stimulate epithelial cell survival, preserve intestinal barrier integrity, reduce oxidative stress, mitigate excessive mucosal inflammation, enhance IgA secretion, and provide long-term protection through epigenetic imprinting. Pili on the cell surface of LGG® promote adhesion to the intestinal mucosa and ensure close contact to host cells. Extracellular vesicles produced by LGG® recapitulate many of these effects through their cargo of effector molecules. Collectively, the effector molecules of LGG® exert a significant influence on both the gut mucosa and immune system, that promotes intestinal homeostasis and immune tolerance.

The global population is at risk of vitamin D deficiency due to low exposure to sunlight and low intake of the vitamin through diet. The aim was to investigate in women the association between vitamin D status and parathyroid hormone (PTH), ultraviolet radiation, lifestyle, ethnicity, social conditions, and residential greenness. A 1-year longitudinal study assessed vitamin D status in 309 women, latitude 51° 14' N. Blood samples were taken four times throughout the year for analysis of 25(OH)D and serum PTH concentration. After each seasonal visit, the individuals completed 4-day diet diaries and used two dosimeter badges for 1 week to estimate weekly UVR exposure. A questionnaire was applied to provide information about lifestyle and their ethnicity. Residential greenness was measured by Normalized Difference Vegetation Index (NDVI), within a 1000 m radius around each participant’s home address. Women living in greener spaces were more likely to have improved vitamin D status (RR: 1.51; 95%CI: 1.13 – 2.02), as well as those who were more exposed to UVR (RR: 2.05; 95%CI: 1.44 – 2.92). Our results provided a first insight into the connection between vitamin D, residential greenness, and lifestyle in a region of temperate climate and with a high degree of urbanization.

Diabetic cardiac autonomic neuropathy (DCAN) is a severe complication of type 1 diabetes mellitus (T1DM) characterized by autonomic nerve fiber dysfunction in the heart and blood vessels. This study aimed to elucidate the histopathological mechanisms underlying DCAN and evaluate the therapeutic potential of MCC950, an NLRP3 inflammasome inhibitor, in a Wistar rat model. Male Wistar rats were divided into control and T1DM groups, with diabetes induced by streptozotocin (STZ) injection. Following confirmation of DCAN through elevated serum noradrenaline levels, diabetic rats were subdivided into positive control (insulin-treated), treatment (MCC950), and untreated groups. The stellate ganglia, thoracic aorta, and left ventricle were dissected for histological examination using Haematoxylin and Eosin (H&E) and Masson Trichrome staining. STZ-induced hyperglycemia was evident by Week 2 and sustained throughout the study. Serum noradrenaline levels significantly increased by Week 14 in diabetic rats, indicating DCAN onset. Histological analysis revealed atrophy in stellate ganglia, endothelial damage in the thoracic aorta, and myocardial fibrosis in untreated diabetic rats. MCC950 treatment preserved ganglionic structure, mitigated vascular damage, and reduced myocardial fibrosis, demonstrating its potential in attenuating DCAN progression. These findings highlight MCC950 as a promising therapeutic agent for DCAN by targeting inflammation and preserving autonomic and cardiovascular function. Further investigations are warranted to validate MCC950’s efficacy in human trials, with the potential to improve clinical outcomes for T1DM patients at risk of DCAN.

This paper presents a co-designed solution aimed at improving community healthcare assistance management. To enhance patients’ self-awareness of their health status, encouraging active participation in care process, and to support nurses in delivering patient-centered care, we have developed an innovative platform with a highly customized app. This platform was designed using a multi-disciplinary bottom-up approach. Patient data collection and processing facilitate the automation of care timeline planning, based on real time patients’ needs and the available resources. To achieve this goal different components have been considered: real-time health data collection and processing, patient care planning, decision support for nurses, secure communication for data transmission, and user-friendly interfaces to ensure easy access to platform functionalities.

Mpox, formerly known as Monkeypox, is a rare viral disease initially discovered in Africa in 1958. Since its first identification, several outbreaks have occurred in various African nations. Recently, the global community has witnessed a resurgence in the number of Mpox cases reported worldwide, prompting the World Health Organization (WHO) to declare the ongoing multi-country outbreak a public health emergency in July 2022. This study reports on the first cases of Mpox detected in Khartoum State, Sudan, outlining the epidemiology, preparedness, and public health response to this new challenge. A total of 55 suspected cases were identified, with two confirmed cases. The clinical manifestations observed in these cases align with the classic skin rash typical of Mpox, presenting alongside symptoms like fever, headache, and joint pain. The findings underscore the need for heightened surveillance, early detection, and timely intervention to prevent the domestic spread of Mpox and its potential impact on public health. Continued global efforts are needed to support effective screening, diagnostic, and control measures, ultimately enhancing preparedness and response in the face of this emerging disease.

Two decades after the antiretroviral therapy (ART) introduction, several challenges still prevail in maintaining people living with HIV (PLHIV), even with "Test and Treat" and/or "Rapid Start of ART" initiatives, as well as the scale-up of ART worldwide to promote access and adherence to treatment. This review examined articles on ART adherence in Africa between 2016 and 2023, published in English and indexed in PubMed. A total of 16 articles out of 2415 were eligible and included for analyses. Overall, ART adherence rates in SSA regions ranged from 43% to 84%. Rates in the centre of the SSA region ranged from 58% to 80%, in the north from 50% to 83%, in the south from 77% to 84%, in the west from 43% to 60% and in the east from 69% to 73%. Most African countries use the self-report to assess treatment adherence, although unreliable. The main factors with negative influence on ART adherence were comorbidities, lack of motivation, socioeconomic difficulties or side effects. Conclusion: Adherence to ART is a good indicator for controlling the spread of HIV. It is important to overcome the barriers that make it difficult to comply with ART and reinforce the factors that facilitate the accession of medication.

In Pakistan, 2018 National Nutrition Survey reported 40% of under five children were stunted. This study assesses the effectiveness of nutritional supplementation in reducing stunting among under-five children in two rural districts in Sindh, Pakistan. This was a mixed-method quasi-experimental study with intervention and control population. 3397 and 3277 under-five children participated in the baseline and end-line surveys. Both study areas were matched for demographic and economic circumstances. The participants received nutrient supplements underpinned by nutrition behaviour change communication for appropriate complementary feeding practices and hand hygiene targeted at primary caregivers during the first 1000 days of an infant's life. The impact was assessed using the difference in difference analysis with kernel propensity score matching to adjust the differences among control and intervention populations.

Objectives: To rate the effects of low molecular weight hyaluronic acid (LMWHA) solution and high concentration oxygen (HCO) through a specific medical device (Caress Flow©), compared to topical administration of hyaluronic acid (HA) alone on symptoms of mild and moderate stress and mixed urinary incontinence in women with genitourinary syndrome of menopause (GSM). Methods: A total of 68 postmenopausal women were enrolled (from October 2021 to September 2023). Patients were separated in two groups: one group used therapy with LMWHA solution and HCO combined and the second group used therapy with HA alone. Patient Global Impres-sion of Improvement (PGI-I) as the first outcome was used. As secondary outcomes International Consultation on Incontinence Questionnaire - short form (ICIQ-SF) questionnaire and Internation-al Quality of Life (IQoL) questionnaire were used. Results: Sixty-eight (68) women, 35 (51%) and 33 (49%), were treated with LMWHA solution and HCO combined and HA alone for 10 weeks, respectively. 28 (80%) versus 7 (20%) women reported an improvement (PGI-I score ≤3) of the symptoms in LMWHA solution and HCO com-bined group versus HA alone group. According to the ICIQ-SF, a statistically significant differ-ence was recorded after treatment between the two groups (median, 7 [5-11] vs 10 [8-11]; P = 0.03). According to the IQoL questionnaire, a statistically significantly lower median score was recorded in the LMWHA solution and HCO combined compared with the HA group, before (71 [IQR 55-81] vs 89 [IQR 67-94]; P < 0.01) and after (78 [IQR 65-86] vs 88 [IQR 72-99]; P = 0.04) treatment. Conclusions: LMWHA solution and HCO combined might improve the mild and moderate stress and mixed urinary incontinence in this set of women and that it is superior to HA therapy alone. However, these results need to be confirmed in further studies with a controlled design and a larger population.

Determination of antibody titre of dogs vaccinated against canine distemper in Jos North and South local Government Areas of Plateau State was carried out by collection of sera of vaccinated dogs and administration of well-structured questionnaires to dog owners. The samples collected were analyzed using the immune-blot ELISA Kit to determining the antibody titre (immunoglobulin G). It indicated that dogs vaccinated against the disease mounted adequate protective immunity. The result revealed that 54 (90.0%) of the sampled dogs have protective immunity, with those given more than one dose having higher level of protective antibody. Statistically, the result showed that the antibody titre did not differ significantly in relation to immunity and sex, breed, age and location but significant difference was seen in relation to number of primary vaccination. The result also revealed that those dogs that received booster doses (secondary vaccination) had more protective antibody. The study was aimed at evaluating the antibody titre of dogs vaccinated against canine distemper in Jos, Plateau State.

This study represents a significant stride in advancing furan chemistry, presenting the synthesis of high-molecular-weight polyfurfuryl alcohol (PFA) resin (Mw = 118,959 g/mol) from furfuryl alcohol (FA) using a co-catalytic system as against the conventional single-catalytic methods. The resulting PFA resin is fully characterised, and we conclude that it exhibits good shelf life and potential in diverse applications, serving as a standalone moulded material or contributing to composites, coatings, adhesives, and nanostructured carbons.

Background/Objectives: The aim of the narrative review was to identify information on the impact of technological interventions (such as telehealth and mobile health) on the health promotion of cardiac patients from diverse populations; Methods: Online databases of PubMed, and Cochrane Library were searched for articles in the English language regarding technological interventions for health promotion in cardiac patients. In addition, a methodological quality control process was conducted. Exclusion was based on first reading the abstract and then the full manuscript confirming content was not related to cardiac patients and technological interventions; Results: 11 studies were included in the review after quality control analysis. The sample size reported in these studies ranged from 12 to 1424 subjects. In 8 studies mobile phones, smartphones and apps were used as mHealth intervention with tracking and texting component; 2 studies used videoconferencing as a digital intervention program, while one study focused on using physical activity trackers; Conclusions: This review highlights the digital divide as individuals with limited eHealth literacy and lack of technological knowledge are not motivated or able participate in these interventions. Finding methods to overcome these barriers are important and can be solved to some extent by providing the technology and technical support.

Polycystic Ovarian Syndrome (PCOS) is a common endocrine condition that affects 8–13% of women of reproductive age and is one of the leading causes of anovulation and infertility. In Kazakhstan, the prevalence of this syndrome is particularly high compared to other countries and the global average. Currently, the diagnosis of polycystic ovarian syndrome is based on internationally established Rotterdam criteria, using hyperandrogenism, i.e. high testosterone levels, as a key parameter. These criteria are applied to diagnose PCOS in all female patients, although obese patients may have excess testosterone produced by adipose tissue. To avoid possible false PCOS diagnoses, an additional criterion could be considered to diagnose PCOS among obese women. Anti-Müllerian hormone (AMH) is promising as a more effective diagnostic criterion, since its level represents the state of the ovarian reserve and adipose tissue does not produce AMH. Therefore, the use of AMH instead of hyperandrogenism as a diagnostic criterion for PCOS among obese women might improve diagnostic precision and patient treatment. In this study, data on the levels of various hormonal indicators such as estrogen, progesterone, and others were analyzed for a large cohort of female patients with and without PCOS to explore possible correlations between these indicators, AMH, and testosterone. The findings suggest that the absence of a negative correlation between AMH and follicle-stimulating hormone (FSH), and a positive correlation of AMH with testosterone could support the use of AMH as a reliable additional criterion for PCOS diagnosis among obese women.

