Life

25 pages, 4471 KiB

Open AccessArticle

Escherichia coli and Enterobacteriaceae Counts, Virulence Gene Profile, Antimicrobial Resistance, and Biofilm Formation Capacity during Pig Slaughter Stages

by Madalena Maria Saldanha Coelho, Emilia Fernanda Agostinho Davanzo, Rebecca Lavarini dos Santos, Virgílio Hipólito de Lemos Castro, Hayanna Maria Boaventura da Costa, Bruno Stéfano Lima Dallago, Simone Perecmanis and Angela Patrícia Santana

Life 2024, 14(10), 1261; https://doi.org/10.3390/life14101261 - 3 Oct 2024

Abstract

This study aimed to count Enterobacteriaceae and Escherichia coli in different locations on pig carcasses (shank, loin, abdomen, shoulder, and jowl) from two slaughterhouses (A and B) between September 2019 and July 2021 during different slaughter stages (after bleeding, after passing through the [...] Read more.

This study aimed to count Enterobacteriaceae and Escherichia coli in different locations on pig carcasses (shank, loin, abdomen, shoulder, and jowl) from two slaughterhouses (A and B) between September 2019 and July 2021 during different slaughter stages (after bleeding, after passing through the epilator machine, after manual toileting in the dirty area, before and after evisceration, and after the final washing), as well as verify antimicrobial resistance and biofilm formation capacity. The main points of Enterobacteriaceae and E. coli contamination were identified in the two slaughterhouses through three collections. The stages with the highest counts were post-bleeding and evisceration in both slaughterhouses and after manual toileting in slaughterhouse B in the first collection. Most E. coli isolates were resistant to multiple antimicrobials, with higher resistance frequencies to amoxicillin, ampicillin, chloramphenicol, sulfonamides, and streptomycin. The virulence genes eae, stx1, and stx2 were also detected. Three isolates had all three genes and exhibited resistance to at least six antimicrobial classes (β-lactams, macrolides, aminoglycosides, sulfonamides, amphenicols, and quinolones). E. coli isolates also showed a high frequency of strains with moderate and strong in vitro biofilm-forming capacity. This is the first study to characterize microbial contamination by pig slaughter stage in the Federal District region, demonstrating the critical points for hygienic production. E. coli was isolated from the surface of pig carcasses, as well as the virulence genes stx1, stx2, and eae were detected. The multi-antimicrobial resistant isolates also had a moderate-to-strong biofilm formation capacity, thus demonstrating risks to public health. Full article

(This article belongs to the Section Microbiology)

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16 pages, 2701 KiB

Open AccessArticle

Investigation of Cell Mechanics and Migration on DDR2-Expressing Neuroblastoma Cell Line

by Theadora Vessella, Esteban J. Rozen, Jason Shohet, Qi Wen and Hong Susan Zhou

Life 2024, 14(10), 1260; https://doi.org/10.3390/life14101260 - 2 Oct 2024

Abstract

Neuroblastoma is a devastating disease accounting for ~15% of all childhood cancer deaths. Collagen content and fiber association within the tumor stroma influence tumor progression and metastasis. High expression levels of collagen receptor kinase, Discoidin domain receptor II (DDR2), are associated with the [...] Read more.

Neuroblastoma is a devastating disease accounting for ~15% of all childhood cancer deaths. Collagen content and fiber association within the tumor stroma influence tumor progression and metastasis. High expression levels of collagen receptor kinase, Discoidin domain receptor II (DDR2), are associated with the poor survival of neuroblastoma patients. Additionally, cancer cells generate and sustain mechanical forces within their environment as a part of their normal physiology. Despite this, evidence regarding whether collagen-activated DDR2 signaling dysregulates these migration forces is still elusive. To address these questions, a novel shRNA DDR2 knockdown neuroblastoma cell line (SH-SY5Y) was engineered to evaluate the consequence of DDR2 on cellular mechanics. Atomic force microscopy (AFM) and traction force microscopy (TFM) were utilized to unveil the biophysical altercations. DDR2 downregulation was found to significantly reduce proliferation, cell stiffness, and cellular elongation. Additionally, DDR2-downregulated cells had decreased traction forces when plated on collagen-coated elastic substrates. Together, these results highlight the important role that DDR2 has in reducing migration mechanics in neuroblastoma and suggest DDR2 may be a promising novel target for future therapies. Full article

