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Life, Volume 13, Issue 3 (March 2023) – 258 articles

Cover Story (view full-size image): The outer space environment poses several health hazards for astronauts that spend extended amounts of time in challenging environments. One factor of particular interest is that astronauts are prone to infections from bacteria that reside both on and in the astronauts’ body, which involves a whole range of bacteria that normally play an integral role in keeping the human host healthy. In this study, we show that the microgravity component of space can be replicated here on Earth through technological advancement and as a result, it can cut the cost and reduce the logistical difficulty and limited access challenges that are inherent to real space investigations and might provide a basis for investigations and discoveries to safeguard astronauts from the harsh outer space environment. View this paper
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12 pages, 2748 KiB  
Article
Phosphorylation of Calpastatin Negatively Regulates the Activity of Calpain
Life 2023, 13(3), 854; https://doi.org/10.3390/life13030854 - 22 Mar 2023
Viewed by 1276
Abstract
Tenderness is an important characteristic of meat quality. Calpastatin and calpain play important roles in meat tenderization. However, it is not clear how phosphorylation affects the regulation of calpastatin on μ-calpain and, consequently, meat tenderness. Calpastatin with high and low phosphorylation levels were [...] Read more.
Tenderness is an important characteristic of meat quality. Calpastatin and calpain play important roles in meat tenderization. However, it is not clear how phosphorylation affects the regulation of calpastatin on μ-calpain and, consequently, meat tenderness. Calpastatin with high and low phosphorylation levels were obtained in vitro corresponding to the treatments by protein kinase A (PKA) and alkaline phosphatase. Then, calpain was incubated with calpastatin with different phosphorylation levels, and the effect of calpastatin on calpain activity under different phosphorylation levels was analyzed. The results showed that PKA promoted the phosphorylation of calpastatin, and a high phosphorylation level was maintained during incubation. The degradation rate of μ-calpain in AP group was higher than that in the other groups, meaning there was lower inhibition of calpastatin on calpain activity. The degradation of calpastatin was lower and its structure was more stable after phosphorylation. One more serine 133 site of calpastatin was identified in PKA group compared with the other groups. Phosphorylation at serine 133 of calpastatin enhanced its inhibition on calpain activity by maintaining its structural stability, thus inhibiting the tenderization of meat. Full article
(This article belongs to the Special Issue Protein Phosphorylation: Mechanism and Regulation)
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10 pages, 1792 KiB  
Case Report
Reflex Auriculo-Cardiac (RAC) Induced by Auricular Laser and Needle Acupuncture: New Case Results Using a Smartphone
Life 2023, 13(3), 853; https://doi.org/10.3390/life13030853 - 22 Mar 2023
Cited by 1 | Viewed by 1399
Abstract
The reflex auriculo-cardiac (RAC), dynamic pulse reaction (Nogier reflex), or vascular autonomic signal was proposed by Nogier. It refers to the pulse changes that can occur in the radial artery immediately after auricular acupuncture is performed. RAC is helpful for the clinical practice [...] Read more.
The reflex auriculo-cardiac (RAC), dynamic pulse reaction (Nogier reflex), or vascular autonomic signal was proposed by Nogier. It refers to the pulse changes that can occur in the radial artery immediately after auricular acupuncture is performed. RAC is helpful for the clinical practice of auricular acupuncture, but there is a lack of objective verification methods. Photoplethysmography (PPG) has been used to objectively calculate radial artery blood flow. This study used PPG via a smartphone to measure RAC induced by auricular acupuncture. Thirty subjects without major diseases were recruited to receive traditional needle and laser acupuncture. The Shen Men ear point and control points were stimulated for 20 s. PPG was continuously measured during the acupuncture. The PPG data were tested for differences with a paired t-test. The results showed that there were no statistical differences in the frequency and amplitude of PPG obtained before and after acupuncture, either with a traditional needle or laser acupuncture. However, interestingly, it was found that one patient with insomnia, one patient with viral respiratory symptoms, and two menstruating females exhibited changes in PPG within five seconds of needle placement. We hypothesized that RAC might be induced by auricular acupuncture and could be quantified by PPG, even among subjects suffering from mild diseases; however, auricular acupuncture might not induce a measurable RAC in totally healthy subjects. Full article
(This article belongs to the Special Issue Laser Acupuncture: Past, Present and Future)
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9 pages, 1008 KiB  
Communication
Green Tea Consumption and the COVID-19 Omicron Pandemic Era: Pharmacology and Epidemiology
Life 2023, 13(3), 852; https://doi.org/10.3390/life13030852 - 22 Mar 2023
Cited by 2 | Viewed by 5184
Abstract
In spite of the development of numerous vaccines for the prevention of COVID-19 and the approval of several drugs for its treatment, there is still a great need for effective and inexpensive therapies against this disease. Previously, we showed that green tea and [...] Read more.
In spite of the development of numerous vaccines for the prevention of COVID-19 and the approval of several drugs for its treatment, there is still a great need for effective and inexpensive therapies against this disease. Previously, we showed that green tea and tea catechins interfere with coronavirus replication as well as coronavirus 3CL protease activity, and also showed lower COVID-19 morbidity and mortality in countries with higher green tea consumption. However, it is not clear whether green tea is still effective against the newer SARS-CoV-2 variants including omicron. It is also not known whether higher green tea consumption continues to contribute to lower COVID-19 morbidity and mortality now that vaccination rates in many countries are high. Here, we attempted to update the information regarding green tea in relation to COVID-19. Using pharmacological and ecological approaches, we found that EGCG as well as green tea inhibit the activity of the omicron variant 3CL protease efficiently, and there continues to be pronounced differences in COVID-19 morbidity and mortality between groups of countries with high and low green tea consumption as of December 6, 2022. These results collectively suggest that green tea continues to be effective against COVID-19 despite the new omicron variants and increased vaccination. Full article
(This article belongs to the Collection COVID-19 and Life)
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11 pages, 825 KiB  
Article
Complications in Patients with Chronic Type B Aortic Dissection (cTBAD)—A Long-Term Analysis
Life 2023, 13(3), 851; https://doi.org/10.3390/life13030851 - 22 Mar 2023
Viewed by 1215
Abstract
Chronic type B aortic dissection (cTBAD) is a rare but challenging condition that requires individual treatment strategies. Especially the long-term therapy impacts prognosis. In this single-center retrospective study, we evaluated patients with cTBAD in our vascular outpatient clinic over 10 years. Follow-up consultations [...] Read more.