Leading and lagging Key performance indicators (KPIs) provide a means for assurance that risk control systems, to prevent or limit major hazards. The relative importance degree of KPIs provides a theorical guidance for monitoring, inspection and maintenance of structural integrity. In this paper, structural integrity KPIs are classified into leading and lagging KPIs based on Bowtie methodology and the importance degree of the KPIs are evaluated by weight calculation on the basis of Fuzzy analytical hierarchy process (FAHP).

Chronic exposure to the nephrotoxic metal pollutant, cadmium (Cd), has been associated with hypertension, but the mechanism by which it raises blood pressure is not understood. We hypothesize that exposure to Cd reduces the glomerular filtration rate (GFR), which in turn, causes a rise in blood pressure. Data were collected from 447 Thai subjects with a mean age of 51.1 years, of which 48.8% had hypertension, 15.4% had diabetes and 6.9% had an estimated GFR (eGFR) below 60 mL/min/1.73 m2 (low eGFR). The mean blood and urinary Cd concentrations were 2.75 and 4.23 µg/L, respectively. The prevalence odds ratio (POR) for hypertension rose twofold in those with blood Cd levels of 0.61-1.69 µg/L or urinary Cd excretion levels ≥ 0.98 µg/g creatinine. In the hypertensive group, the eGFR was inversely associated with age (β =−0.517), the Cd excretion rate (β = −0.177), and diabetes (β = −0.175). Mean eGFR in the normotensive group was 7.5 mL/min/1.73 m2 higher than the hypertensive with a similar Cd body burden. Mean systolic blood pressure (SBP) in those with low or medium eGFR plus heavy Cd body burden was 9.5 mmHg higher than those with the same Cd body burden and a normal eGFR. By mediation analysis, a 22.7% increase in SBP and a 5% increase in diastolic blood pressure (DBP) were attributable to the effect of Cd on GFR. Thus, a rise of blood pressure appears to be a consequence of GFR loss due to Cd-induced kidney damage. This finding is consistent with a well-known role of the kidney in long-term blood pressure regulation.

Background: Rabies, a zoonotic disease caused by the Lyssavirus genus, is widely distributed and a significant cause of human death in Africa and Asia. This study aimed to investigate human rabies exposure and associated risk factors in Northwest Ethiopia. Methods: The study encompassed four zones, seven districts, and four kebeles from each district. The research team developed a questionnaire for data collection. Results: A total of 642 households were interviewed. The present study highlighted an exposure to rabies of 10.47%.”. Over 98% of residents displayed a strong understanding of rabies, with 99.69% correctly identifying rabies as a zoonotic disease. However, 80.22% of the interviewees believed that traditional medicine can treat the disease. Only 21.93% of victims were subjected to post-exposure prophylaxis. More than 87% of exposed residents were affected by the dogs. Of that, 48.70% were bitten by their own dogs. Metema district had the highest risk of exposure (p < 0.001) compared to the other six that were investigated. Dog ownership (p<0.05) and a higher number of households (p<0.01) were also identified as risk factors for rabies exposure. Conclusion: Residence, low education levels, high household density, free-roaming dogs, and dog ownership are key risk factors for rabies exposure. Public health awareness campaigns are crucial to emphasize the risks associated with animal bites.

This study investigates Autism Spectrum Disorders (ASD) in Greece, focusing on estimating prevalence and identifying regional disparities in children aged 4 to 7 years. Utilizing a quantitative, descriptive, and exploratory methodology, the research employed a structured questionnaire to gather extensive maternal and child health data. The sample consisted of 517 mothers of children diagnosed with ASD from all over Greece contributing to a nuanced understanding of ASD predictors. The study aims to elucidate the role of prenatal factors in the likelihood of an ASD diagnosis and their impact on the subsequent functionality of children with ASD. The study identified significant predictors of lower functionality in children with ASD, including higher maternal age, delayed ASD diagnosis, lower family income, and higher birth order. Prenatal health issues, such as vaginal bleeding and infections, also influenced functional outcomes. Notably, a family history of neurological or psychiatric conditions appeared protective. The regression model demonstrated robust predictive power, underscoring the complexity of genetic, environmental, and socioeconomic factors in ASD development. The findings advocate for early diagnosis and intervention, systematic screening, and addressing socioeconomic disparities to improve functional outcomes. The results support evidence-based service development and policy adjustments to enhance early identification, intervention, and rehabilitation for children with ASD. Establishing standardized case-recording procedures and an ASD register at national and regional levels is recommended for systematic monitoring and resource evaluation.

Vaccination, particularly against pneumoccus and influenza, is a low-cost primary prevention, useful to avoid hard complications, particularly among frail older people. In this study, we aimed to assess the effect of a strategy for influenza and pneumococcal vaccination for outpatients, never practiced before, evaluating what could stimulate or demotivate vaccination among older people. This study was conducted during the 2023-2024 influenza season at the outpatient clinics of the Geriatrics section, University Hospital of Palermo (Italy). A total of 101 vaccinations were carried out. Half of the patients could be considered as pre-frail and about 20% frail, according to a comprehensive geriatric evaluation. Among participants, 46.3% received only vaccination against Pneumococcus and 26.8% only anti-influenza or the combination of anti-pneumococcus and anti-influenza. Compared with the previous seasons, a 19.5% increase of influenza and 90.2 % of pneumococcal vaccine uptake was observed. Side effects of vaccination were the main reason of the previous rejections, namely 74.8% for influenza and 29.5% for anti-pneumococcal vaccination. In conclusion, our study indicates how a new vaccination strategy in different settings is possible. Proposing influenza and pneumococcal vaccination for outpatients could be an effective instrument to improve immunization coverage that is still low among older people.

Background/Objectives: This study aimed to compare the diagnostic accuracy of the Wells and Geneva scores, used with a 500 ng/mL D-dimer cutoff, along with the age-adjusted D-dimer (AADD), YEARS, and PEGeD algorithms in patients with and without COVID-19. The performance of various D-dimer thresholds was also evaluated. Methods: This retrospective study included patients who presented to the emergency department and underwent computed tomography pulmonary angiography (CTPA) for suspected pulmonary embolism (PE). The diagnostic performance of clinical prediction algorithms was compared between two groups. Results: We analyzed data from 1423 patients; PE diagnosis and COVID-19 positivity rates were 7.3% and 69.9%, respectively. In patients with COVID-19, the Wells score with a 500 ng/mL D-dimer threshold exhibited 97.22% sensitivity (95% CI: 80.53–100.00) and 4.99% specificity (95% CI: 3.58–6.39). Using AADD increased the specificity to 7.81% (95% CI: 6.08–9.54) while maintaining sensitivity at 97.22% (95% CI: 93.43–100.00); similar results were observed for the Geneva score. The YEARS algorithm exhibited 86.11% sensitivity (95% CI: 78.12–94.10) and 32.75% specificity (95% CI: 29.73–35.78), whereas the PEGeD algorithm exhibited 86.11% sensitivity (95% CI: 78.12–94.10) and 34.06% specificity (95% CI: 31.00–37.12). The YEARS and PEGeD algorithms demonstrated better performance in patients with COVID-19 in terms of specificity and accuracy. Conclusion: COVID-19 infection did not significantly affect the diagnostic performances of the clinical algorithms for PE. YEARS and PEGeD performed better in patients with COVID-19, making them preferable. Higher D-dimer thresholds improved specificity but increased the risk of missed PE diagnoses.

Introduction: Decreasing overweight and obesity prevalence requires precise data at sub-national levels to monitor progress and initiate interventions. This study aimed to estimate baseline age-standardized overweight prevalence at the lowest administrative units among women, 18 years and older, in seven African countries. The study aims are synonymous with indicator 14 of the global non-communicable disease monitoring framework. Methods: We used the most recent Demographic and Health Survey and administrative boundaries data from the GADM. Three Bayesian hierarchical models were fitted and model selection tests implemented. The age-standardized prevalence of overweight among adult women at national, first and second administrative levels were individually reported in each country in the form of maps and tables. Results: Substantial variation in the age-standardized prevalence of adult female overweight was noted across several second-level administrative units. In numerous locations in Tanzania, Nigeria and Zimbabwe, more than half of the adult female population were overweight and in one location in Tanzania, over 72% of the adult female population were overweight. These estimates were roughly twice the national level overweight prevalence and, in some cases, roughly 10 – 20% greater than the overweight prevalence in first-level administrative units. Conclusion: The observed overweight burden in subnational administrative units suggests the presence of an epidemic tantamount to the situation in more affluent economies. African countries lack the resources to effectively handle the fallout from such epidemic, therefore motivating the need for increased urgency in adopting WHO obesity-related intervention guidelines and implementing more rigorous studies to validate the study findings.

Literature pertaining to youth development has identified the importance of understanding the physical, intellectual and emotional needs of adolescent youth. The purpose of this study was to compare the use of a ‘traditional’ and ‘progressive’ coaching style to train a general male youth population to improve sprint and jump performances, whilst assessing enjoyment to comment on long term application. Maximal sprint times, sprint kinematics, unilateral jump distances and repetitive tuck jump scores were measured alongside anthropometric variables to characterise performance. Results revealed significant (p>0.05) pre/post differences in anthropometric variables across all maturation groups, and each of the maturational levels displayed a tendency to favour a particular coaching or control condition. Pre-PHV groups responded most effectively to the progressive style of coaching, displaying improvements in horizontal jump performances, and -0.7 to -2.7% improvements in all sprint times, despite also showing the largest increase in tuck jump scores (25.8%). The circa-PHV group produced their greatest improvements in the traditional intervention, as displayed through significant improvements (p<0.05) in 20m sprint times and dominant-leg horizontal jump performance, whilst also revealing the greatest deterioration in tuck jump scores (14.2%). Post-PHV displayed the greatest improvements in the control setting, suggesting the natural benefits gained through adolescent development were greater than the influence of the training interventions. In conclusion, it is suggested that matching coaching strategies and delivery techniques to the period of biological maturation may have implications for both performance and athlete safety.

Increasing awareness of the potential health risks associated with microplastics (MPs) presence in the environment has led to significant rise in research focused on these particles over the past few years. This review focuses on research on MPs presence and spread, pathways of exposure and toxicological effects on human health and legal framework related to MP challenges. Several research projects have aimed to assess their potential harm to human health. Toxicological effects have been noticed at high concentrations of MPs, specifically polystyrene, the most widespread typical MP, but only short-term effects have been mostly studied. Significant quantities of consumed MP have been discovered to have diverse detrimental effects, posing a threat to human welfare. The exact concentrations of microplastics that are inhaled and swallowed and then build up in the human body are still not known. Further investigation is necessary to evaluate the impact of MP contamination at minimal concentrations and for prolonged durations.

How hands-on gardening impacts behaviors including healthy eating and physical activity during early childhood can be of critical importance for preventing early onsets of obesity. This research investigates how participating in hands-on gardening impacts preschoolers’ (3-5 years old) physical activity (measured by accelerometers) in childcare centers in the Semi-Arid Climate Zone. The research was conducted in eight licensed childcare centers located in West Texas with 149 children (n=149). Four childcare centers in the experimental group received hands-on garden interventions; the other four in the control group did not. In both experimental (intervention) and control (non-intervention) centers, children wore Actigraph GT3X+ accelerometers continuously for 5 days before and for 5 days after intervention (a total of 10 days). Results show that the duration of sedentary behavior of children in the experimental (intervention) group significantly decreased compared to children in the control (non-intervention) group. The finding suggests that the positive effects of childcare hands-on gardening on physical activity extend to semi-arid climate zones where gardening is challenging due to high temperatures and lack of annual rainfall. The research emphasizes the critical need to incorporate hands-on gardening in childcare centers as an obesity prevention strategy nationally in the U.S. and beyond.