(This article belongs to the Section Physiology and Pathology)

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15 pages, 267 KiB

Open AccessArticle

New Approaches Based on Inflammatory Indexes in the Evaluation of the Neoplastic Potential of Colon Polyps

by Sedat Ciftel, Serpil Ciftel, Aleksandra Klisic and Filiz Mercantepe

Life 2024, 14(10), 1259; https://doi.org/10.3390/life14101259 - 2 Oct 2024

Abstract

Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective [...] Read more.

Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective cross-sectional study was conducted on 758 patients aged 61.0 ± 11.8 who underwent polypectomy between June 2021 and May 2024. Patients with colorectal adenocarcinoma (n = 22) were excluded. The polyps were classified into neoplastic and nonneoplastic categories based on histopathological evaluation. The study compared the CALLY index, HALP score, and various inflammatory indexes between neoplastic and nonneoplastic polyps. Out of 758 polyps analyzed, 514 were neoplastic, and 244 were nonneoplastic. Neoplastic polyps exhibited significantly lower CALLY and HALP scores (p < 0.05) and higher immuno-inflammatory indexes (p < 0.05) compared to nonneoplastic polyps. Dysplasia status, polyp diameter, and sigmoid colon localization were significant factors in determining neoplastic growth potential. No significant differences were observed in polyp localization in the proximal and distal colon segments or in solitary versus multiple polyps. The CALLY and HALP scores and immuno-inflammatory indexes can serve as valuable markers for distinguishing neoplastic from nonneoplastic polyps. These indexes reflect underlying inflammatory and immune responses, highlighting their potential utility in the early detection and risk stratification of colorectal polyps. Integrating these markers into clinical practice may enhance diagnostic accuracy and improve patient management, leading to timely interventions and better outcomes for individuals at risk of CRC. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

9 pages, 1003 KiB

Open AccessArticle

Regular Physical Activity Seems to Eliminate Lower Limb Perfusion Asymmetries in Sedentary Non-Healthy Older Individuals

by Margarida Florindo, João Gregório and Luís Monteiro Rodrigues

Life 2024, 14(10), 1258; https://doi.org/10.3390/life14101258 - 2 Oct 2024

Abstract

Perfusion asymmetries have been associated with vascular pathology. Physical activity is a component of vascular health. Here, we investigate the impact of a thirty-day regular home-based physical activity program in older individuals with multiple age-related comorbidities. Eleven participants of both sexes were included. [...] Read more.

Perfusion asymmetries have been associated with vascular pathology. Physical activity is a component of vascular health. Here, we investigate the impact of a thirty-day regular home-based physical activity program in older individuals with multiple age-related comorbidities. Eleven participants of both sexes were included. Skin perfusion was assessed in both feet by laser Doppler flowmetry (LDF, for deeper perfusion) and polarized light spectroscopy (PSp, for superficial perfusion). At baseline, participants had significant perfusion differences between right and left feet (p = 0.005 with LDF; p = 0.028 with PSp), which disappeared with activity and reappeared in recovery. After 30 days, both feet showed significant perfusion increases as assessed with LDF (p = 0.005) compared to D0. At this point, the perfusion asymmetry observed at D0 was no longer present. However, the superficial perfusion asymmetry assessed by PSp persisted at D30 (p = 0.028). Data show that regular physical activity positively altered the lower limb perfusion pattern. Systolic pressure and mean arterial pressure were also significantly reduced at D30. These impacts seem to be directly related to the physical activity program introduced in the day-by-day routines of these participants. These also encourage further research on the role of symmetry–asymmetry in prevention, treatment, and rehabilitation in vascular medicine. Full article