Chronic type B aortic dissection (cTBAD) is a rare but challenging condition that requires individual treatment strategies. Especially the long-term therapy impacts prognosis. In this single-center retrospective study, we evaluated patients with cTBAD in our vascular outpatient clinic over 10 years. Follow-up consultations included contrast-enhanced, electrocardiogram-triggered, high-resolution CT angiography (CTA) covering the entire aorta. Evaluated characteristics went beyond demographic characteristics combining the treatment approach and the timing and occurrence of potential complications. We analyzed 133 patients in total (n = 92, 69.2% male) with cTBAD with a mean follow-up of 67.7 months. Most of them underwent invasive treatment (n = 102, 76.7%), the majority received thoracic endovascular aortic repair (TEVAR) (n = 82, 61.7%). A total of 80 patients (60.2%) had major complications, whereas over a third was free of complications even after 5 years. Most common complications were progress of dissection and endoleaks, aneurysms of true (TL) and false lumen (FL) were more common in the later time periods. The treatment of cTBAD in terms of timing, therapy approach, and complications is still challenging for the entire aortic team. Nevertheless, the early recognition of complications permits promising treatment options and highlights the importance of frequent follow-up examinations especially within the first years. Full article
(This article belongs to the Special Issue Mechanism, Diagnosis, and Treatment of Aortic Diseases)
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10 pages, 262 KiB  
Article
Impact of Animal By-Products on Diet Digestibility and Fecal Quality in Beagle Dogs
Life 2023, 13(3), 850; https://doi.org/10.3390/life13030850 - 22 Mar 2023
Cited by 1 | Viewed by 1852
Abstract
In animal feeds and pet food, meat industry rendered by-products as a source of high-quality protein are commonly used. Among all rendered protein sources, poultry carcasses and neck meal are frequently used as ingredients in commercial pet foods due to their agreeable fatty [...] Read more.
In animal feeds and pet food, meat industry rendered by-products as a source of high-quality protein are commonly used. Among all rendered protein sources, poultry carcasses and neck meal are frequently used as ingredients in commercial pet foods due to their agreeable fatty acid and amino acid profiles, and they have no impact on the palatability of the diet. Nonetheless, it is unclear how poultry by-product meal affects companion animals regarding diet digestibility and fecal quality. This study either aimed to provide information on poultry by-product meal, including coarsely, finely, or very finely ground varieties, regarding their nutrient digestibility and characteristics of feces in dogs. One type of animal by-product meal was used in the three aforementioned particle sizes. Beagle dogs (n = 6; body weight, 16.6 kg ± 2.03) participated in a crossover experiment design. Each trial consisted of a five day adaptation period to the diet, and five days of fecal samples were collected and measured for individual apparent nutritional digestibility and fecal scores. The animal by-product supplementation in the diet of dogs was well accepted, with an acceptable percentage of apparent nutrient digestibility. Different particle sizes had no significant effect on the organic matter, crude protein, and crude fat digestibility as well as the fecal fatty acid concentrations. In addition, feces remained firm and well-formed and increased fecal dry matter. This indicates that poultry by-products should be taken into account as a potential dietary protein source in dog food. Full article
(This article belongs to the Special Issue Novel Approaches and Strategies in Nutrition and Feeding of Animals)
18 pages, 3570 KiB  
Systematic Review
The Effectiveness of Psychological Interventions for Rheumatoid Arthritis (RA): A Systematic Review and Meta-Analysis
Life 2023, 13(3), 849; https://doi.org/10.3390/life13030849 - 21 Mar 2023
Cited by 7 | Viewed by 3253
Abstract
Rheumatoid arthritis (RA) is a long-term disorder that significantly impairs somatic, emotional, and psychological functioning. The objective of this review is to identify, appraise, and synthesize the effects of psychological interventions (e.g., cognitive behavioral therapy (CBT), emotional disclosure (ED), group therapy (GT), mindfulness [...] Read more.
Rheumatoid arthritis (RA) is a long-term disorder that significantly impairs somatic, emotional, and psychological functioning. The objective of this review is to identify, appraise, and synthesize the effects of psychological interventions (e.g., cognitive behavioral therapy (CBT), emotional disclosure (ED), group therapy (GT), mindfulness (M), patient education (PE), and relaxation (R)) on biopsychosocial outcomes in the treatment of rheumatoid arthritis (RA). A systematic search of all relevant existing randomized clinical trials (RCTs) was conducted using the following online bibliographic databases: JSTOR, PubMed, PsycNET, and The Cochrane Library. Reference lists were searched for additional reports. The Cochrane Risk of Bias tool (RoB 2.0) was used to assess the risk of bias in the included studies. After the selection process, 57 articles were included and 392 were excluded. Three separate meta-analyses were conducted involving psychological interventions as the main variables, showing: (1) significant positive medium effect sizes for average values (Hedges-g = 0.399, Z = 0.399, p = 0.009); (2) significant positive large effect sizes for maximum values (Hedges-g = 0.856, Z = 4.223, p < 0.001); and (3) non-significant results for minimum values (Hedges-g = −0.047, Z = −0.335, p = 0.738). These results demonstrate that, when grouped, psychological interventions are, on average, moderately effective in treating RA. Overall, this review shows consistent, supportive evidence that psychological interventions can significantly contribute to the standard medical care of RA patients. However, more high-quality, large-sample RCTs still need to confirm these findings. Full article
(This article belongs to the Special Issue The Complexity of Chronic Pain)
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12 pages, 273 KiB  
Article
Free-Choice Feeding of Whole Grains Improves Meat Quality and Intestinal Development of Pigeon Squabs Compared with Complete Pelleted Feed
Life 2023, 13(3), 848; https://doi.org/10.3390/life13030848 - 21 Mar 2023
Cited by 1 | Viewed by 1104
Abstract
Effects of different feeding strategies on meat quality and intestinal development in pigeon squabs were investigated. 120 pairs of pigeons with two squabs each were assigned to five groups (four free-choice feeding systems and one complete feeding system): T1 (corn, pea, wheat, and [...] Read more.