Background: Cardiovascular diseases (CVDs) and their risk factors are increasing with associated disability and mortality burden globally, especially in low- and middle-income countries, including Cameroon. Physiotherapist-led health promotion (PLHP) interventions provide opportunities to improve health and reduce this burden. Understanding physiotherapists' practice, confidence, and perception is crucial for designing effective, context-specific PLHP interventions. Methods: This qualitative study explored physiotherapists' practice, perceptions, and confidence in delivering PLHP to pwCVDs in Cameroon. Results: Sixteen participants completed the interviews and analyses of the transcripts generated three main themes which included 1) Perception of Physiotherapists’ role in health promotion (HP), 2) Current practice of PLHP 3) Competence in delivery of PLHP. Physiotherapists believe that delivering HP interventions in practice is within their professional role. Current HP practice was limited to exercise, physical activity and dietary/nutritional interventions. Participants reported a lack of knowledge and formal training in PLHP delivery. Conclusion: Despite strong interest in HP, HP practice among physiotherapists is limited in scope, under-resourced and limited by a lack of confidence in delivering behavioural change interventions. These findings are relevant for the design of appropriate clinical training and policies for the care of pwCVDs.

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial for designing effective, context-specific PLHP interventions. This study explored patients' views, experiences, perceived usefulness, acceptability, and preferred methods of PLHP through a sequential explanatory mixed-methods approach. The quantitative data highlights a significant burden of CVD conditions and risk factors among patients seen in physiotherapy services. Qualitatively, three themes were identified and included: 1) perspectives and experiences of people at risk or with CVDs (pwCVDs) on PLHP; 2) Perceived usefulness and acceptability of PLHP; 3) Preferred delivery methods of PLHP. Participants reported positive feedback on PLHP and physiotherapy services. Barriers to effective PLHP included high workloads for physiotherapists, limited service access in rural areas, and prohibitive costs. Despite these challenges, participants expressed strong confidence in physiotherapists' competence, though they also called for improved regulation and ongoing professional development. PLHP components, especially physical treatment and dietary advice, were deemed highly useful and acceptable. Patients suggested various delivery methods, including peer support groups, home visits, and mass media interventions. This study highlights the need to improve the scope of practice, competence of physiotherapists and accessibility of physiotherapy services in Cameroon for pwCVDs. It is necessary to adopt multidisciplinary approaches to achieve better outcomes for risk factors like diabetes and hypertension in context.

TThe passion of bodybuilding athletes for a symmetric, lean, heavily muscled body leads them to carry out exhausting exercise programs and restrictive eating regimens, sometimes resulting in disordered eating behaviors. This study investigates potential exacerbators on the development of disordered eating in bodybuilding and strength athletes. The study involved 103 Cypriot bodybuilding athletes of both sexes, performing at three levels: professional, recreational and strength athletes. The Eating Attitude Test 26 (EAT-26) and The Three Factor Eating Question-naire (TFEQ-R21) were used to evaluate disordered eating and eating behaviors respectively. The current study was performed under the auspices of the Hellenic Center of Education & Treatment of Eating Disorders (KEADD). The degree of deviation between the perceived ideal body weight and the actual body weight was associated with increased risk of eating disorder. Athletes who desired a lower body weight recorded higher scores on EAT-26 overall, (p=0.001), and the subscales of dieting (p=0.01) and bulimia. (p=0.001). Cognitive restraint and emotional eating scales of TFEQ-R21 were more pronounced in the non-professional athletes. (p=0.01). The emotional eating score was higher in women. There is a need for appropriate sport-specific, gender-specific preventive intervention to deescalate the risk of eating disorder, in both profes-sional and non-professional bodybuilding athletes.

Fucoidan is a brown algae-derived polysaccharide having several biomedical applications. This study simultaneously compares the anticancer activities of crude fucoidans from Fucus vesiculosus and Sargassum filipendula, and effects of low (LMW, 10-50kDa), medium (MMW, 50-100kDa) and high (HMW, >100kDa) molecular weight fractions of S. filipendula fucoidan against osteosarcoma cells. Glucose, fucose and acid levels were lower and sulphation was higher in F. vesiculosus crude fucoidan compared to S. filipendula crude fucoidan. MMW had highest the levels of sugars, acids and sulphation among molecular weight fractions. There was a dose dependent drop in focal adhesion formation and proliferation of cells for all fucoidan-types, but F. vesiculosus fucoidan and HMW had the strongest effects. G1-phase arrest was induced by F. vesiculosus fucoidan, MMW and HMW, however F. vesiculosus fucoidan treatment also caused accumulation in sub G1-phase. Mitochondrial damage occurred for all fucoidan-types, however F. vesiculosus fucoidan led to mitochondrial fragmentation. Annexin V/PI, TUNEL and cytochrome c staining confirmed stress induced apoptosis-like cell death for F. vesiculosus fucoidan but features of stress-induced necrosis-like cell death for S. filipendula fucoidans. There was also variation in penetrability of different fucoidans inside the cell. These differences in anti-cancer activity of fucoidans are applicable for osteosarcoma treatment.

The global polyvinyldene flouride market is estimated to reach $937,278.5 thousand by 2019, therefore to develop new membranes and gain pioneering ideas, which could create innovative business opportunities, a fundamental knowledge about membrane properties fabricated from recent commercially available PVDF polymers is highly mandatory. In this study, we successfully prepared nine non-woven supported PVDF membranes using a phase inversion precipitation method starting from a 15 wt% PVDF solution in N-methyl-2-pyrrolidone. Various membrane morphologies were obtained by using (1) PVDF polymers with diverse molecular weight in a range from 300.000 Da to 700.000 Da and (2) different temperatures of the coagulation bath (20, 40, and 60 ±2°C) used for the films precipitation. Environmental Scanning Electron Microscope (ESEM) was used for surface and cross-section morphologies characterization. Atomic Force Microscope (AFM) was employed to investigate surface roughness, while Contact Angle (CA) instrument was used for membranes wettability studies. Fourier Transform Infrared Spectroscopy (FTIR) results show that the fabricated membranes are formed by a mixture of TGTG’ chains in α phase crystalline domains and all-TTTT trans planar zigzag chains characteristic to β phase. Moreover, generated results indicate that the phases content and membrane morphologies depend on the polymer molecular weight and conditions used for the membranes preparation. The diversity of fabricated membranes could be applied by the End User Industries for different applications.

Abstract: Carbohydrates form the major source of energy in Asian diets. A lower carbohydrate diet became the recommended golden standard for healthy lifestyle. However, the effects of low-carbohydrates diet on health in apparently healthy individuals have been poorly studied, especially in relation to insulin resistance syndrome (IRS). A total of 120 healthy weight participants with no previous history of a major medical condition and an average BMI of ≤ 25kg/m2 were recruited. Self-reported dietary intake and objective physical activity by accelerometry were tracked for seven days. Participants were divided into three categories according to their dietary intake of carbohydrates. Blood samples were collected for metabolic markers analysis. HOMA of insulin resistance (HOMA-IR), β-cell function (HOMA-B) and C-peptide were used to evaluate glucose homeostasis. The consumption of low carbohydrates (less than 45% of total energy) significantly correlated with higher HOMA-IR, Lower HOMA-β % compared to moderate carbohydrate intake (between 45% to 65%). However, only the HOMA-β % was significantly influenced by carbohydrates intake. Moreover, low carbohydrates intake was significantly associated with elevated C-peptide secretion. The substitution of carbohydrates with other macronutrients, such as fat and proteins in the Atkins/ketogenic diet, resulted in a pronounced induction of IRS-related inflammatory markers; FGF2, IP-10, IL-6, IL-17A, MDC and reduction of IL-13. Overall, the presented data highlight, for the first time, that low carbohydrate intake results in significant glucose homeostasis imbalance that may be driven by a heightened state of inflammatory response.

This study aimed to investigate the efficacy of manual therapy and exercise versus synchronized telerehabilitation with self-manual therapy and exercise in treating Subacromial Pain Syndrome (SAPS). Sixty individuals diagnosed with SPS, aged 18-50 years, were randomly assigned to home exercise (HE), manual therapy (MT), and telerehabilitation (TR) groups. Treatment protocols were administered over 8 weeks and included specific exercises and therapy interventions. Out-come measures included Visual Pain Scale (VAS), shoulder range of motion (ROM) via gonio-metric measurements, Quick Disability Arm-Shoulder-Hand Problems Survey (Q-DASH), and patient satisfaction. Results revealed that both MT and TR groups exhibited reduced pain, in-creased ROM, lower Q-DASH scores, and higher patient satisfaction compared to the HE group. However, no significant differences were found between MT and TR groups in pain levels, ROM, Q-DASH scores, or patient satisfaction. The study concludes that both telerehabilitation and manual therapy effectively alleviate pain and are well-received by patients with SPS. Addition-ally, manual therapy demonstrates superiority in enhancing functional levels compared to exer-cise-based interventions. (Registration: NCT05200130)

In August 4 2011, United Nations Environmental Program (UNEP) submitted an unprecedented, scientific, groundbreaking Environmental Assessment Report (EAR) of Ogoniland, to the Nigerian government. This was the outcome of a 14–month intensive evaluation of the extent of pollution. It was intended that UNEP’s recommendations would be implemented to restore the devastated environment, on the one hand, and on the other, counteract the numerous environmental health issues that have for decades, plagued Ogoniland. However, five years post EAR, and, despite the seriousness of the situation, no significant resolution has occurred, both on the part of the government, and on the part of Shell Petroleum Development Company (SPDC) or Shell. To date, millions of Niger Delta residents, particularly those living in the oil-bearing communities, continue to suffer severe consequences. Although, the assessment was conducted in Ogoniland, other communities in the Niger Delta are also affected. This article explores prevailing issues, using Ogoniland (a microcosm of the Niger Delta) as an example. A multidisciplinary approach for sustainable mitigation of environmental health risks in the Niger Delta is paramount, and Environmental Management tools offer valuable strategies. Adopting UNEP’s recommendations for addressing environmental health problems requires implementing the Environmental Management/Environmental Management System (EM/EMS) model.

Background: Current management of COPD is predominantly focused on respiratory aspects. A multidimensional assessment including nutritional assessment, quality of life and disability provides a more reliable perspective of the true complexity of COPD patients. Methods: Prospective observational study of 120 elderly COPD patients at high risk of acute exacerbations. The Mini-Nutritional Assessment (MNA) was administered in addition to the usual respiratory assessment. The primary outcome was a composite of moderate or severe acute exacerbations during 52 weeks of follow-up. Results: The median MNA Short Form (SF) score was 11 (8-12), 39 participants (32.50%) had normal nutritional status, 57 (47.5%) were at risk of malnutrition and 24 (20%) were malnourished. Our multivariate linear logistic models showed that the MNA score was associated with dyspnea and respiratory symptoms severity assessed by the Modified British Medical Research Council (mMRC) and the COPD Assessment Test (CAT) score, with spirometric variables, in particular with the severity of airflow limitation based on the value of FEV1 and with poorer QoL as assessed by the EQ-5D-3 questionnaire. Cox regression analysis according to nutritional status based on the MNA score showed that COPD participants "at risk of malnutrition" and "malnourished" had a higher risk of moderate to severe acute exacerbations with a hazard ratio (HR) of 3.54 (p=0.002) and 8.20 (p=0.0001), respectively. Conclusion: Our study confirms the importance of assessing nutritional status in elderly COPD patients and its prognostic value.