(This article belongs to the Special Issue Cardiovascular Diseases: From Basic Research to Clinical Application–2nd Edition)

13 pages, 1214 KiB

Open AccessArticle

Early Mortality Stratification with Serum Albumin and the Sequential Organ Failure Assessment Score at Emergency Department Admission in Septic Shock Patients

by Sang-Min Kim, Seung-Mok Ryoo, Tae-Gun Shin, You-Hwan Jo, Kyuseok Kim, Tae-Ho Lim, Sung-Phil Chung, Sung-Hyuk Choi, Gil-Joon Suh and Won-Young Kim

Life 2024, 14(10), 1257; https://doi.org/10.3390/life14101257 - 2 Oct 2024

Abstract

Background: Early risk stratification is crucial due to septic patients’ heterogeneity. Serum albumin level may reflect the severity of sepsis and host status. This study aimed to evaluate the prognostic ability of the initial sequential organ failure assessment (SOFA) score alone and combined [...] Read more.

Background: Early risk stratification is crucial due to septic patients’ heterogeneity. Serum albumin level may reflect the severity of sepsis and host status. This study aimed to evaluate the prognostic ability of the initial sequential organ failure assessment (SOFA) score alone and combined with serum albumin levels for predicting 28-day mortality in patients with septic shock. Methods: We conducted an observational study using a prospective, multicenter registry of septic shock patients between October 2015 and May 2022 from 12 emergency departments in the Korean Shock Society and the results were validated by examining those from the septic shock cohort in Asan Medical Center. The primary outcome was 28-day mortality. The area under the receiver operating characteristic (ROC) curve was used to compare the predictive values of SOFA score alone and SOFA score combined with serum albumin level. Results: Among 5805 septic shock patients, 1529 (26.3%) died within 28 days. Mortality increased stepwise with decreasing serum albumin levels (13.6% in albumin ≥3.5, 20.7% in 3.5–3.0, 29.7% in 3.0–2.5, 44.0% in 2.5–2.0, 56.4% in <2.0). The albumin SOFA score was calculated by adding the initial SOFA score to the 4 points assigned for albumin levels. ROC analysis for predicting 28-day mortality showed that the area under the curve for the albumin SOFA score was 0.71 (95% CI 0.70–0.73), which was significantly higher than that of the initial SOFA score alone (0.68, 95% CI: 0.67–0.69). Conclusions: The combination of the initial SOFA score with albumin can improve prognostic accuracy for patients with septic shock, suggesting the albumin SOFA score may be used as an early mortality stratification tool. Full article

(This article belongs to the Special Issue Current Advances in Diagnosis and Treatment of Sepsis)

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14 pages, 4599 KiB

Open AccessArticle

Deep Learning Method Applied to Autonomous Image Diagnosis for Prick Test

by Ramon Hernany Martins Gomes, Edson Luiz Pontes Perger, Lucas Hecker Vasques, Elaine Gagete Miranda Da Silva and Rafael Plana Simões

Life 2024, 14(10), 1256; https://doi.org/10.3390/life14101256 - 2 Oct 2024

Abstract

Background: The skin prick test (SPT) is used to diagnose sensitization to antigens. This study proposes a deep learning approach to infer wheal dimensions, aiming to reduce dependence on human interpretation. Methods: A dataset of SPT images (n = 5844) was used to [...] Read more.