Effects of different feeding strategies on meat quality and intestinal development in pigeon squabs were investigated. 120 pairs of pigeons with two squabs each were assigned to five groups (four free-choice feeding systems and one complete feeding system): T1 (corn, pea, wheat, and pelleted feed), T2 (corn, wheat, and pelleted feed), T3 (corn, pea, and pelleted feed), T4 (corn and pelleted feed), and T5 (complete pelleted feed). Compared with T5, the diet in T4 made the breast meat redder and more yellow (p < 0.05). T2 and T4 resulted in an enhanced total superoxide dismutase activity of meat. Breast muscle in T1 and T2 was determined to have higher contents of nonessential amino acids, glycine, alanine, and glutamic acid (p < 0.05). The contents of the essential amino acids, lysine, threonine, valine, histidine, and arginine were also higher in T1 (p < 0.05). Villus height, surface area, and alkaline phosphatase activity of the duodenum and jejunum in T2 were the highest among the treatments (p < 0.05). In conclusion, free-choice feeding system can improve the meat quality and intestinal development of pigeon squabs, but which combination method of whole grains to use in the production depends on the feeding purpose. Full article
(This article belongs to the Special Issue Trends and Outlooks in Poultry Nutrition)
10 pages, 707 KiB  
Article
First Comparative Evaluation of Short-Chain Fatty Acids and Vitamin-K-Dependent Proteins Levels in Mother–Newborn Pairs at Birth
Life 2023, 13(3), 847; https://doi.org/10.3390/life13030847 - 21 Mar 2023
Cited by 1 | Viewed by 1252
Abstract
Background: The interplay between vitamin K (vitK) (as carboxylation cofactor, partially produced by the gut microbiota) and short-chain fatty acids (SCFAs), the end-product of fiber fermentation in the gut, has never been assessed in mother–newborn pairs, although newborns are considered vitK deficient and [...] Read more.
Background: The interplay between vitamin K (vitK) (as carboxylation cofactor, partially produced by the gut microbiota) and short-chain fatty acids (SCFAs), the end-product of fiber fermentation in the gut, has never been assessed in mother–newborn pairs, although newborns are considered vitK deficient and with sterile gut. Methods: We collected venous blood from 45 healthy mothers with uncomplicated term pregnancies and umbilical cord blood from their newborns at birth. The concentrations of total SCFAs and hepatic/extra-hepatic vitK-dependent proteins (VKDPs), as proxies of vitK status were assayed: undercarboxylated and total matrix Gla protein (ucMGP and tMGP), undercarboxylated osteocalcin (ucOC), undercarboxylated Gla-rich protein (ucGRP), and protein induced by vitK absence II (PIVKA-II). Results: We found significantly higher ucOC (18.6-fold), ucMGP (9.2-fold), and PIVKA-II (5.6-fold) levels in newborns, while tMGP (5.1-fold) and SCFAs (2.4-fold) were higher in mothers, and ucGRP was insignificantly modified. In mother–newborn pairs, only ucGRP (r = 0.746, p < 0.01) and SCFAs (r = 0.428, p = 0.01) levels were correlated. Conclusions: We report for the first time the presence of SCFAs in humans at birth, probably transferred through the placenta to the fetus. The increased circulating undercarboxylated VKDPSs in newborns revealed a higher vitamin K deficiency at the extrahepatic level compared to liver VKDPs. Full article
(This article belongs to the Section Reproductive and Developmental Biology)
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14 pages, 3099 KiB  
Article
ZJUSAH Classification: A New Classification for Primary Brainstem Hemorrhage
Life 2023, 13(3), 846; https://doi.org/10.3390/life13030846 - 21 Mar 2023
Cited by 1 | Viewed by 1508
Abstract
To analyze and improve ZJUSAH classification for primary brainstem hematoma, we retrospectively reviewed 211 patients with primary brainstem hemorrhage who were admitted to our institution between January 2014 and October 2020. The primary clinical outcomes were the 30-day survival rate and 90-day consciousness [...] Read more.
To analyze and improve ZJUSAH classification for primary brainstem hematoma, we retrospectively reviewed 211 patients with primary brainstem hemorrhage who were admitted to our institution between January 2014 and October 2020. The primary clinical outcomes were the 30-day survival rate and 90-day consciousness recovery rate, which were evaluated using the National Institutes of Health Stroke Scale score. Univariate logistic regression and multivariate Cox regression analyses were performed to evaluate the prognostic model. The overall 30-day survival rate of the 211 patients was 69.7%. The 30-day survival rate was 95% among Type 1 patients, 77.8% among Type 2 patients, and 63.2% among Type 3 patients. The 90-day consciousness recovery rate was 63.2% among Type 1 patients, 61.9% among Type 2 patients, and 30.2% among Type 3 patients. Our findings suggest that ZJUSAH classification can be optimized according to hematoma volume, with Type 3 patients with a hematoma larger than 12.4 mL tending to have a worse state of consciousness. Additionally, we discovered that ZJUSAH classification is valuable in predicting 30-day survival rates in conservative treatment patients. In conclusion, our study established and optimized a new CT-based hematoma classification system for primary brainstem hematoma, which facilitates treatment selection and prognostic prediction. Full article
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15 pages, 1170 KiB  
Review
Application of Arthrospira platensis for Medicinal Purposes and the Food Industry: A Review of the Literature
Life 2023, 13(3), 845; https://doi.org/10.3390/life13030845 - 21 Mar 2023
Cited by 9 | Viewed by 3704
Abstract
Arthrospira platensis is a filamentous cyanobacterium of the class Cyanophyceae and is the most cultivated photosynthetic prokaryote. It is used in the pharmaceutical sector, medicine and the food industry. It has a rich micro- and macro-element composition, containing proteins, lipids, carbohydrates, essential amino [...] Read more.
Arthrospira platensis is a filamentous cyanobacterium of the class Cyanophyceae and is the most cultivated photosynthetic prokaryote. It is used in the pharmaceutical sector, medicine and the food industry. It has a rich micro- and macro-element composition, containing proteins, lipids, carbohydrates, essential amino acids, polyunsaturated fatty acids, minerals and raw fibers. It is a commonly used ingredient in food products and nutritional supplements. The wide range of biologically active components determines its diverse pharmacological properties (antioxidant, antidiabetic, antimicrobial, antineoplastic, antitumor, anti-inflammatory, photoprotective, antiviral, etc.). This review summarizes research related to the taxonomy, distribution and chemical composition of Arthrospira platensis as well as its potential application in the food and pharmaceutical industries. Attention is drawn to its various medical applications as an antidiabetic and antiobesity agent, with hepatoprotective, antitumor, antimicrobial and antiviral effects as well as regulatory effects on neurodegenerative diseases. Full article
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19 pages, 2662 KiB  
Article
Autonomic Nervous System Adaptation and Circadian Rhythm Disturbances of the Cardiovascular System in a Ground-Based Murine Model of Spaceflight
Life 2023, 13(3), 844; https://doi.org/10.3390/life13030844 - 21 Mar 2023
Viewed by 1502
Abstract
Whether in real or simulated microgravity, Humans or animals, the kinetics of cardiovascular adaptation and its regulation by the autonomic nervous system (ANS) remain controversial. In this study, we used hindlimb unloading (HU) in 10 conscious mice. Blood pressure (BP), heart rate (HR), [...] Read more.