The endometrium, the inner mucosal lining of the uterus, undergoes complex molecular and cellular changes across the menstrual cycle in preparation for embryo implantation. Transcrip-tome-wide analyses have mainly been utilized to study the endometrial receptivity, the prerequisite for successful implantation, with most of the studies, so far, comparing the endometrial transcriptomes between (i) secretory versus proliferative endometrium or (ii) mid-secretory versus early-secretory endometrium. In the current study, we provide the complete transcriptome description of the endometrium across the entire menstrual cycle and, for the first time, comprehensively characterize the proliferative phase of the endometrium. Our temporal transcriptome analysis includes five time points: mid-proliferative, late-proliferative (peri-ovulatory phase), early-secretory, mid-secretory, and late-secretory phases. Thus, we exhaustively unveil the transitions between the consecutive proliferative and secretory phases, highlighting their unique gene expression profiles and possible distinct biological functions. Transcriptome analysis reveals many differentially expressed genes (DEGs) across the menstrual cycle, most of which are phase-specific. As an example of the coordinated gene activity, the expression profile of his-tone-encoding genes within the HIST cluster on chromosome 6 showed an increase in cluster activity during the late-proliferative and a decline during the mid-secretory phase. Moreover, numerous DEGs are shared among all phases. In conclusion, in the current study, we delineate the endometrial proliferative phase-centered view of transcriptome dynamics across the menstrual cycle. Data analysis highlights significant transcriptomic and functional changes occurring during the late-proliferative phase – an essential transition point from the proliferative to the secretory phase. Future studies should explore how the biology of the late-proliferative phase endometrium impacts the achievement of mid-secretory endometrial receptivity or contributes to molecular aberrations leading to embryo implantation failure.

Background and Objectives. Prevalence of GERD is increased among individuals with obesity and RYGB is considered as the most effective procedure to control GERD and obesity. However, some patients continue to have GERD after RYGB. The aim of the study was to investigate the prevalence and the risk factors of GERD after RYGB. Material and Methods. This prospective study included 180 patients operated with RYGB and followed for on average of 12.2 (0.6) years. 126 (70%) patients agreed to participate in online consultations and provided data on weight, GERD symptoms, filled GERD-HRQL, TFEQ-18 and GSRS questionnaires. Results. The average age before surgery was 42.7 (10.5) years and BMI was 45.2 (6.4) kg/m2. 128 (71.1%) were females and preoperative GERD was diagnosed in 74 (41.1%) patients. At 12 years follow-up the mean %EBMIL and %TWL were 60.37 and 25.73, respectively. The median %WR was 18.0 (39.0). The GERD was present in 30 (23.8%) patients, of whom 12 (40%) continued to have GERD symptoms and 18 (60%) developed de novo GERD. The GERD-HRQL score significantly decreased from 3.0 (8.0) at baseline to 2.0 (5.0) (p=0.028) at 12 years. GSRS Diarrhea and Indigestion median scores increased significantly, from 1.33 (0.67) to 1.5 (2.42) (p 3.2.

Functional articular cartilage regeneration remains an unmet medical challenge, increasing the interest for innovative biomaterial-based tissue engineering (TE) strategies. Hydrogels, 3D macromolecular networks with hydrophilic groups, present articular cartilage-like features such as high water content and load-bearing capacity. In this study, 3D porous polyethylene glycol diacrylate (PEGDA) hydrogels were fabricated combining the gas foaming technique and an UV-based crosslinking strategy. The 3D porous PEGDA hydrogels were characterized in terms of their physical, structural and mechanical properties. Our results showed that the size of the hydrogels pores can be modulated by varying the initiator concentration. In vitro cytotoxicity tests showed that 3D porous PEGDA hydrogels presented high biocompatibility both with human chondrocytes and osteoblast-like cells. Importantly, the 3D porous PEGDA hydrogels supported the viability and chondrogenic differentiation of human bone marrow-derived mesenchymal stem/stromal cells (hBM-MSCs)-based spheroids as demonstrated by the positive staining of typical cartilage extracellular matrix (ECM) (glycosaminoglycans (GAGs)) and upregulation of chondrogenesis marker genes. Overall, the produced 3D porous PEGDA hydrogels presented cartilage-like mechanical properties and supported MSC-spheroid chondrogenesis, highlighting their potential as suitable scaffolds for cartilage TE or disease modelling strategies.

Maternal obesity has been found to be impaired oxidative status in placenta and newborn which can lead to adverse pregnancy outcomes and long-term adverse influence on metabolic programming in the offspring. This study aimed to investigate the role of maternal obesity on maternal and umbilical cord plasma oxidative status and placental oxidative adaptation. Maternal obesity (n=20) defined as pre-pregnancy BMI ≥ 25 kg/m² and maternal lean (n=20) defined as pre-pregnancy BMI < 25 kg/m² were recruited into this study. Both groups were matched by gestational age at delivery. Maternal blood, umbilical cord blood and placental tissue were collected to assess nutritional content (cholesterol, triglyceride, and protein), oxidative stress marker (MDA and protein carbonyl) and antioxidant activity (SOD and catalase). Placenta protein expression (SOD2, catalase, UCP2 and Nrf2) was evaluated by western blot analysis. Catalase activity in maternal plasma significantly increased in maternal obesity group (p = 0.0200) with an increased trend in MDA and protein carbonyl levels. Umbilical cord plasma triglyceride, protein carbonyl and catalase activity significantly increased in maternal obesity compared with that in maternal lean (p = 0.0462, 0.0485, and 0.0348, respectively). Although placenta protein expression analysis exhibited significant decreased SOD2 (p = 0.0169) and catalase (p = 0.0067), accompanied by Nrf2 downregulation (p = 0.0453). An increased mitochondrial antioxidant UCP2 expressions was observed (p = 0.0143). Hence, our study provided evidence that maternal obesity is associated with placental and fetal oxidative stress with the parallel increased placental antioxidant UCP2 expression.

The global antibiotic resistance crisis, driven by antibiotic overuse and misuse, is multifaceted. This study aimed to assess the microbiological and genetic characteristics of raw retail pork meat, including the isolation, antibiotic susceptibility testing (AST), whole genome sequencing (WGS) of selected indicator bacteria, antibiotic residue testing, and metagenomic sequencing. Samples were purchased from 10 randomly selected retail stores in Gauteng, South Africa. Samples were aseptically separated, with a portion sent to an external laboratory for isolating indicator bacteria and antibiotic residue testing. Identification of the isolated bacteria was reconfirmed using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). AST was performed using the Microscan Walkaway system. WGS and metagenomic sequencing were performed using the Illumina NextSeq 550 instrument. The isolated E. coli and enterococci exhibited little phenotypic resistance, with WGS revealing tetracycline resistance genes. Isolated bacteria and meat samples all harboured tetracycline resistance genes, and the antibiotic residue concentrations were within acceptable limits for human consumption. In the metagenomic context, most identified bacteria were of food/meat spoilage and environmental origin, with the resistome analysis primarily indicating beta-lactam, tetracycline and multidrug resistance genes. Further research is needed to understand the broader implications of these findings on environmental health and antibiotic resistance.

The skin, being the largest organ of the human body, serves as the primary barrier against external insults, including UV radiation, pollutants, and microbial pathogens. However, prolonged exposure to these environmental stressors can lead to the generation of reactive oxygen species (ROS), causing oxidative stress, inflammation, and ultimately, skin aging and diseases. Antioxidants play a crucial role in neutralizing ROS and preserving skin health by preventing oxidative damage. In recent years, nanotechnology has emerged as a powerful tool for enhancing the delivery of an-tioxidants onto the skin. In particular, liposomal formulations have offered unique advantages such as improved stability, controlled release, and enhanced penetration through the skin barrier. This has led to a surge in research focused on developing liposomal-based antioxidant delivery systems tailored for skin health applications. Through a comprehensive analysis of the literature from the 2019-2024 period, this review provides an overview of emerging trends in the use of liposomal delivery systems developed for antioxidants aimed at improving skin health. It explores the latest advancements in liposomal formulation strategies, vesicles characterization and their applications in delivering antioxidants to combat oxidative stress-induced skin damage and other associated skin pathologies.

Brain pathological changes impair cognition early in disease etiology. There is an urgent need for understanding aging-linked mechanisms of early memory loss to develop therapeutic strategies and prevent the development of cognitive impairment. Tusc2, also named Fus1, is a mitochondrial-resident protein regulating Ca2+ fluxes to and from mitochondria impacting overall health. We reported that Tusc2-/- female mice develop chronic inflammation and age prematurely, causing age- and gender-dependent spatial memory deficits at 5 m.o. Therefore, we investigated Tusc2-dependent mechanisms of memory impairment in mice, comparing changes in resident and brain-infiltrating immune cells. Interestingly, Tusc2-/- female mice demonstrated proinflammatory increase in astrocytes, IFN-γ expression in CD4+T cells and Granzyme-B in CD8+T cells. We also found fewer FOXP3+ T-regulatory cells and Ly49G+ NK and Ly49G+ NKT cells in female Tusc2-/- brain, suggesting a weakened anti-inflammatory response. Moreover, Tusc2-/- hippocampi exhibited Tusc2- and sex-specific protein changes associated with brain plasticity, including mTOR activation, and Calbindin and CamKII dysregulation affecting intracellular Ca2+ dynamics. Overall, data suggest that dysregulation of Ca2+-dependent processes and proinflammatory brain microenvironment heighten in Tusc2-/- mice could underlie cognitive impairment. Thus, strategies to modulate the brain’s Tusc2-, Ca2+, and mitochondria-dependent pathways should be explored to improve cognitive health.

Healthcare professionals constantly face situations that reflect ecosystems’ degradation. These can negatively affect their mental health. Research suggests that hope and resilience can play an important role in this scenario, since they are related to/predict mental health in highly heterogeneous samples (considering geography, age, profession, health, etc.). In this context, the aims of the present study are: to characterize and explore the relationship between hope, resilient coping and mental health of Portuguese healthcare professionals. Using Google Forms, 276 healthcare professionals answered to the GHQ-28, the (adult) Trait Hope Scale, and the Brief Resilient Coping Scale (cross-sectional study). The minimum and maximum possible scores were reached, with the exception of the maximum score of GHQ-28-Total. Regarding Hope, 19.6% scored below the midpoint (M=43.46, SD=11.97); 29.3% revealed low resilience (M=14.93, SD=4.05); and the average of 4 of the 5 Mental Health scores (exception: Severe Depression) indicates the probability of a psychiatric case. Hope correlated with Social Dysfunction and GHQ-28-Total; resilient coping proved to be a (weak) predictor of 4 of the 5 GHQ-28 indicators (exception: Severe depression). The results support the need to promote the sample's mental health, hope and resilient coping. They also suggest that stimulating resilient coping may contribute to improving healthcare professionals’ mental health.

Background: Asthma is a widespread chronic respiratory disease that poses a significant public health challenge. The current study investigated the associations between air pollution and asthma severity among individuals residing near the Sohar industrial port (SIP) in Oman. Despite the presence of multiple major industrial complexes in Oman, limited knowledge regarding their impact on respiratory health is accredited. Hence, the primary objective of this study is to offer valuable insights into the respiratory health consequences of industrial air pollution in Al Batinah North. Methods: The state health clinics' records for patient visits related to asthma were collected for the timeframe spanning 2014 to 2022. Exposure was defined as the distance from SIP, Majan Industerial Area (MIA) and Sohar Industerial Zone (SIZ) to determine high, intermediate, and low exposure zones (12 km, respectively). Exposure effect modifications by age, gender, and smoking status were also examined. Results: The conducted cross-sectional study of 410 patients (46.1% males and 53.9% females) living in over 17 areas around SIP revealed that 73.2% of asthmatics were under 50 years old, with severity significantly associated with closeness to the port. Risk ratios were estimated to be (RR:2.42; CI95%: 1.01–5.78), (RR:1.91; CI95%: 1.01–3.6), and (RR:1.68; CI95%: 0.92–3.09) for SIP, MIP and SIZ areas, respectively, compared to the control area. Falaj Al Qabail (6.4 km) and Majees (6 km) had the highest number of asthma patients (N. 69 and N. 72), and highest percentages of severe asthma cases among these patients (28% and 24%) with significant risk ratios (RR:2.97; CI95%: 1.19–7.45 and RR:2.55; CI95%: 1.00–6.48), correspondingly. Moreover, severe asthma prevalence peaked in the 25-50 age group (RR:2.05; CI95%: 1.26–3.33), and this linkage between asthma and age was much more pronounced in males than females. Smoking and exposure to certain contaminant (dust and smoke) increased also the risk of severe asthma symptoms, but their effects were less important in the high risk zone, suggesting much more important risk factor. A neural network model accurately predicted asthma risk (94.8% accuracy), with proximity to Sohar Industrial Port as the most influential predictor. Conclusion: The study highlights the High asthma burden near Sohar Industrial Port, linked to port proximity and smoking and wind direction as major risk factors. These findings inform vital public health policies to reduce air pollution and improve respiratory health in the region, prompting national policy review.