Background: The skin prick test (SPT) is used to diagnose sensitization to antigens. This study proposes a deep learning approach to infer wheal dimensions, aiming to reduce dependence on human interpretation. Methods: A dataset of SPT images (n = 5844) was used to infer a convolutional neural network for wheal segmentation (ML model). Three methods for inferring wheal dimensions were evaluated: the ML model; the standard protocol (MA1); and approximation of the area as an ellipse using diameters measured by an allergist (MA2). The results were compared with assisted image segmentation (AIS), the most accurate method. Bland–Altman analysis, distribution analyses, and correlation tests were applied to compare the methods. This study also compared the percentage deviation among these methods in determining the area of wheals with regular geometric shapes (n = 150) and with irregular shapes (n = 150). Results: The Bland–Altman analysis showed that the difference between methods was not correlated with the absolute area. The ML model achieved a segmentation accuracy of 85.88% and a strong correlation with the AIS method (ρ = 0.88), outperforming all other methods. Additionally, MA1 showed significant error (13.44 ± 13.95%) for pseudopods. Conclusions: The ML protocol can potentially automate the reading of SPT, offering greater accuracy than the standard protocol. Full article

(This article belongs to the Special Issue Noninvasive Skin Imaging: The Present and the Future in General Dermatology)

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11 pages, 1812 KiB

Open AccessArticle

Hemostatic Properties of Aortic Root Preservation versus Root Replacement for Acute Type A Aortic Dissection: A Pooled Analysis

by Dimitrios E. Magouliotis, Arian Arjomandi Rad, Alessandro Viviano, Aung Ye Oo, Andrew Xanthopoulos, Serge Sicouri, Basel Ramlawi and Thanos Athanasiou

Life 2024, 14(10), 1255; https://doi.org/10.3390/life14101255 - 1 Oct 2024

Abstract

Objective: We reviewed the available literature on patients undergoing aortic repair for acute type A aortic dissection (ATAAD) with either aortic root preservation (RP) or root replacement (RR). Methods: Original research studies that evaluated short- and mid-term hemostatic properties of RP versus RR [...] Read more.

Objective: We reviewed the available literature on patients undergoing aortic repair for acute type A aortic dissection (ATAAD) with either aortic root preservation (RP) or root replacement (RR). Methods: Original research studies that evaluated short- and mid-term hemostatic properties of RP versus RR groups were identified, from 2000 to 2024. Intraoperative transfusions of red blood cells (RBCs), reoperation for bleeding, strategy of hemostatic sealing of the anastomosis in root repair following the reapproximation of the dissected layers of the aortic wall (with/without biological glue), and operative mortality were the primary endpoints. Postoperative morbidity and overall and reoperation-free survival at one and five years were the secondary endpoints. A sensitivity analysis was performed using the leave-one-out method. Results: Ten studies were included in the qualitative and quantitative synthesis, incorporating data from 6850 patients (RP: 4389 patients; RR: 2461 patients). Root preservation demonstrated a lower median transfusion of RBCs (WMD: −1.00; 95% CI: −1.41, −0.59; p < 0.01) and incidence of reoperation for bleeding compared to root replacement (OR: 0.67; 95% CI: 0.58, 0.77; p < 0.01). The majority of studies did not use biological glue in root repair to avoid the risk of an anastomotic pseudoaneurysm. No difference was found regarding postoperative morbidity, along with mid-term overall and reoperation-free survival. Conclusions: Root preservation without the use of biological glue during aortic repair is associated with enhanced hemostatic traits compared to the root replacement approach. A future well-designed Randomized Controlled Trial should further validate our outcomes. Full article

(This article belongs to the Special Issue Biomarkers and Prognostic Markers in Cardiovascular Diseases)

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16 pages, 1981 KiB

Open AccessReview

Genetic Polymorphisms of Prokineticins and Prokineticin Receptors Associated with Human Disease

by Roberta Lattanzi and Rossella Miele

Life 2024, 14(10), 1254; https://doi.org/10.3390/life14101254 - 1 Oct 2024

Abstract

Prokineticins (PKs) are low molecular weight proteins that exert their effects by binding to two seven-transmembrane G-protein-coupled receptors (prokineticin receptors, PKRs). The prokineticin system is an important player in the development of various diseases. Several polymorphisms that are associated with infertility, neuroendocrine disorders, [...] Read more.