Whether in real or simulated microgravity, Humans or animals, the kinetics of cardiovascular adaptation and its regulation by the autonomic nervous system (ANS) remain controversial. In this study, we used hindlimb unloading (HU) in 10 conscious mice. Blood pressure (BP), heart rate (HR), temperature, and locomotor activity were continuously monitored with radio-telemetry, during 3 days of control, 5 days of HU, and 2 days of recovery. Six additional mice were used to assess core temperature. ANS activity was indirectly determined by analyzing both heart rate variability (HRV) and baroreflex sensitivity (BRS). Our study showed that HU induced an initial bradycardia, accompanied by an increase in vagal activity markers of HRV and BRS, together with a decrease in water intake, indicating the early adaptation to fluid redistribution. During HU, BRS was reduced; temperature and BP circadian rhythms were altered, showing a loss in day/night differences, a decrease in cycle amplitude, a drop in core body temperature, and an increase in day BP suggestive of a rise in sympathetic activity. Reloading induced resting tachycardia and a decrease in BP, vagal activity, and BRS. In addition to cardiovascular deconditioning, HU induces disruption in day/night rhythmicity of locomotor activity, temperature, and BP. Full article
(This article belongs to the Section Astrobiology)
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11 pages, 3519 KiB  
Article
Molecular Characteristics and Pathogenicity of Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) 1 in Taiwan during 2019–2020
Life 2023, 13(3), 843; https://doi.org/10.3390/life13030843 - 21 Mar 2023
Cited by 2 | Viewed by 1426
Abstract
Two variants of porcine reproductive and respiratory syndrome virus (PRRSV), PRRSV 1 and PRRSV 2, have caused abortion in pregnant sows and respiratory distress in nursery pigs worldwide. PRRSV 2 has been thoroughly researched in Taiwan since 1993; however, the first case of [...] Read more.
Two variants of porcine reproductive and respiratory syndrome virus (PRRSV), PRRSV 1 and PRRSV 2, have caused abortion in pregnant sows and respiratory distress in nursery pigs worldwide. PRRSV 2 has been thoroughly researched in Taiwan since 1993; however, the first case of PRRSV 1 was not reported until late 2018. To decipher the genetic characteristics of PRRSV 1 in Taiwan, open reading frame 5 (ORF5) genes of PRRSV 1 strains collected from 11 individual pig farms in 2019–2020 were successfully sequenced. All Taiwanese ORF5 sequences were closely related to Spanish-like PRRSV strains, which are considered to share a common evolutionary origin with the strain used for the PRRSV 1 vaccine. Analyses of amino acid (aa) and non-synonymous substitutions showed that genetic variations resulted in numerously specific codon mutations scattered across the neutralizing epitopes within the ORF5 gene. The PRRSV 1 challenge experiment disclosed the pathogenetic capability of the NPUST2789 isolate in nursery pigs. These findings provide comprehensive knowledge of the molecular diversity of the PRRSV 1 variant in local Taiwanese fields and facilitate the development of suitable immunization programs against this disease. Full article
(This article belongs to the Special Issue Porcine Reproductive and Respiratory Syndrome Virus (PRRSV))
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8 pages, 713 KiB  
Communication
Bladder Neck Obstruction: Experience and Management in a Sperm Bank
Life 2023, 13(3), 842; https://doi.org/10.3390/life13030842 - 20 Mar 2023
Viewed by 1218
Abstract
Primary Bladder Neck Obstruction (PBNO) management provides medical and surgical treatment, such as transurethral incisions that can lead to retrograde ejaculation. The aim of this study was to investigate the maintenance of anterograde ejaculation and semen quality before and after this surgical procedure. [...] Read more.
Primary Bladder Neck Obstruction (PBNO) management provides medical and surgical treatment, such as transurethral incisions that can lead to retrograde ejaculation. The aim of this study was to investigate the maintenance of anterograde ejaculation and semen quality before and after this surgical procedure. A retrospective evaluation was carried out between 2011 and 2020. A total of 73 patients diagnosed with PBNO were recruited. Ejaculatory function, semen quality, and the fertility of recruited subjects were evaluated. Semen parameters—Baseline, 8.2% of patients were oligozoospermic and 12.3% had a semen volume below the WHO 2010 fifth percentile. Post-surgery, 20% of patients were oligozoospermic. We detected a significant decrease in total sperm number, a significant increase in the number of abnormal forms, and a reduction in the leukocyte concentration. Ejaculatory function—A total of 7.7% of patients reported anejaculation after transurethral incision of the bladder neck. Fertility—9.2% of the patients already had children before surgery; 13.8% had naturally conceived children in the years following surgery; 76.9% had no desire for paternity at the time. Our data have important implications for sperm bank management. The alterations in semen parameters and the risk of anejaculation suggest that the use of sperm cryopreservation before surgery for PBNO should be encouraged. Full article
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27 pages, 4445 KiB  
Review
Progressive Biocatalysts for the Treatment of Aqueous Systems Containing Pharmaceutical Pollutants
Life 2023, 13(3), 841; https://doi.org/10.3390/life13030841 - 20 Mar 2023
Cited by 4 | Viewed by 1462
Abstract
The review focuses on the appearance of various pharmaceutical pollutants in various water sources, which dictates the need to use various methods for effective purification and biodegradation of the compounds. The use of various biological catalysts (enzymes and cells) is discussed as one [...] Read more.