COVID-19 vaccine hesitancy and its enablers would shape community uptake of non-covid vaccines such as oral cholera vaccine (OCV) in the post-COVID-19 era. This study assessed the impact of COVID-19 vaccine hesitancy and its drivers on OCV hesitancy in a cholera endemic region of the Democratic Republic of Congo. We conducted a community-based survey in Bukavu. The survey included characteristics, intention to take OCV and COVID-19, reasons for COVID-19 hesitancy, and thinking and feeling about COVID-19 vaccines. Poisson regression analyses were performed. Of the 1708 respondents, 84.66% and 77.57% were hesitant to OCV alone and to both OCV and COVID-19, respectively. Hesitancy to COVID-19 vaccines rose OCV hesitancy by 12% (crude Prevalence Ratio, [cPR]=1.12, 95%CI[1.03-1.21]). Independent predictors of OCV hesitancy were living in semi-urban area (adjusted Prevalence Ratio [aPR]=1.10, 95%CI[1.03-1.12]), religious refusal of vaccines (aPR=1.06, 95%CI[1.02-1.12]), concerns about vaccine safety (aPR=1.05, 95%CI[1.01-1.11]) and adverse effects (aPR=1.06, 95%CI[1.01-1.12]), as well as poor knowledge (aPR=1.07, 95%CI[1.01-1.14]). Conversely, the belief about COVID-19 vaccine effectiveness reduced OCV hesitancy (aPR=0.76, 95%CI[0.62-0.93]). COVID-19 vaccine hesitancy and its drivers exhibiting a significant domino effect on OCV uptake. Addressing vaccine hesitancy through community-based health literacy interventions would likely improve the introduction of novel non-COVID-19 vaccines in post-COVID-19 era.

In July 2017, a family of three members; a 46-year-old male, a 45-year-old female and their 8-year-old daughter, returned to South Africa from Thailand. They presented symptoms consistent with mosquito-borne diseases, including fever, headaches, severe body aches and nausea. Mosquito bites in all family members suggested recent exposure to arthropod-borne viruses. Dengue virus 1 (Genus Orthoflavivirus) was isolated (isolate no. SA397) from the serum of the 45-year-old female via intracerebral injection in neonatal mice and subsequent passage in VeroE6 cells. Phylogenetic analysis of this strain indicated close genetic identity with cosmopolitan genotype 1 DENV1 strains from Southeast Asia, assigned to major lineage K, minor lineage 1 (DENV1I_K.1), such as GZ8H (99.92%) collected in November 2018 from China and DV1I-TM19-74 isolate (99.72%) identified in Bangkok, Thailand, in 2019. Serum samples from the 46-year-old male yielded a virus isolate that could not be confirmed as DENV1, prompting unbiased metagenomic sequencing for virus identification and characterization. Illumina sequencing identified multiple segments of a Mammalian orthoreovirus (MRV), designated Human/SA395/SA/2017. Genomic and phylogenetic analysis classified Human/SA395/SA/2017 as MRV-3 and assigned a tentative genotype MRV-3d based on the S1 segment. Genomic analyses suggested Human/SA395/SA/2017 may have originated from reassortments of segments among swine, bat, and human MRVs. The closest identity of the viral attachment protein σ1 (S1) was related to a human isolate identified from Tahiti, French Polynesia, in 1960. This indicates ongoing circulation and cocirculation of Southeast Asian and Polynesian strains, but detailed knowledge is hampered by limited availability of genomic surveillance. This case represents a rare concurrent importation of two distinct viruses with different transmission routes in the same family with similar clinical presentations. It highlights the complexities of diagnosing diseases with similar sequelae in travellers returning from tropical areas.

Nutritional status problems in school-age children are a crucial public health problem worldwide. This research explored the relationships between family factors, food consumption behaviors, and the nutritional status of Muslim school-age children in Thasala District, Nakhon Si Thammarat Province, Thailand. This descriptive research was conducted among 228 children aged 9-12 years. Data were collected using demographic data, nutritional status, and food consumption behaviors assessment. Data were analyzed using descriptive, chi-square, and binary logistic regression statistics. The results revealed that most samples reported having moderately healthy food consumption behaviors (M = 2.01, SD = 0.56). The samples had a normal weight (72.4%), while 15.8% were classified as overweight and obese. The number of siblings and food consumption behaviors had a significant relationship with nutritional status (p &lt; 0.05). Confirmation with binary logistic regression results also revealed that the likelihood of normal nutritional status was 2.40 times higher in children who had 3 or 4 siblings compared to those with 1 or 2 siblings (AOR = 2.40; 95% CI: 1.299-4.459). Additionally, children with healthy food consumption behaviors were 2.34 times more likely to have normal nutritional status compared to those with unhealthy dietary consumption (AOR = 2.34; 95% CI: 1.183-4.631). Conclusion: Since the number of siblings and healthy food consumption behaviors were associated with nutritional status, healthcare providers must consider these 2 factors when establishing health education and behavior modification care plans to promote healthy food consumption and nutritional status among this group.

Iron is an essential nutrient and necessary for biological functions from DNA replication and repair to transcriptional regulation, mitochondrial respiration, electron transfer, oxygen transport, photosynthesis, enzymatic catalysis, and nitrogen fixation. However, due to iron’s propensity to generate toxic radicals which can cause damage to DNA, proteins, and lipids, multiple processes regulate uptake and distribution of iron in living systems. Understanding how intracellular iron metabolism is optimized and how iron is utilized to regulate other intracellular processes is important to our overall understanding of a multitude of biological processes. One of the tools that the cell utilizes to regulate a multitude of functions is ligation of the iron-sulfur (Fe-S) cluster cofactor. Fe-S clusters comprised of iron and inorganic sulfur are ancient components of living matter on earth that are integral for physiological function in all domains of life. Here we will explore the ways in which the cell utilizes Fe-S clusters to sense the intracellular environment and respond to maintain equilibrium.

Minimizing optical losses in resonant cavities is crucial for improving photonic device performance. This study focuses on the development of a simulation tool to analyze scattering losses in Fabry-Pérot interferometers (FPI), offering precise modeling of waveguide dynamics and contributing to accurate loss predictions across various platforms. Optical cavities often suffer from scattering losses due to surface roughness and material defects. Our approach integrates theoretical models and simulations to quantify these losses, utilizing the FPI as a model system. We identified upper and lower reflectivity thresholds, beyond which accurate measurement of losses becomes unreliable. For reflectivity below a certain threshold, measurement errors arise, while excessively high reflectivity can reduce fringe visibility and introduce detector sensitivity issues. Simulations were used to validate the model's ability to predict reflectivity and attenuation in waveguides with varying loss levels. The software’s flexibility to adjust transmission parameters for different cavity configurations enhances its utility for a broad range of photonic systems. Our study offers a novel methodology for optical loss analysis, with practical applications in optimizing photonic devices. By providing a reliable tool for precise loss measurement, this work supports advancements in optical technologies, enabling the design of more efficient, high-performance devices across various applications.

Ecological changes evoke many felt losses and types of grief. These affect sustainability efforts in profound ways. Scholarship on the topic is growing, but the relationship between general grief research and ecological grief has received surprisingly little attention. This interdisciplinary article applies theories of grief, loss, and bereavement to ecological grief. Special attention is given to research about “non-death loss” and other broad frameworks about grief. Dynamics related to both local and global ecological grief are discussed. Kinds of potential losses arising out of ecological issues are clarified with the frameworks of tangible/intangible loss, ambiguous loss, nonfinite loss, and shattered assumptions. Various possible types of ecological grief are illuminated by discussing the frameworks of chronic sorrow and anticipatory grief/mourning. Earlier scholarship about disenfranchised ecological grief is augmented by further distinctions about various forms it may take. The difficulties in defining complicated or prolonged grief in ecological context are discussed, and four types of “complicated ecological grief” are explored. Based on the findings, three special forms of ecological loss and grief are named and discussed: transitional loss and grief, lifeworld loss, and shattered dreams. The implications of the results for ecological grief scholarship, counselling and coping are briefly discussed. The results can be used by psychological and healthcare professionals and researchers, but also by members of the public who wish to reflect on their eco-emotions.

Hearing loss stands as the most prevalent sensory deficit among humans, posing a significant global health challenge. Projections indicate that by 2050, approximately 10% of the world's population will grapple with disabling hearing impairment. While approximately half of these cases have a genetic etiology, traditional interventions such as hearing aids and cochlear implants do not completely restore normal hearing. The absence of biological treatment has prompted significant efforts in recent years, with a strong focus on gene therapy to address hereditary hearing loss. Although several studies have exhibited promising recovery of common forms of genetic deafness in mouse models, existing challenges must be overcome to make gene therapy applicable in the near future. Herein, we summarize the primary gene therapy strategies employed over past years, provide an overview of the recent achievements in the preclinical studies for genetic hearing loss, and outline the current key obstacles to cochlear gene therapy.

This study proposes a method for image matching between infrared(IR)-RGB images using a deep learning network to estimate the deformation field. We propose a deformation field generator (DFG) that estimates the deformation field of the transformation matrix to match each pixel or IR image to the RGB image. DFG is a network that receives IR and RGB images as input; the output size is two channels and has the sample resolution as the input image. By warping the IR image through a grid-sampler that warps the image according to the value of the deformation field, we can obtain a warped IR image that matches the RGB image. Additionally, to check whether the warped IR image matched the RGB image, the masking images detecting the segmentation of objects were photographed in two images. Without directly comparing IR and RGB images, we proposed mask loss that warps the IR mask image through the deformation field and grid sampler and then compares the warped IR mask image with the RGB mask image. Mask loss solves the spatial similarity comparison problem with multi-modality images, such as IR and RGB images, by comparing the mask image with the same modality image as the mask image.

A comparative analysis between Bidirectional Evolutionary Structural Optimization (BESO) and Smoothing-ESO (SESO), simultaneously considering Reliability-Based Topology Optimization (RBTO) and the structure's self-weight in the case of three-dimensional elasticity, is presented in this study. Due to the important role of the existence of uncertainties in making the structural design more realistic, geometry, volumetric fraction, modulus of elasticity, compliance, and loading are considered random variables with normal probability distribution. When adopting the First Order Reliability Method (FORM), the failure probability is calculated based on the reliability index. Furthermore, considering the influence of self-weight in problems involving large structures in civil engineering, especially in the case of bridges, makes the optimal configuration more reliable for design. A series of examples are covered to validate the methods presented, showing their efficiency and robustness.

Synthetic Aperture Radar has been extensively used in numerous fields and can gather a wealth of information about the area of interest. This large-scene data-intensive technology puts a high value on automatic target recognition (ATR) which can free the utilizers and boost the efficiency. Recent advances in artificial intelligence have made it possible to create a deep learning-based SAR ATR that can automatically identify target features from massive input data. In the last 6 years, intensive research has been conducted in this area, however, most papers in the current SAR ATR field used recurrent neural network (RNN) and convolutional neural network (CNN)-varied models to deepen the regime’s understanding of the SAR images. To equip SAR ATR with updated deep learning technology, this paper tries to apply a lightweight vision transformer (LViT)-based model to classify SAR images. The entire structure was verified by an open- accessed SAR data set and recognition results show that the final classification outcomes are robust and more accurate in comparison with referred traditional network structures without even using any convolutional layers.