Prokineticins (PKs) are low molecular weight proteins that exert their effects by binding to two seven-transmembrane G-protein-coupled receptors (prokineticin receptors, PKRs). The prokineticin system is an important player in the development of various diseases. Several polymorphisms that are associated with infertility, neuroendocrine disorders, Hirschsprung’s syndrome (HSCR), idiopathic central precocious puberty (CPP) and congenital disorders such as Kallmann syndrome (KS) have been described for both the PKs and PKR genes. The aim of this study is to summarize and describe the impact of PK/PKR polymorphisms on the pathogenesis and outcome of the above diseases, highlighting the PK system as a therapeutic target and diagnostic biomarker in pathological conditions. Full article

(This article belongs to the Special Issue G Protein-Coupled Receptors: Molecular Mechanisms Involved in Receptor Activation and Selectivity: Second Edition)

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19 pages, 4570 KiB

Open AccessArticle

Effects of Arthrospira platensis on Human Umbilical Vein Endothelial Cells

by Anne Krüger-Genge, Kudor Harb, Steffen Braune, Conrad H. G. Jung, Sophia Westphal, Stefanie Bär, Olivia Mauger, Jan-Heiner Küpper and Friedrich Jung

Life 2024, 14(10), 1253; https://doi.org/10.3390/life14101253 - 1 Oct 2024

Abstract

Atherosclerosis is initiated by injury or damage to the vascular endothelial cell monolayer. Therefore, the early repair of the damaged vascular endothelium by a proliferation of neighbouring endothelial cells is important to prevent atherosclerosis and thrombotic events. Arthrospira platensis (AP) has been used [...] Read more.

Atherosclerosis is initiated by injury or damage to the vascular endothelial cell monolayer. Therefore, the early repair of the damaged vascular endothelium by a proliferation of neighbouring endothelial cells is important to prevent atherosclerosis and thrombotic events. Arthrospira platensis (AP) has been used as a dietary supplement, mainly due to its high content of vitamins, minerals, amino acids, and pigments such as chlorophylls, carotenoids, and phycocyanin, ingredients with antioxidant, anti-inflammatory, and anti-thrombotic properties. Therefore, in this prospective, placebo-controlled, data-driven, sample-size-estimated in vitro study, we tested whether an aqueous extract of AP at different concentrations (50, 100, and 200 µg/mL) had an effect on the different cellular parameters of human umbilical vein endothelial cells. Therefore, cell impedance measurement and cell proliferation were measured to investigate the monolayer formation. In addition, cell viability, integrity, and metabolism were analysed to evaluate singular cellular functions, especially the antithrombotic state. Furthermore, cell–cell and cell–substrate interactions were observed. The highest proliferation was achieved after the addition of 100 µg/mL. This was consistently confirmed by two independent optical experiments in cell cultures 48 h and 85 h after seeding and additionally by an indirect test. At this concentration, the activation or dysfunction of HUVECs was completely prevented, as confirmed by prostacyclin and interleukin-6 levels. In conclusion, in this study, AP induced a significant increase in HUVEC proliferation without inducing an inflammatory response but altered the hemostasiological balance in favour of prostacyclin over thromboxane, thereby creating an antithrombotic state. Thus, APE could be applied in the future as an accelerator of endothelial cell proliferation after, e.g., stent placement or atherosclerosis. Full article

(This article belongs to the Section Physiology and Pathology)

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10 pages, 578 KiB

Open AccessArticle

The Effectiveness and Safety of Remdesivir Use in COVID-19 Patients with Neutropenia: A Retrospective Cohort Study

by Peng-Huei Liu, Ming-Wei Pan, Yan-Bo Huang, Chip-Jin Ng and Shou-Yen Chen

Life 2024, 14(10), 1252; https://doi.org/10.3390/life14101252 - 1 Oct 2024

Abstract

Background: The COVID-19 pandemic poses severe risks for immunocompromised patients, especially those with neutropenia due to chemotherapy. This study evaluates the safety and effectiveness of remdesivir use in COVID-19 patients with neutropenia. Methods: This retrospective study used the Chang Gung Research Database (CGRD) [...] Read more.