The review focuses on the appearance of various pharmaceutical pollutants in various water sources, which dictates the need to use various methods for effective purification and biodegradation of the compounds. The use of various biological catalysts (enzymes and cells) is discussed as one of the progressive approaches to solving problems in this area. Antibiotics, hormones, pharmaceuticals containing halogen, nonsteroidal anti-inflammatory drugs, analgesics and antiepileptic drugs are among the substrates for the biocatalysts in water purification processes that can be carried out. The use of enzymes in soluble and immobilized forms as effective biocatalysts for the biodegradation of various pharmaceutical compounds (PCPs) has been analyzed. Various living cells (bacteria, fungi, microalgae) taken as separate cultures or components of natural or artificial consortia can be involved in biocatalytic processes under aerobic or anaerobic conditions. Cells as biocatalysts introduced into water treatment systems in suspended or immobilized form are used for deep biodegradation of PCPs. The potential of combinations of biocatalysts with physical–chemical methods of wastewater treatment is evaluated in relation to the effective removing of PCPs. The review analyzes recent results and the main current trends in the development of biocatalytic approaches to biodegradation of PCPs, the pros and cons of the processes and the biocatalysts used. Full article
(This article belongs to the Special Issue Advances in Research in Biocatalysis)
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14 pages, 1301 KiB  
Review
Shedding Lights on the Extracellular Vesicles as Functional Mediator and Therapeutic Decoy for COVID-19
Life 2023, 13(3), 840; https://doi.org/10.3390/life13030840 - 20 Mar 2023
Cited by 2 | Viewed by 1755
Abstract
COVID-19 is an infectious disease caused by the novel coronavirus (SARS-CoV-2) that first appeared in late 2019 and has since spread across the world. It is characterized by symptoms such as fever, cough, and shortness of breath and can lead to death in [...] Read more.
COVID-19 is an infectious disease caused by the novel coronavirus (SARS-CoV-2) that first appeared in late 2019 and has since spread across the world. It is characterized by symptoms such as fever, cough, and shortness of breath and can lead to death in severe cases. To help contain the virus, measures such as social distancing, handwashing, and other public health measures have been implemented. Vaccine and drug candidates, such as those developed by Pfizer/BioNTech, AstraZeneca, Moderna, Novavax, and Johnson & Johnson, have been developed and are being distributed worldwide. Clinical trials for drug treatments such as remdesivir, dexamethasone, and monoclonal antibodies are underway and have shown promising results. Recently, exosomes have gained attention as a possible mediator of the COVID-19 infection. Exosomes, small vesicles with a size of around 30–200 nm, released from cells, contain viral particles and other molecules that can activate the immune system and/or facilitate viral entry into target cells. Apparently, the role of exosomes in eliciting various immune responses and causing tissue injury in COVID-19 pathogenesis has been discussed. In addition, the potential of exosomes as theranostic and therapeutic agents for the treatment of COVID-19 has been elaborated. Full article
(This article belongs to the Special Issue The Therapeutic Applications of Extracellular Vesicles)
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15 pages, 559 KiB  
Article
The Safety Profile of Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-like Peptide 1 Receptor Agonists in the Standard of Care Treatment of Type 2 Diabetes Mellitus
Life 2023, 13(3), 839; https://doi.org/10.3390/life13030839 - 20 Mar 2023
Cited by 1 | Viewed by 1503
Abstract
Aim: We evaluated the safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for their use with other glucose-lowering drugs and drugs for the treatment of type 2 diabetes mellitus (T2DM), in a standard-of-care regimen with maximum tolerated [...] Read more.
Aim: We evaluated the safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for their use with other glucose-lowering drugs and drugs for the treatment of type 2 diabetes mellitus (T2DM), in a standard-of-care regimen with maximum tolerated doses, and, respectively, when compared with metformin. Methods: We conducted a retrospective, observational study on 405 patients that were seen in the outpatient clinic of the N Paulescu National Institute for Diabetes Mellitus, Bucharest, Romania, in 2019. Their demographics, metabolic parameters, and medication safety were evaluated at three follow-up visits, from baseline, six months, and twelve months. Results: Both SGLT-2is and GLP-1 RAs are safe regarding creatinine, eGFR, urea, GOT, and GPT upon the comparison of the data from the six- and twelve-month visits with the initial visit, and also the twelve-month visit with the six-month visit. Moreover, when comparing SGLT-2is and GLP-1 RAs with metformin, there are safety data only for urea. Conclusions: In this retrospective analysis, both SGLT-2is and GLP-1 RAs, when used in conjunction with other glucose-lowering, blood-pressure-lowering, and lipid-lowering medications, appeared to be safe for the management of T2DM. Full article
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10 pages, 595 KiB  
Article
Effectiveness of SMILE Combined with Micro-Monovision in Presbyopic Patients: A Pilot Study
Life 2023, 13(3), 838; https://doi.org/10.3390/life13030838 - 20 Mar 2023
Cited by 2 | Viewed by 1358
Abstract
Binocular summation along all defocus range after a micro-monovision procedure has scarcely been studied. The aim of this pilot study was to evaluate the efficacy of SMILE combined with different levels of micro-monovision in presbyopic patients and to assess the binocular summation effect [...] Read more.
Binocular summation along all defocus range after a micro-monovision procedure has scarcely been studied. The aim of this pilot study was to evaluate the efficacy of SMILE combined with different levels of micro-monovision in presbyopic patients and to assess the binocular summation effect on contrast sensitivity defocus curves (CSDC) at the 6-month follow-up. Efficacy was assessed on the basis of visual acuity (VA) and stereopsis at far, intermediate, and near distances. Patient-reported outcomes (PROs) and binocular CSDC were also evaluated. Six patients completed the study with a programmed median anisometropia of 0.81 Diopter. The median binocular uncorrected VA was better than 0 logMAR at the three evaluated distances, and stereopsis was not impaired in any patient, achieving a median of ≤119 arcsec at any distance. CSDC increased binocularly after surgery, significantly in the range of −2 to −3 D (p < 0.05). No clinically relevant changes were observed in PROs compared with the preoperative period, and all patients achieved spectacle independence at intermediate/near distance and were likely or very likely to undergo the same surgery. In conclusion, micro-monovision with SMILE could be an effective procedure, with results that might be comparable to other laser correction techniques specifically designed for presbyopia correction. Full article
(This article belongs to the Special Issue New Horizons in Vision Science, Optometry and Ocular Surface)
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17 pages, 1900 KiB  
Review
The Role of Oxidative Stress in the Aging Eye
Life 2023, 13(3), 837; https://doi.org/10.3390/life13030837 - 20 Mar 2023
Cited by 8 | Viewed by 2702
Abstract
Given the expanding elderly population in the United States and the world, it is important to understand the processes underlying both natural and pathological age-related changes in the eye. Both the anterior and posterior segment of the eye undergo changes in biological, chemical, [...] Read more.