Wastewater-based epidemiology (WBE) has emerged as a key method for continuous monitoring of COVID-19 prevalence including circulating SARS-CoV-2 lineages. WBE addresses limitations of traditional clinical COVID-19 surveillance such as clinical test availability, fluctuating testing rates and increased reliance on rapid antigen tests. Our study in Perth, Western Australia, found a significant positive correlation between SARS-CoV-2 concentrations in wastewater and clinical PCR positivity rates (rs = 0.772; p < 0.001) over an 18-month period that included four successive COVID-19 waves. A strong positive correlation was apparent between the proportions of SARS-CoV-2 lineages in wastewater and clinical cases within the same region (rs = 0.728; p < 0.001), including earlier detection of Omicron and recombinant lineages in wastewater before clinical case confirmation. The successful integration of WBE with healthcare data underscores its critical role in enhancing public health decision-making and pandemic management. This approach not only demonstrates the value of WBE in current global health surveillance efforts but also highlights the potential of WBE to address future public health challenges, as a comprehensive disease monitoring and response approach.

Introduction: Arterial hypertension and obesity are two major risk factors for cardiovascular morbidity and mortality closely linked. The objective of this study was to describe the epidemiological and clinical characteristics of hypertensive patients according to their level of obesity as proposed by the classification of the World Health Organization (WHO). Patients and Methods: Retrospective study (January 2022-April 2023) involving 230 hypertensive and obese adult patients whose mean age was 52.5 ± 12.05 years [Extremes: 24-85 years] followed on an outpatient basis and classified into 3 Classes according to their body mass index (BMI). Epidemiological, clinical parameters and cardiovascular risk stratification were analyzed. The relevance of the risk stratification method was analyzed by area under the curve (AUC). Statistical analysis was performed using SPPS version 26 software (SPSS Inc., Chicago, IL, USA). Results: Classes 1 (n=170; 73.9%), 2 (n=43; 18.7%) and 3 (n=17; 7.4%) were identified. There were significantly more women than men in Class 3 (9.7% versus 2.7%; p=0.001). The risk of being diabetic (OR=0.135;95%CI=0.034–0.541;p=0.005), of having angina pain (OR=0.084;95%CI=0.009–0.790;p=0.030) or developing chronic renal failure (OR=2.416;95%CI=1.471–85.268;p=0.020) was significantly higher in Class 3 than in Class 1. According to cardiovascular risk stratification, 152 patients (66.1%) were at high and very high risk. The level of cardiovascular risk of our patients was not related to the degree of obesity based on body mass index (p=0.32). The risk stratification method was relevant (AUC˃0.70;p˂0.001). Conclusion: Morbid obesity exposes hypertensives more to cardiovascular, renal and metabolic complications.

Abstract: (1) Background: We determined the prevalence of hepatitis B virus (HBV) amongst people without human immunodeficiency virus (HIV) in rural and peri-urban areas in Botswana. (2) Methods: We screened hepatitis B surface antigen (HBsAg) from archived plasma samples of people without HIV (n=2135) randomly selected from the Botswana Combination Prevention Program (BCPP) (2013–2018). We sequenced 415 bp of the surface region using BigDye sequencing chemistry. (3) Results: The median age of participants was 31 (IQR: 24–46) and 64% (1360/2135) were female. HBsAg prevalence was 4.0% (86/2135) [95% CI: 3.3 – 4.9]) and ranged between 0%–9.2%. Older participants (>35 years) had increased odds of HBsAg positivity (OR: 1.94; 95% CI: [1.32–2.86]; p = 0.001. Thirteen samples were sequenced and 7 (53.8%) were genotype A, 3 (23.1%) were genotype D and genotype E each. Clinically significant mutations were identified in the surface region, but no classic drug resistance mutations were identified. (4) Conclusions: We report an HBV prevalence of 4.0% (95% CI 3.3 – 4.9) among people without HIV in rural and pe-ri-urban communities in Botswana with varying rates in different communities. A comprehen-sive national HBV program is required in Botswana to guide HBV prevention, testing and management.

Sepsis is a pervasive condition that affects individuals of all ages, with significant social and economic consequences. Early diagnosis of sepsis is fundamental for establishing appropriate treatment and is based on warning scores and clinical characteristics, with positive microbiological cultures being the gold standard. Research has yet to identify a single biomarker to meet this diagnostic demand. Presepsin is a molecule that has the potential as a biomarker for diagnosing sepsis. In this paper, we present a narrative review of the diagnostic and prognostic performance of presepsin in different age groups. Given its particularities, it is identified that presepsin is a potential biomarker for sepsis at all stages of life.

This study examines the association of sociodemographic risk factors and the comorbidities of COVID-19. Most COVID-19-related studies were conducted in inpatient settings among patients with severe infection during the first and second waves of the pandemic. The third wave with less severe Omicron variant presented a unique opportunity to observe the adult patients treated in outpatient settings. We conducted a cross-sectional study (117 patients aged &gt; 40 years presented with symptomatic COVID-19). We employed the Charlson Comorbidity Index (CCI) to compute comorbidity burden, Medical Outcomes Survey Short form (SF-12) to measure general health, and Self-care Self- Efficacy Scale (SCSES) to assess self-care ability. Fisher’s exact test and analysis of variance (ANOVA) were used to compute the relationship between comorbidities and demographics. This study report focuses on the distribution of the comorbidities and its relationship to demographic variables. The top five comorbidities were hypertension (42%), diabetes (31%), pulmonary disease/asthma (19%), depression (14%), and cancer (11%). Depression was significantly higher among younger age groups (p&lt;0.01) and women (p&lt;0.05). Age (p&lt;0.0001) and income (p&lt;0.01) were the most significantly associated demographics with the comorbidity burden. Incidence of pulmonary disease showed a positive association to educational status (p=0.05). This was the first study to report a significant prevalence of depression among adults with symptomatic COVID-19.

: The phenomenon of dark scleral spots postmortem is well-known in forensic pathology, first de-scribed by Sommers in 1833. Despite this, their presence is currently considered a nonspecific sign, and their pathogenesis has received little attention in forensic literature. In recent years, however, preliminary studies have suggested new mechanisms in their pathogenesis and links to specific types of death. This study aims to create a model for studying scleral spots using an animal model. Thirty-three sheep, already slaughtered for food, were used. After decapitation, the heads were transported to an environment with known temperature and humidity. The right eye underwent eyelid excision, while the left eye's eyelids were sutured. Continuous observation for approximately 24 hours was conducted, with brief interruptions to observe the closed eyes. Macroscopic obser-vation revealed dark scleral spots in 100% (20 out of 20) of the open eyes after an average of 240.96± 58,36 minutes. The spots did not appear in any of the closed eyes. Experimental data indicate that, despite the different location compared to human cadavers, this model serves as an excellent ex-perimental framework for studying postmortem scleral spots.

The Australian tropical montane cloud forest (TMCF) is home to approximately 18 percent of the nation’s total vascular plant species. Over the past century, human activity and industrial development have caused global climate changes, posing a severe and irreversible danger to the entire land-based ecosystem, and WTWHA is no exception. The current average annual temperature of WTWHA in FNQ is 24 °C. However, in the coming years (by 2030), the average annual temperature increase is estimated to be between 0.5 and 1.4 °C compared to the climate observed between 1986 and 2005. Looking further ahead to 2070, the anticipated temperature rise is projected to be between 1.0 and 3.2 °C, with the exact range depending on future emissions. We identified 84 plant species endemic to the WTWHA in FNQ, which are already experiencing climate change threats. Few of these plants are used in herbal medicines. This study comprehensively reviewed metabolomics studies conducted on these 84 plant species until now toward understanding their physiological and metabolomics responses to global climate change. This review also discusses: i) recent developments in plant metabolomics studies that can be applied to study and understand the interactions of wet tropical plants with climatic stress, ii) medicinal plants and isolated phytochemicals with structural diversity, and iii) reported biological activities of crude extracts and isolated compounds.

Background: Several studies have questioned the reliability of the interview process in predicting resident success. Objective: Statistical analysis of the resident interview structure might guide process improvements and increase the validity of the selection methodologyMethod: We performed a prospective comparative analysis of our general surgery residency interview process over two consecutive academic years (AY 2022 and 2023). We used descriptive statistics as well as a mixed effects ordered logit model to measure bias and guide process improvement. Results: Eighty total students were interviewed. We found numerous statistical biases including leniency bias exacerbated by the unequal distribution of evaluators; significant differences in the variance from evaluator’s scoring (p<0.0001) and non-normal distribution (p<0.001). Rater reliability was “good” in both years: 0.69 (C.I. 0.51-0.82). Using uncorrected means, on average, each student was statistical different from 11.5±1.1 other students. Using our model, we improved the number of statistically distinct groupings as each student now differed by 30±1.0 others (p<0.0001). In AY23, we restructured the interviews so that all the evaluators scored every student which greatly improved the interview accuracy using the same mixed model; R-squared of 0.95 versus 0.70; and a smaller percent of students had a change in their rank using with the improved structure (57% versus 90%, p<0.05), compared to AY22.Conclusions: Due to numerous statistical biases, there is little differentiation between students and thus little validity in the process for scoring students using raw mean scores. This can be overcome by developing a structured interview and correcting for statistical biases.

Microalgae are abundant components of biosphere rich in low molecular weight carbohy-drate-containing natural products (glycoconjugates). Glycoconjugates take a part in processes of photosynthesis, provide producers with important biological properties, influence other organ-isms and known by biological activities. Some of them, for example glycosylated toxins and ar-senicals, are detrimental and can be transferring via food chains into higher organisms including humans. So far, the studies on a series of particular groups of microalgal glycoconjugates were not comprehensively discussed in special reviews. In this review, a special focus was made on the isolation, structure determination, properties and approaches to the search for new bioactive metabolites. Analysis of literature data concerning structures, functions and biological activities of ribosylated arsenicals, galactosylated and sulfoquinovosylated lipids, phosphoglycolipids, gly-coside derivatives of toxins, and other groups of glycoconjugates was carried out and discussed. The discovery of a great variety of new carbohydrate-containing metabolites, important biological roles some of them, participation in regulation of microalgal blooms via viral infections as well as the detection of potent immunomodulatory activity, shown by these type metabolites could be attributed to the most interesting recent achievements. Structures, properties and biological roles of glycoconjugates from microalgae attract a great attention growing year to year.

Fetal weight estimation before delivery is important in obstetrics, which assists doctors diagnose abnormal or diseased cases. Linear regression based on ultrasound measures such as bi-parietal diameter (bpd), head circumference (hc), abdominal circumference (ac), and fetal length (fl) is common statistical method for weight estimation but the regression model requires that time points of collecting such measures must not be too far from last ultrasound scans. Therefore this research proposes a method of early weight estimation based on expectation maximization (EM) algorithm so that ultrasound measures can be taken at any time points in gestational period. In other words, gestational sample can lack some or many fetus weights, which gives facilities to practitioners because practitioners need not concern fetus weights when taking ultrasound examinations. The proposed method is called dual regression expectation maximization (DREM) algorithm. Experimental results indicate that accuracy of DREM decreases insignificantly when completion of ultrasound sample decreases significantly. So it is proved that DREM withstands missing values in incomplete sample or sparse sample.

Non-compliance with iron supplementation consumption contributes to the high rate of anemia among adolescent girls in Indonesia. This study explores the barriers and enablers perceived by adolescent girls regarding regular iron supplement consumption. Using a qualitative design, eight focus group discussions (FGD) were conducted in Makassar and Padang involving 32 girls grade 8 and 9 from four junior high schools. Data on perceived barriers and enablers were collected using a social cognitive theory framework and analyzed thematically. The average age of the informants was 13,65±0,60 years. Although all participants received supplement at school, most did not consume them regularly. Key barriers include dislike of the taste and smell, parental prohibition negative experience consuming iron supplement, and the belief that iron supplements increase menstrual blood flow and volume. Enablers include self-awareness of the supplement’s benefits, trust in school-provided supplements, and positive support from parents and peers. Behavior change strategies are needed to address these barriers and strengthen supporting factors to improve iron supplementation consumption.