Background: The COVID-19 pandemic poses severe risks for immunocompromised patients, especially those with neutropenia due to chemotherapy. This study evaluates the safety and effectiveness of remdesivir use in COVID-19 patients with neutropenia. Methods: This retrospective study used the Chang Gung Research Database (CGRD) and extracted data from 98,763 patients with COVID-19 diagnosed between April 2021 and September 2022. The patients were divided into groups based on their remdesivir use and the presence of neutropenia. The adverse effects of remdesivir and their outcomes were analyzed after propensity score matching. Results: We compared common adverse effects of remdesivir in neutropenic patients before and after a 5-day regimen. A slight decrease in heart rate was observed but lacked clinical significance. There were no significant differences observed in hemoglobin, liver function tests, and blood glucose levels. After propensity score matching of COVID-19 patients with neutropenia according to gender, age, dexamethasone use, oxygen use, MASCC score, and WHO ordinal scale, no significant differences were found in length of stay, intubation rate, or ICU admission rate between the matched patients. Conclusions: Our study found remdesivir to be safe for COVID-19 patients with neutropenia, with no common adverse reactions observed. However, its effectiveness for these patients remains uncertain. Full article

(This article belongs to the Special Issue Current Advances in Diagnosis and Treatment of Sepsis)

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28 pages, 1582 KiB

Open AccessReview

Mechanisms of Germline Stem Cell Competition across Species

by Rachel A. Hodge and Erika A. Bach

Life 2024, 14(10), 1251; https://doi.org/10.3390/life14101251 - 1 Oct 2024

Abstract

In this review, we introduce the concept of cell competition, which occurs between heterogeneous neighboring cell populations. Cells with higher relative fitness become “winners” that outcompete cells of lower relative fitness (“losers”). We discuss the idea of super-competitors, mutant cells that expand at [...] Read more.

In this review, we introduce the concept of cell competition, which occurs between heterogeneous neighboring cell populations. Cells with higher relative fitness become “winners” that outcompete cells of lower relative fitness (“losers”). We discuss the idea of super-competitors, mutant cells that expand at the expense of wild-type cells. Work on adult stem cells (ASCs) has revealed principles of neutral competition, wherein ASCs can be stochastically lost and replaced, and of biased competition, in which a winning ASC with a competitive advantage replaces its neighbors. Germline stem cells (GSCs) are ASCs that are uniquely endowed with the ability to produce gametes and, therefore, impact the next generation. Mechanisms of GSC competition have been elucidated by studies in Drosophila gonads, tunicates, and the mammalian testis. Competition between ASCs is thought to underlie various forms of cancer, including spermatocytic tumors in the human testis. Paternal age effect (PAE) disorders are caused by de novo mutations in human GSCs that increase their competitive ability and make them more likely to be inherited, leading to skeletal and craniofacial abnormalities in offspring. Given its widespread effects on human health, it is important to study GSC competition to elucidate how cells can become winners or losers. Full article

(This article belongs to the Special Issue Stem Cell and Developmental Biology: At the Interface of Differentiation and Morphogenesis)

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14 pages, 659 KiB

Open AccessReview

Diaphragmatic Ultrasonography in Sports Performance: A Systematic Review

by Harold Andrés Payán-Salcedo, Florencio Arias-Coronel, Jose Luis Estela-Zape and Maria Fernanda Serna-Orozco

Life 2024, 14(10), 1250; https://doi.org/10.3390/life14101250 - 1 Oct 2024

Abstract

This paper aims to investigate and analyze the correlation between diaphragmatic parameters through ultrasonography and sports performance in various sports disciplines. This systematic review followed the PRISMA methodology. The search strategy was applied in the Medline database through Ovid, EMBASE, LILACS, the Cochrane [...] Read more.