Given the expanding elderly population in the United States and the world, it is important to understand the processes underlying both natural and pathological age-related changes in the eye. Both the anterior and posterior segment of the eye undergo changes in biological, chemical, and physical properties driven by oxidative stress. With advancing age, changes in the anterior segment include dermatochalasis, blepharoptosis, thickening of the sclera, loss of corneal endothelial cells, and stiffening of the lens. Changes in the posterior segment include lowered viscoelasticity of the vitreous body, photoreceptor cell loss, and drusen deposition at the macula and fovea. Age-related ocular pathologies including glaucoma, cataracts, and age-related macular degeneration are largely mediated by oxidative stress. The prevalence of these diseases is expected to increase in the coming years, highlighting the need to develop new therapies that address oxidative stress and slow the progression of age-related pathologies. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
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13 pages, 4286 KiB  
Article
Detection of Lymphatic Vessels in the Superficial Fascia of the Abdomen
Life 2023, 13(3), 836; https://doi.org/10.3390/life13030836 - 20 Mar 2023
Cited by 1 | Viewed by 2118
Abstract
Recently, the superficial fascia has been recognized as a specific anatomical structure between the two adipose layers—the superficial adipose tissue (SAT) and the deep adipose tissue (DAT). The evaluation of specific characteristics of cells, fibers, blood circulation, and innervation has shown that the [...] Read more.
Recently, the superficial fascia has been recognized as a specific anatomical structure between the two adipose layers—the superficial adipose tissue (SAT) and the deep adipose tissue (DAT). The evaluation of specific characteristics of cells, fibers, blood circulation, and innervation has shown that the superficial fascia has a clear and distinct anatomical identity, but knowledge about lymphatic vessels in relation to the superficial fascia has not been described. The aim of this study was to evaluate the presence of lymphatic vessels in the hypodermis, with a specific focus on the superficial fascia and in relation to the layered subdivision of the subcutaneous tissue into SAT and DAT. Tissue specimens were harvested from three adult volunteer patients during abdominoplasty and stained with D2-40 antibody for the lymphatic endothelium. In the papillary dermis, a huge presence of lymphatic vessels was highlighted, parallel to the skin surface and embedded in the loose connective tissue. In the superficial adipose tissue, thin lymphatic vessels (mean diameter of 11.6 ± 7.71 µm) were found, close to the fibrous septa connecting the dermis to the deeper layers. The deep adipose tissue showed a comparable overall content of lymphatic vessels with respect to the superficial layer; they followed the blood vessel and had a larger diameter. In the superficial fascia, the lymphatic vessels showed higher density and a larger diameter, in both the longitudinal and transverse directions along the fibers, as well as vessels that intertwined with one another, forming a rich network of vessels. This study demonstrated a different distribution of the lymphatic vessels in the various subcutaneous layers, especially in the superficial fascia, and the demonstration of the variable gauge of the vessels leads us to believe that they play different functional roles in the collection and transport of interstitial fluid—important factors in various surgical and rehabilitation fields. Full article
(This article belongs to the Section Physiology and Pathology)
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13 pages, 594 KiB  
Review
Interventional Radiology in the Treatment of Pancreatic Adenocarcinoma: Present and Future Perspectives
Life 2023, 13(3), 835; https://doi.org/10.3390/life13030835 - 20 Mar 2023
Cited by 1 | Viewed by 1618
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease; patients’ long-term survival is strictly linked to the surgical resection of the tumor but only a minority of patients (2–3%) have a resectable disease at diagnosis. In patients with surgically unresectable disease, interventional radiology is [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease; patients’ long-term survival is strictly linked to the surgical resection of the tumor but only a minority of patients (2–3%) have a resectable disease at diagnosis. In patients with surgically unresectable disease, interventional radiology is taking on an increasing role in treatment with the application of loco-regional percutaneous therapies. The primary purposes of this narrative review are to analyze the safety and efficacy of ablative techniques in the management of borderline resectable and locally advanced diseases and to underline the role of the interventional radiologist in the management of patients with distant metastases. The secondary purpose is to focus on the synergy between immunotherapy and ablative therapies. Full article
(This article belongs to the Section Medical Research)
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5 pages, 209 KiB  
Editorial
COVID-19 Prevention and Treatment
Life 2023, 13(3), 834; https://doi.org/10.3390/life13030834 - 20 Mar 2023
Cited by 1 | Viewed by 1638
Abstract
Coronavirus disease 2019 (COVID-19) has spread and become a substantial public health concern worldwide [...] Full article
(This article belongs to the Special Issue COVID-19 Prevention and Treatment)
6 pages, 1526 KiB  
Case Report
Immunoglobulin G4-Related Disease-Associated Dermatitis with Pruritus: A Positive Response to Dupilumab
Life 2023, 13(3), 833; https://doi.org/10.3390/life13030833 - 20 Mar 2023
Cited by 1 | Viewed by 1878
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a rare fibro-inflammatory condition characterized by IgG4-expressing plasma cell infiltration of the skin and other organs, leading to profound itchiness. Oral corticosteroids are the first-line therapy for IgG4-RD but relapses and potential side effects are common. In this [...] Read more.
Immunoglobulin G4-related disease (IgG4-RD) is a rare fibro-inflammatory condition characterized by IgG4-expressing plasma cell infiltration of the skin and other organs, leading to profound itchiness. Oral corticosteroids are the first-line therapy for IgG4-RD but relapses and potential side effects are common. In this case, we discuss a patient with a hyperpigmented, scaling dermatitis on his arms, back, and chest with lichen amyloidosis (LA) that incompletely responded to corticosteroids. He had reduced quality of life secondary to chronic pruritus. Dupilumab, an IL-4 and IL-13 inhibitor, was initiated. He experienced a transient worsening, followed by complete resolution of his itch with remission of his rash. While the pathogenesis of IgG4-RD is not entirely understood, a T-helper 2 (Th2) immune response has been implicated, with interleukins (IL) 4, 5, 10, and 13 playing a role in IgG4 class switch, resulting in eosinophilia and elevated IgE. The strong response of dupilumab in this case may provide evidence in favor of the involvement of IL-4 and IL-13 in the pathogenesis of cutaneous IgG4-RD. Future clinical studies involving larger patient populations may be warranted. Full article
(This article belongs to the Special Issue Feature Paper in Physiology and Pathology)
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12 pages, 683 KiB  
Article
Basal Cell Carcinoma—A Retrospective Descriptive Study Integrated in Current Literature
Life 2023, 13(3), 832; https://doi.org/10.3390/life13030832 - 19 Mar 2023
Cited by 1 | Viewed by 1388
Abstract
Basal cell carcinoma (BCC) is considered to be the most common cancer in humans. It has a slow growth rhythm, and for this reason, metastases are rare. For our retrospective study, we selected 180 patients from those who underwent surgery for a variety [...] Read more.