This review explores the challenges and emerging trends in pancreatic cancer therapy. In particular, we focus on the tumor microenvironment and the potential of immunotherapy in pancreatic cancer. We discuss novel strategies targeting the desmoplastic barrier and immunosuppressive cells to enhance immune cell infiltration and activation. Recent clinical trials, particularly those involving novel immunotherapeutic agents and tumor vaccines, are examined to understand their efficacy and limitations. This review aims to highlight the ongoing efforts to refine immunotherapy approaches for better patient outcomes.

This paper investigates an Energy Neutral System using Micro Energy Harvesters for a Health Monitoring Wireless Sensor Node (HM-WSN). We have implemented HM-WSN consisting of a solar cell energy harvester, a Power Management Unit (PMU) and the ucontroller, sensor and transmitter acting as load. A battery extender and a switching logic circuit for sensor node is designed to evaluate the efficiency of the proposed system. The HM-WSN senses body temperature with improvement in lifetime of coincell. The HM-WSN is built using commercially available off the shelf (COTS components and consumes 47.2uW for data being updated every 134s. It can be operated for approximately 1.32 years only on a coincell. Furthermore, the HM-WSN can be operated with solar energy at 200lux, achieving 96.36 years with a combination of a coincell with an additional capacitor of 2.2mF. It attains 4.07 years to 16.87 years lifetime with the load capacitor varying from 1mF to 1.5mF at 350lux lighting condition. With the same ambient condition and a 2mF load capacitor, HM-WSN attains complete energy autonomy.

The high prevalence of childhood obesity is known to increase the risk of non-communicable diseases typically found in adults, such as cardiovascular disease and type 2 diabetes mellitus. However, worldwide childhood obesity cases continue to rise, thus comprehending its multiple causes to build healthier approaches and revert this scenario is urgent. Obesity development is now strongly associated with high fructose intakes, so mitigating the idea that fructose is a ‘natural nutrient’ and therefore beneficial to health, may be required, since. Excessive consumption of this highly lipogenic sugar leads to white fat accumulation, stimulates adipogenesis and causes white adipose tissue (WAT) inflammation, oxidative stress and dysregulated adipokine release. Unfortunately, dietary consumption of fructose is not always evident to consumers, as it is commonly added as a sweetener in food and sugar-sweetened beverages (SSB). Global consumption of fructose has increased dramatically in recent years. Therefore, it is important that the population has access to reliable information about food ingredients, via food labels. Consumers also need scientific education to understand potential health risks to themselves and their children. Here we discuss the impact of excessive fructose intake on adipose tissue biology, its contribution to childhood obesity and make suggestions for reversing this trend.

The Colombian Orinoquia is an ecosystem of major importance due to its hydrological and bio-logical richness. However, these natural landscapes share space and land use with livestock production systems. This study was developed to identify the perceptions and experiences of traditional livestock producers and institutional representatives on human welfare, animal wel-fare and the environment and to identify environmental challenges and opportunities for im-provement within the One Welfare concept. Focus groups were held with producers (men and women) and institutional representatives from Vichada. Cultural and identity dynamics define the concept of human welfare. Animal welfare was based on favoring the animals' natural behavior, maintaining the animal's physical health and good care. The environment was focused on the conservation of the natural savannah. Climate change, solid waste management and the use of controlled burns were major challenges. As solutions, it was proposed that institutional work, partnerships, environmental governance and education should be promoted.

The Dutch PET@home Toolkit was developed to mitigate challenges and foster conversations and planning concerning pets in long-term care at home. This process evaluation study aimed to evaluate the practical application of the toolkit on four topics: 1) satisfaction; 2) relevance; 3) feasibility; and 4) integration of the PET@home Toolkit materials in home care. Outcomes may be used to improve the toolkit materials to better align with the long-term care at home setting. Accounting for data saturation, professional caregivers (N=6), clients (N=2), and family caregivers (N=2) who used toolkit materials participated in semi-structured interviews. Interviews were analysed by two researchers in ATLAS.ti using an inductive-iterative approach. The researchers reached consensus on themes and clustering within interview topics. This led to the identification of the following topics and (themes): satisfaction (general impression, suggestions for improvement), relevance (awareness, planning, pet-related aspects in practice, impact on healthcare quality), feasibility (healthcare practice, competence, quantity), and implementation (digitalisation, task owner, piloting, timing). Several improvements were made to toolkit materials, such as providing clearer instructions for clients in the information booklet. Participants acknowledged the toolkit could lead to better planning while mitigating potential challenges concerning pets which may lead to longer-lasting relationships between clients and their pets.

Bergamot flavonoids have been shown to prevent metabolic syndrome, non-alcoholic fatty liver disease (NAFLD) and stimulate autophagy in animal models and patients. To investigate further the mechanism of polyphenol-dependent effects, we performed RT2-PCR array analysis on 168 metabolism, transport and autophagy-related genes expressed in rat livers exposed for 14 weeks to different diets: standard, cafeteria (CAF) and CAF diet supplemented with 50 mg/kg of Bergamot Polyphenol Fraction (BPF). CAF diet caused a strong upregulation of the gluconeogenesis pathway (Gck, Pck2) and a moderate (>1.7 fold) induction of genes regulating lipogenesis (Srebf1, Pparg, Xbp1), lipid and cholesterol transport or lipolysis (Fabp3, Apoa1, Lpl) and inflammation (Il6). However, only one -oxidation gene (Cpt1a) and a few autophagy genes were modulated in the CAF group compared to controls. While most of these transcripts were significantly modulated by BPF, we observed a particularly potent effect on lipogenesis genes, like Acly, Acaca, Fasn and Scd1, which were suppressed far below the mRNA levels of control livers as confirmed by alternative primers-based RT2-PCR analysis and western blotting. These effects were accompanied by downregulation of pro-inflammatory cytokines (Il6, Tnfa, and Il10) and diabetes-related genes. Few autophagy (Map1Lc3a, Dapk) and no -oxidation gene expression changes were observed, suggesting minor transcriptional effects on autophagy. In conclusion, chronic BPF supplementation efficiently prevents NAFLD by modulating hepatic energy metabolism and inflammation gene expression programs, with no effect on -oxidation, but profound suppression of de-novo lipogenesis.

Background: During the stay in the neonatal intensive care unit, parents play a crucial role in the care of their infants. Recent studies reported a decrease in parental participation due to Coronavirus Disease (COVID-19) pandemic that determined restricted access policies in hospitals. The aim of this study is to describe the barriers to a good parents’ participation during the stay in the neonatal intensive care unit in the COVID-19 era. Methods: A quantitative observational study was carried out. Results: 270 parents participated in this study. Mothers’ participation in care seems to be higher as compared to fathers (p = 0.017). Parents who lived the birth of their first child reported a better level of participation in care when compared to those who lived the birth of their second born (p = 0.005). Parents of extremely preterm neonates reported a lower interaction with their infant if compared to parents of term newborns (p &lt; 0.001). Conclusions: Some more disadvantaged categories have reported lower scores: cultural and linguistic minorities, parents of multiple children and fathers. COVID-19 pandemic made several Family Centred Care activities not possible with a higher impact on those who benefited the most of these facilities. This study was prospectively registered by the IRB-CRRM of the University “G. d’Annunzio” Chieti-Pescara on the 23/01/2024 with registration number CRRM;2023_12_07_01.

Fortified human milk is the first choice for preterm infants. Although individualized fortification is recommended, the optimal method for this population remains uncertain. We conducted a comparative study assessing the growth effects of adjusted (AF) and targeted fortification (TF) in extremely low birth weight (ELBW) infants. This single-center, randomized, controlled clinical trial was conducted at a tertiary neonatal unit in Spain. Eligible participants were premature infants with a birthweight <1000g exclusively fed with human milk. A total of 38 patients were enrolled, 15 of them randomised to AF group and 23 to TF group. AF was based on BUN concentration and TF on human milk analysis. The primary outcome was weight gain velocity (g/kg/day).No significant differences were found in weight gain velocity at 28 days, at 36 weeks of postmenstrual age, at discharge nor during intervention. Protein intake was significantly higher in AF group (5.02 g/kg/day vs 4.48 g/kg/day, p= 0.001). No differences were found in lipids, carbohydrates and energy intake; neither in weight z score change between the different time points; nor in length and head circumference growth. Both AF and TF are comparable methods of fortification and provide appropriate growth rate in ELBW infants.

Breast cancer (BC) is the leading cause of cancer-related mortality among women, and hormone receptor (HR)-positive subtype makes up majority of all cases. The standard-of-care (SOC) in HR+/HER2- metastatic BC (MBC) is endocrine therapy (ET) plus a CDK4/6 inhibitor (CDK4/6i). ESR1 mutations could impair clinical efficacy of the ETs. Similarly, PIK3CA mutations may serve as a negative prognostic marker. Furthermore, MBC is challenging to treat despite new drug approvals. Our patient received multiple lines of ET ± CDK4/6i and chemotherapy but persistently progressed after each or stopped the treatment due to adverse events. Here we showed for the first time that all-oral combination of elacestrant plus alpelisib was feasible, tolerable and clinically active in an ESR1 and PIK3CA co-mutated and heavily pretreated patient. We achieved a remarkable response in the metastatic lesions with minor toxicity issues. This case highlights the importance of utilizing up-to-date therapeutic agents and reactive decision-making during personalized cancer treatment.

Background: The prevalence of obesity, defined as body mass index (BMI) ≥ 30 kg/m2, has reached epidemic levels. Obesity is associated with an increased risk of various cancers, including gastrointestinal ones. Recent evidence has suggested that obesity disproportionately impacts males and females with cancer, resulting in varied transcriptional and metabolic dysregulation. Methods: This study aimed to elucidate the differences in the metabolic milieu of adenocarcinomas of the gastrointestinal (GI) track both related and unrelated to sex in obesity. To demonstrate these obesity and sex-related effects, we utilized three primary data sources: serum metabolomics from obese and non-obese patients assessed via the Biocrates MxP Quant 500 mass spectrometry-based kit, the ORIEN tumor RNA-sequencing data for all adenocarcinoma cases to assess the impacts of obesity, and publicly available TCGA transcriptional analysis to assess GI cancers and sex-related differences in GI cancers specifically. We applied and integrated our unique transcriptional metabolic pipeline in combination with our metabolomics data to reveal how obesity and sex can dictate differential metabolism in patients. Results: Differentially expressed genes (DEG) analysis of ORIEN obese adenocarcinoma as compared to normal-weight adenocarcinoma patients resulted in large-scale transcriptional reprogramming (4029 DEGs, adj. p < 0.05 and |logFC|>0.58). Gene Set Enrichment and metabolic pipeline analysis showed genes enriched for pathways relating to immunity (inflammation, and CD40 signaling, among others) and metabolism. Specifically, we found alterations to steroid metabolism and tryptophan/kynurenine metabolism in obese patients, both of which are highly associated with disease severity and immune cell dysfunction. These findings were further confirmed using the TCGA colorectal adenocarcinoma (CRC) and esophageal adenocarcinoma (ESCA) data, which showed similar patterns of increased tryptophan catabolism for kynurenine production in obese patients. These patients further showed disparate alterations between males and females when comparing obese to non-obese patient populations. Alterations to immune and metabolic pathways were validated in 6 patients (2 obese and 4 normal weight) via CD8+/CD4+ peripheral blood mononuclear cell RNA-sequencing and paired serum metabolomics, which showed differential kynurenine and lipid metabolism, which corresponded with altered T-cell transcriptome in obese populations. Conclusions: Overall, obesity is associated with differential transcriptional and metabolic program in various disease sites. Further, these alterations, like kynurenine and tryptophan metabolism, which impact both metabolism and immune phenotype, vary with sex and obesity together. This study warrants further in-depth investigation into obesity and sex-related alterations in cancers that may better define biomarkers of response to immunotherapy.