This paper aims to investigate and analyze the correlation between diaphragmatic parameters through ultrasonography and sports performance in various sports disciplines. This systematic review followed the PRISMA methodology. The search strategy was applied in the Medline database through Ovid, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, and Open Gray. Clinical trials, cohort, case–control, and cross-sectional studies were included, and animal experiments were excluded. A total of 388 studies were identified. After removing duplicates and screening titles and abstracts, sixteen studies were selected for full review, and six were included in the qualitative analysis. The results demonstrated a positive correlation between diaphragm excursion and thickness during inspiration with the anaerobic power, highlighting their importance in high-intensity performance. Additionally, one study reported a positive correlation between diaphragm thickness and aerobic power, suggesting the need for further research. The impact of inspiratory muscle training in Paralympic athletes was also evaluated, providing valuable insights into diaphragmatic adaptation in disabled populations. Ultrasonography is a feasible tool for evaluating the structure and function of the diaphragm, the main element of the respiratory process during sports practice. Its use could contribute to the evaluation and planning of sports training and be a possible indicator of performance improvement. Full article

(This article belongs to the Section Medical Research)

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18 pages, 3855 KiB

Open AccessArticle

Is Thrombectomy Effective for Large Vessel Occlusion Stroke Patients with Mild Symptoms? Meta-Analysis and Trial Sequential Analysis

by Kuan-Chih Chen, Te-Wei Li, Ji-Kuan Huang, Cheng-Chieh Huang, Siang-Yan Zhang, Chih-Hung Chen, Zong-Syuan Lin, Po-Huang Chen and Hong-Jie Jhou

Life 2024, 14(10), 1249; https://doi.org/10.3390/life14101249 - 1 Oct 2024

Abstract

Background: Endovascular treatment (EVT) is an established method for managing large vessel occlusion (LVO), but its efficacy in patients with mild stroke (National Institutes of Health Stroke Scale [NIHSS] score < 6) remains debated. Given the clinical problem of early neurological deterioration in [...] Read more.

Background: Endovascular treatment (EVT) is an established method for managing large vessel occlusion (LVO), but its efficacy in patients with mild stroke (National Institutes of Health Stroke Scale [NIHSS] score < 6) remains debated. Given the clinical problem of early neurological deterioration in approximately 10% of mild stroke patients, understanding the role of EVT in managing these patients is crucial. Our objective was to perform a meta-analysis with trial sequential analysis (TSA) focusing on mild stroke patients with LVO to determine whether EVT offers better outcomes than best medical therapy alone. Methods: A comprehensive search of PubMed, Cochrane, and Embase databases up to 12 December 2023 identified 14 retrospective and prospective cohort studies, including a total of 4436 patients with NIHSS scores less than 6 and presenting with LVO. Studies were categorized into crossover and non-crossover groups to prevent overestimation of the treatment effect. In the crossover group, patients initially treated with BMT were moved to EVT upon clinical deterioration. In the non-crossover group, patients remained in their initially assigned treatment. Meta-analysis and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome was achieving an excellent functional outcome, defined as a modified Rankin scale (mRS) score of 0–1 at 3 months. Secondary outcomes included good (mRS 0–2) and favorable (mRS 0–3) functional outcomes. Safety outcomes were symptomatic intracerebral hemorrhage (sICH) and mortality at 3 months. Results: In the crossover group, EVT did not significantly improve excellent functional outcomes, and TSA results were inconclusive. Conversely, in the non-crossover group, EVT significantly improved the excellent functional outcome rates at 3 months (65.0% vs. 53.7%; OR 1.62; 95% CI 1.13 to 2.32), supported by TSA. EVT increased the risk of sICH in both crossover and non-crossover groups, while mortality rates did not significantly differ between EVT and BMT groups. Conclusions: Our research indicates that thrombectomy may not significantly help mild stroke patients in recovering functional status and could increase the risk of sICH. The disparity in results between crossover and non-crossover studies highlights the critical need for the prompt identification of patients at risk of early neurological deterioration to minimize negative outcomes. Additional randomized controlled trials are essential to optimize the application of EVT in this patient population. Full article