Basal cell carcinoma (BCC) is considered to be the most common cancer in humans. It has a slow growth rhythm, and for this reason, metastases are rare. For our retrospective study, we selected 180 patients from those who underwent surgery for a variety of skin tumours between January 2019 and August 2022 and whose histopathological examination revealed basal cell carcinoma. All surgeries were performed by plastic surgeons at the “St. John” hospital in Bucharest. The aim of this article is to provide observational data regarding BCC—in terms of histopathology and diagnostic and therapeutic management and to integrate these data into the current knowledge of this pathology. Full article
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11 pages, 1853 KiB  
Communication
Understanding the Diurnal Oscillation of the Gut Microbiota Using Microbial Culture
Life 2023, 13(3), 831; https://doi.org/10.3390/life13030831 - 19 Mar 2023
Viewed by 1357
Abstract
The composition of the gut microbiota oscillates according to the light–dark cycle. However, the existing literature demonstrates these oscillations only by molecular methods. Microbial cultures are an interesting method for studying metabolically active microorganisms. In this work, we aimed to understand the diurnal [...] Read more.
The composition of the gut microbiota oscillates according to the light–dark cycle. However, the existing literature demonstrates these oscillations only by molecular methods. Microbial cultures are an interesting method for studying metabolically active microorganisms. In this work, we aimed to understand the diurnal oscillation of the intestinal microbiota in Wistar male rats through microbial culture analysis. Over a 24 h period, three animals were euthanized every 6 h. Intestinal segments were dissected immediately after euthanasia and diluted in phosphate-buffered saline (PBS) for plating in different culture media. The CFU/mL counts in feces samples cultured in the Brucella medium were significantly higher at ZT0, followed by ZT6, ZT18, and ZT12 (p = 0.0156), which demonstrated the diurnal oscillation of metabolically active anaerobic bacteria every 6 h using microbial culture. In addition, quantitative differences were demonstrated in anaerobic bacteria and fungi in different gastrointestinal tract tissues. Full article
(This article belongs to the Special Issue Trends in Microbiology 2024)
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14 pages, 1016 KiB  
Review
Prostate MRI for Improving Personalized Risk Prediction of Incontinence and Surgical Planning: The Role of Membranous Urethral Length Measurements and the Use of 3D Models
Life 2023, 13(3), 830; https://doi.org/10.3390/life13030830 - 19 Mar 2023
Cited by 2 | Viewed by 1521
Abstract
Prostate MRI has an important role in prostate cancer diagnosis and treatment, including detection, the targeting of prostate biopsies, staging and guiding radiotherapy and active surveillance. However, there are other ‘’less well-known’’ applications which are being studied and frequently used in our highly [...] Read more.
Prostate MRI has an important role in prostate cancer diagnosis and treatment, including detection, the targeting of prostate biopsies, staging and guiding radiotherapy and active surveillance. However, there are other ‘’less well-known’’ applications which are being studied and frequently used in our highly specialized medical center. In this review, we focus on two research topics that lie within the expertise of this study group: (1) anatomical parameters predicting the risk of urinary incontinence after radical prostatectomy, allowing more personalized shared decision-making, with special emphasis on the membranous urethral length (MUL); (2) the use of three-dimensional models to help the surgical planning. These models may be used for training, patient counselling, personalized estimation of nerve sparing and extracapsular extension and may help to achieve negative surgical margins and undetectable postoperative PSA values. Full article
(This article belongs to the Special Issue MRI in Cancer: Ongoing Developments and Controversies)
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12 pages, 1241 KiB  
Brief Report
Patterns of Care in Patients with Basilar Artery Occlusion (BAO): A Population-Based Study
Life 2023, 13(3), 829; https://doi.org/10.3390/life13030829 - 19 Mar 2023
Cited by 1 | Viewed by 1331
Abstract
Basilar artery occlusion (BAO) is associated with high morbidity and mortality. Endovascular therapy (EVT) has been shown to be beneficial in acute BAO patients. This retrospective observational study used the National Inpatient Sample (NIS) database to identify BAO patients using the International Classification [...] Read more.
Basilar artery occlusion (BAO) is associated with high morbidity and mortality. Endovascular therapy (EVT) has been shown to be beneficial in acute BAO patients. This retrospective observational study used the National Inpatient Sample (NIS) database to identify BAO patients using the International Classification of Diseases (ICD). Multivariable models were used to evaluate the association of risk factors, comorbidities, length of stay (LOS) in hospital, total cost, disposition, and transfer status. A total of 1120 (447 females, 39.95%) patients were identified, with a higher proportion of White individuals (66.8% vs. 57.6%), atrial fibrillation (31.5% vs. 17.2%; p < 0.0001), and peripheral vascular disease (21.2% vs. 13.7%; p = 0.009). A lower proportion of individuals with diabetes mellitus (32.1% vs. 39.5%; p = 0.05) was found in the EVT group. Majority of the patients (924/1120, 82.5%) were treated at the urban teaching facility, which also performed most of the EVT procedures (164, 89.13%), followed by non-academic urban (166, 14.8%) and rural (30, 2.7%) hospitals. Most patients (19/30, 63%) admitted to rural hospitals were transferred to other facilities. Urban academic hospitals also had the highest median LOS (8.9 days), cost of hospitalization (USD 117,261), and disposition to home (32.6%). This study observed distinct patterns and geographical disparities in the acute treatment of BAO patients. There is a need for national- and state-level strategies to improve access to stroke care. Full article
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14 pages, 1322 KiB  
Systematic Review
Melanoma Brain Metastases: A Systematic Review of Opportunities for Earlier Detection, Diagnosis, and Treatment
Life 2023, 13(3), 828; https://doi.org/10.3390/life13030828 - 19 Mar 2023
Cited by 3 | Viewed by 5746
Abstract
Introduction: Melanoma continues to represent the most serious skin cancer worldwide. However, few attempts have been made to connect the body of research on advanced melanoma. In the present review, we report on strides made in the diagnosis and treatment of intracranial metastatic [...] Read more.