Countless disasters have resulted from climate change, causing severe damage to infrastructure and the economy. These disasters have significant societal impacts, necessitating mental health services for the millions affected. To prepare for and respond effectively to such events, it is crucial to understand people's emotions and the life incidents they experience both before and after a disaster strikes. In this case study, we mined the emotions and life incidents expressed on Twitter during the 2017 Hurricane Harvey. Between August 20 and August 30, we collected a dataset of approximately 400,000 public tweets related to the storm. Using a BERT-based model, we predicted the emotions associated with each tweet. Following emotion prediction, we applied various natural language processing techniques to analyze the content of the tweets, aiming to uncover the 'topics' discussed alongside specific 'emotions.' To efficiently identify these topics, we utilized the Latent Dirichlet Allocation (LDA) technique for topic modeling, which allowed us to bypass manual content analysis and extract meaningful patterns from the data. However, rather than stopping at topic identification, we further refined our analysis by integrating Graph Neural Networks (GNN) and Large Language Models (LLM). The GNN was employed to generate embeddings and construct a similarity graph of the tweets, which was then used to optimize clustering. This step ensured that related tweets were accurately grouped together based on their content and context. Subsequently, we used an LLM to automatically generate descriptive names for each event cluster. This advanced approach allowed us to identify and label life incidents automatically, providing a nuanced understanding of the key issues faced by the community during the hurricane. The results revealed significant emotional shifts as the hurricane reached its most devastating phase. These shifts coincided with pressing concerns and demands from the population, such as evacuation plans, animal safety, safety updates, public policy, help requests, flood impacts, and the spread of fake news. By combining GNN and LLM for automatic event name prediction, our study not only mapped out the emotions but also accurately categorized the specific life incidents that were most relevant during the disaster, offering critical insights for disaster preparedness and response strategies.

Introduction: Vitamin B1 (thiamine) deficiency (TD) after metabolic and bariatric surgery (MBS) is often insidious and, if unrecognized, can lead to irreversible damage or death. As TD symptoms are vague and overlap with other disorders, we aim to identify predictors of recurrent TD and failure to collect B1 labs. Methods: We analyzed a large sample of data from patients with MBS (n=878) to identify potential predictors of TD risk. We modeled recurrent TD and failure to collect B1 labs using classical statistical and machine learning (ML) techniques. Results: We identified clusters of labs associated with increased risk of recurrent TD: micronutrient deficiencies, abnormal blood indices, malnutrition, and fluctuating electrolyte levels (aIRR range: 1.62-4.68). Additionally, demographic variables associated with lower socioeconomic status were predictive of recurrent TD. ML models predicting characteristics associated with failure to collect B1 labs achieved 75-81% accuracy, indicating that clinicians may fail to match symptoms with the underlying condition. Conclusion: Our analysis suggests that both clinical and social factors can increase the risk of life-threatening TD episodes in some MBS patients. Identifying these indicators can help with diagnosis and treatment.

Objective: To analyse the association between maternal risk factors such as age, body mass index (BMI) and cigarette smoking, with perinatal outcomes. Materials and Methods: This a retrospective analysis from prospectively collected data performed at Hospital Universitario de Torrejón (Madrid, Spain), between September 2017 and December 2019. All pregnant women with singleton pregnancies and non-malformed live fetuses attending their routine ultrasound examination at 11+0 to 13+6 weeks' gestation were invited to participate. Association between preeclampsia, preterm birth, gestational diabetes mellitus (GDM), small for gestational age (SGA) or fetal growth restricted (FGR) neonates and type of delivery according to maternal age, BMI, and cigarrete smoking was studied. Logistic mixed models were used to analyze the data. Results: 1921 patients were included in the analysis. Women of 40 years old had a significantly higher risk of having GDM (Odds Ratio (OR) 1.61, 95% Confidence Interval (CI) 1.08 to 2.36), and SGA neonates (OR 1.54, 95% CI 1.00 to 2.37). Women with a BMI &lt;18 had an increased rate of birth SGA and FGR neonates (OR 3.28, 95% CI 1.51 to 7.05, and OR 3.73, 95% CI 1.54 to 8.37, respectively), whereas women with a BMI ≥35 had a higher risk of GDM (OR 3.10, 95% CI 1.95 to 4.89). Smoking increased the risk of having SGA and FGR neonates (OR 1.83, 95% CI 1.36 to 2.46, and OR 1.91, 95% CI 1.29 to 2.78). Conclusions: Advanced maternal age, low or high BMI, and smoking status are significant risk factors for pregnancy complications. Both clinicians and society should concentrate their efforts on addressing these factors to enhance reproductive health.

Objective: To explore the acceptability and feasibility of conducting comprehensive, community-based, hy-brid (in-person and virtual) mental health screening and feedback with diverse youth in the community. Methods: The Screening and Support for Youth intervention provides comprehensive assessment and thera-peutic feedback in community settings including symptoms, diagnoses, functional impairment, suicide, and clinical risk. Symptom severity, seven diagnoses and suicidality were assessed with the Kiddie Computer-ized Adaptive Test. Functional impairment was evaluated by youth self-report on the Weiss Functional Im-pairment Rating Scale. Measures were scored according to nationally developed norms and an algorithm was developed to aggregate symptoms and functioning to determine clinical risk. The results were discussed with participants in a motivational interview to promote insight and engagement in an online intervention. Results: Methodological innovations included using a QR code for recruitment, integrated in-person and virtual participation, and expansion from in-person recruitment within the schools to virtual engagement with youth throughout the community. The final sample included disproportionately more Black or African American and Hispanic youth as compared to school and community statistics, suggesting that hybrid re-search may facilitate recruitment of diverse populations. Qualitative interviews indicated that the screening and feedback raised youth awareness of their wellbeing and/or distress, its impact on their functioning, and engagement with options for improving wellbeing. Conclusion: Hybrid research, developed as a necessity during the pandemic, proved advantageous to the feasibility and acceptability of community-based recruit-ment of at risk, minoritized youth.

This paper presents the work done to transition the lab scale synthesis (1 g) to a large scale (400 g) synthesis of the 3-5-diamino-1H-Pyrazole Disperazol; a new pharmaceutical for treatment of antibiotic resistant Pseudomonas aeruginosa biofilm infections. The potentially hazardous diazotisation step in the lab scale synthesis was transformed to a safe and easy to handle flow chemistry step. Additionally, the paper presents an OSHA recommended safety assessment of the active compound E, performed by Fauske and Associates, LLC.

Background/Objectives: Early diagnosis of ASD a very important factor in improving the quality of life of people on the spectrum, but it still remains a major problem in Europe, especially concerning girls. In this study, we tried to answer the question of what factors affect the age of diagnosis in Poland. Additionally, we tried to establish the time between the first visit to the mental health center and the diagnosis in this population, and what factors affect its length. Methods: 77 children were randomly recruited among the patients who came to local MHC at the Child and Family Health Center in Sosnowiec. All participants were tested using the ADOS-2 protocol. In addition, the study used TAS-20 test and BDI. Results The mean age of the first enrollment in the MHC was 9.09 years for girls and 6.42 for the boys. The time needed to obtain a diagnosis from the first visit was consecutively 2.90 years and 4.29 years, but the difference was not statistically significant (p&gt;0.05). Obtaining a different psychiatric diagnosis did not affect the average time to diagnosis and the age of diagnosis. Conclusions: The results of the study indicate that the diagnosis of ASD is still a significant problem both in Poland and in the world. The long time needed to obtain the correct diagnosis, the frequent need to change diagnosticians in order to obtain it is a common problem. the diagnostic process should be flexible, and the diagnostician should always take into account the axial symptoms, but remain aware that "overdiagnosis" of ASD can also have harmful consequences for the child.

Human osteosarcoma (OS) is a rare tumor predominantly affecting long bones and characterized by a poor prognosis. Currently, the first line of intervention consists of surgical resection of primary tumors combined with radiotherapy and chemotherapy, with a profound impact on patient’s life. Since surgical removal of OS frequently results in large resection of bones the use of biomaterials to sustain the stability of remaining tissue and to stimulate bone regeneration is challenging. Moreover, residual neoplastic cells might be responsible for tumor recurrence. Here we explored the potential of doped-bioactive glass as novel therapeutic intervention to both eradicate residual malignant cells and promote bone regeneration. Bioactive glass (BAG) has been extensively studied and employed in the field of regenerative medicine, due to its osseointegration properties and ability to improve bone tissue regeneration. We found that the incorporation of tellurium in BAG selectively kills OS cells through ferroptosis while preserving the viability of hBMSCs, and stimulating their osteodifferentiation. Although the mechanism of Te toxicity is still unclear: i) Te-BAG generates lipid-ROS through LOXs activity but not iron overload; ii) Te-dependent ferroptosis is mediated by GPX4 down-regulation, and iv) abrogates the anti-ferroptotic activity of FSP1, which expression confers resistance of OS to canonical induction of ferroptosis.

This paper investigates the dynamic properties of artificial neural networks using differential equations and explores the influence of parameters on stability and neural oscillations. By analyzing the equilibrium point of the differential equations, we identify conditions for asymptotic stability and criteria for oscillation in artificial neural networks. Furthermore, we demonstrate how adjusting synaptic weights between neurons can effectively control stability and oscillation. The proposed model offers potential insights into the malfunctioning mechanisms of biological neural networks implicated in neurological disorders like Parkinson's disease tremors and epilepsy seizures, which are characterized by abnormal oscillations.

The healthcare situation in Africa is characterized by limited resources and a high burden of disease, presenting significant challenges to the healthcare systems in the region. The integration of Artificial Intelligence (AI) technologies in African healthcare holds immense potential for addressing these challenges and improving health outcomes. This paper aims to provide a comprehensive understanding of the current healthcare landscape in Africa and the urgent need for AI-driven solutions.In addition to discussing the potential applications of AI in African healthcare, such as disease diagnosis, treatment planning, and medical imaging analysis, this manuscript seeks to shed light on the specific challenges hindering the implementation of AI in the region. By providing detailed examples and case studies, we aim to offer insights into the obstacles that need to be overcome and potential solutions that can be pursued.By leveraging AI technologies, Africa has the opportunity to revolutionize its health systems, bridging the gap in access to quality healthcare across the continent. The objective of this review article is to not only highlight the potential benefits that AI can bring to African healthcare but also to emphasize the urgent need for action and collaboration in implementing and scaling up AI innovations in the region. By doing so, African countries can pave the way for improved health outcomes and ensure that their populations receive the healthcare services they deserve.

In the United States, obesity is prevalent, and it could be described as a pandemic. Obesity is excessive fat accumulation, leading to a BMI ≥ 30 (Fruh, 2017). Surveys conducted by the CDC show that the obesity prevalence in the US is on the rise, as several obese people rose from 30.5% to 41.9% between 1999 and 2020 (Bryan et al., 2021). During the same time, several people suffering from severe obesity rose from 4.7% to 9.2% (Bryan et al., 2021). Additionally, childhood obesity is on the rise. Statistics indicate that between 2017-2020 over 19.7% of children and adolescents aged 2-19 years had obesity. During the same period, obesity prevalence in children aged 2-5 years, 6-11 years, and 12-19 years olds was 12.7%, 20.7%, and 22.2%, respectively (Bryan et al., 2021). With so many people suffering from obesity, the WHO declared it a public health crisis (WHO, 2020). The COVID-19 pandemic further exacerbated the prevalence of obesity in the US. According to the surveys, there was a 4.4% increase in obesity between 2019 to March 2020 due to lifestyle changes that were put on people during the COVID-19 pandemic (Akter et al., 2022). Many comorbidities are associated with obesity. Without adequate health interventions, millions of people could suffer severe health disorders like respiratory problems, type II diabetes, psychological issues, gastrointestinal disorders, and cardiovascular diseases. It is also essential to develop health interventions to mitigate obesity due to its strain on the healthcare system. Research shows that people suffering from obesity spend $2,505 more than people with average weight on healthcare (Cawley et al., 2021). Obesity has financial ramifications in every healthcare category: inpatient, outpatient, and prescription drugs (Cawley et al., 2021). One essential action toward the efforts to mitigate the soaring obesity rates is understanding the demographic inequities across populations and how they can be resolved.