Introduction: Melanoma continues to represent the most serious skin cancer worldwide. However, few attempts have been made to connect the body of research on advanced melanoma. In the present review, we report on strides made in the diagnosis and treatment of intracranial metastatic melanoma. Methods: Relevant Cochrane reviews and randomized-controlled trials published by November 2022 were systematically retrieved from the Cochrane Library, EMBASE, and PubMed databases (N = 27). Search and screening methods adhered to the 2020 revision of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Results: Although the research surrounding the earlier detection of melanoma brain metastasis is scarce, several studies have highlighted specific markers associated with MBM. Such factors include elevated BRAFV600 mutant ctDNA, high LDH concentration, and high IGF-1R. The approach to treating MBM is moving away from surgery and toward nonsurgical management, namely, a combination of stereotactic radiosurgery (SRS) and immunotherapeutic agents. There is an abundance of emerging research seeking to identify and improve both novel and established treatment options and diagnostic approaches for MBM, however, more research is still needed to maximize the clinical efficacy, especially for new immunotherapeutics. Conclusions: Early detection is optimal for the efficacy of treatment and MBM prognosis. Current treatment utilizes chemotherapies and targeted therapies. Emerging approaches emphasize biomarkers and joint treatments. Further exploration toward preliminary identification, the timing of therapies, and methods to ameliorate adverse treatment effects are needed to advance MBM patient care. Full article
(This article belongs to the Special Issue Therapeutic Prevention and Early Detection of Melanoma)
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14 pages, 1920 KiB  
Review
An Overview of E-Cigarette Impact on Reproductive Health
Life 2023, 13(3), 827; https://doi.org/10.3390/life13030827 - 18 Mar 2023
Cited by 7 | Viewed by 8092
Abstract
Electronic cigarettes (e-cigarettes) are often considered a “safe substitute” for conventional cigarette cessation. The composition of the fluid is not always clearly defined and shows a large variation within brands and manufacturers. More than 80 compounds were detected in liquids and aerosols. E-cigarettes [...] Read more.
Electronic cigarettes (e-cigarettes) are often considered a “safe substitute” for conventional cigarette cessation. The composition of the fluid is not always clearly defined and shows a large variation within brands and manufacturers. More than 80 compounds were detected in liquids and aerosols. E-cigarettes contain nicotine, and the addition of flavorings increases the toxicity of e-cigarette vapour in a significant manner. The heat generated by the e-cigarette leads to the oxidation and decomposition of its components, eventually forming harmful constituents in the inhaled vapour. The effects of these toxicants on male and female reproduction are well established in conventional cigarette smokers. Although toxins were measured at much lower levels in e-cigarette aerosols compared to smoke from a conventional cigarette, there are concerns about their potential impact on male and female reproduction. The information available was mainly obtained from studies conducted in animal models, and investigations in humans are scarce. However, the effects observed in animal models suggest that caution should be taken when vaping and that more research needs to be conducted to identify its potential adverse effects on fertility. The prevalence of e-cigarette usage is alarming, and warnings should be made about the impact of vaping on reproductive health. This document reviews the data regarding the impact of e-cigarette use on male and female reproduction. Full article
(This article belongs to the Section Medical Research)
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14 pages, 1323 KiB  
Article
Differential Impact of Social Isolation and Space Radiation on Behavior and Motor Learning in Rats
Life 2023, 13(3), 826; https://doi.org/10.3390/life13030826 - 18 Mar 2023
Cited by 2 | Viewed by 1248
Abstract
Future missions to Mars will expose astronauts to several physical and psychological challenges, including exposure to space radiation (SR) and periods of social isolation (SI). Each of these stressors, in addition to mission demands, can affect physical and mental health and potentially negatively [...] Read more.
Future missions to Mars will expose astronauts to several physical and psychological challenges, including exposure to space radiation (SR) and periods of social isolation (SI). Each of these stressors, in addition to mission demands, can affect physical and mental health and potentially negatively impact sleep. The effects of inflight stressors may vary with duration and time course, may be additive or compounding, and may vary with individual differences in stress resilience and vulnerability. Determining how individual differences in resilient and vulnerable phenotypes respond to these mission-related stressors and their interactions with sleep will be crucial for understanding and mitigating factors that can impair performance and damage health. Here, we examined the single and compound effects of ground-based analogs of SI and SR on sensorimotor performance on the balance beam (BB) in rats. We also assessed emotional responses during testing on the BB and assessed whether sensorimotor performance and emotion varied with individual differences in stress resiliency using our established animal model in which stress produces different effects on sleep. Results showed differential motor performance and emotion in the BB task between SI and SR, and these varied based on resilient and vulnerable phenotypes. These findings demonstrate that identifying individual responses to stressors that can impact sensorimotor ability and behavior necessary to perform mission-related tasks will be of particular importance for astronauts and future missions. Should similar effects occur in humans, there may be considerable inter-individual variability in the impact that flight stressors have on the mental health of astronauts and their ability to perform mission-related tasks. Full article
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13 pages, 723 KiB  
Review
Tension-Type Headache in Children and Adolescents
Life 2023, 13(3), 825; https://doi.org/10.3390/life13030825 - 18 Mar 2023
Cited by 1 | Viewed by 3641
Abstract
In pediatric neurology, tension-type headache (TTH) represents a very common type of primary headache during the pediatric age. Despite the high prevalence of TTH, this diagnosis is often underestimated in childhood, with relevant difficulties in the differential diagnosis of TTH from secondary and [...] Read more.
In pediatric neurology, tension-type headache (TTH) represents a very common type of primary headache during the pediatric age. Despite the high prevalence of TTH, this diagnosis is often underestimated in childhood, with relevant difficulties in the differential diagnosis of TTH from secondary and primary headache manifestations. Even among primary headaches, a clinical overlap is not so infrequent in children: migraine attacks could present tension headache-like features while tension-type headaches may display migraine-like symptoms as well. Several variables play a role in the complex trajectory of headache evolution, such as hormonal changes during adolescence, triggers and genetic and epigenetic factors. The trajectories and outcomes of juvenile migraine and TTH, as well as the transition of one form to the other, have been investigated in several long-term prospective studies. Thus, the aim of this paper is to review the current literature on the differential diagnosis workout of TTH in pediatrics, the possible outcomes during the developmental age and the appropriate therapeutic strategies. Indeed, TTH represents a challenging diagnostic entity in pediatrics, both from a clinical and a therapeutic point of view, in which early diagnosis and appropriate treatment are recommended. Full article
(This article belongs to the Special Issue The Other Pediatric Primary Headaches)
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