(This article belongs to the Special Issue Etiology, Prediction and Prognosis of Ischemic Stroke)

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14 pages, 1316 KiB

Open AccessReview

The Integration of Radiomics and Artificial Intelligence in Modern Medicine

by Antonino Maniaci, Salvatore Lavalle, Caterina Gagliano, Mario Lentini, Edoardo Masiello, Federica Parisi, Giannicola Iannella, Nicole Dalia Cilia, Valerio Salerno, Giacomo Cusumano and Luigi La Via

Life 2024, 14(10), 1248; https://doi.org/10.3390/life14101248 - 1 Oct 2024

Abstract

With profound effects on patient care, the role of artificial intelligence (AI) in radiomics has become a disruptive force in contemporary medicine. Radiomics, the quantitative feature extraction and analysis from medical images, offers useful imaging biomarkers that can reveal important information about the [...] Read more.

With profound effects on patient care, the role of artificial intelligence (AI) in radiomics has become a disruptive force in contemporary medicine. Radiomics, the quantitative feature extraction and analysis from medical images, offers useful imaging biomarkers that can reveal important information about the nature of diseases, how well patients respond to treatment and patient outcomes. The use of AI techniques in radiomics, such as machine learning and deep learning, has made it possible to create sophisticated computer-aided diagnostic systems, predictive models, and decision support tools. The many uses of AI in radiomics are examined in this review, encompassing its involvement of quantitative feature extraction from medical images, the machine learning, deep learning and computer-aided diagnostic (CAD) systems approaches in radiomics, and the effect of radiomics and AI on improving workflow automation and efficiency, optimize clinical trials and patient stratification. This review also covers the predictive modeling improvement by machine learning in radiomics, the multimodal integration and enhanced deep learning architectures, and the regulatory and clinical adoption considerations for radiomics-based CAD. Particular emphasis is given to the enormous potential for enhancing diagnosis precision, treatment personalization, and overall patient outcomes. Full article

(This article belongs to the Special Issue New Insights into Artificial Intelligence in Medical Imaging)

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17 pages, 6284 KiB

Open AccessReview

Current Trends in Stroke Biomarkers: The Prognostic Role of S100B and GFAP

by Georgios Anogianakis, Stylianos Daios, Nikolaos Topouzis, Konstantinos Barmpagiannos, Georgia Kaiafa, Athena Myrou, Eleftheria Ztriva, Alexandra Tsankof, Eleni Karlafti, Antonia Anogeianaki, Nikolaos Kakaletsis and Christos Savopoulos

Life 2024, 14(10), 1247; https://doi.org/10.3390/life14101247 - 1 Oct 2024

Abstract

Stroke is the third leading cause of death in the developed world and a major cause of chronic disability, especially among the elderly population. The major biomarkers of stroke which are the most promising for predicting onset time and independently differentiating ischemic from [...] Read more.

Stroke is the third leading cause of death in the developed world and a major cause of chronic disability, especially among the elderly population. The major biomarkers of stroke which are the most promising for predicting onset time and independently differentiating ischemic from hemorrhagic and other stroke subtypes are at present limited to a few. This review aims to emphasize on the prognostic role of S100 calcium-binding protein b (S100B), and Glial Fibrillary Acidic Protein (GFAP) in patients with stroke. An electronic search of the published research from January 2000 to February 2024 was conducted using the MEDLINE, Scopus, and Cochrane databases. The implementation of S100B and GFAP in existing clinical scales and imaging modalities may be used to improve diagnostic accuracy and realize the potential of blood biomarkers in clinical practice. The reviewed studies highlight the potential of S100B and GFAP as significant biomarkers in the prognosis and diagnosis of patients with stroke and their ability of predicting long-term neurological deficits. They demonstrate high sensitivity and specificity in differentiating between ischemic and hemorrhagic stroke and they correlate well with stroke severity and outcomes. Several studies also emphasize on the early elevation of these biomarkers post-stroke onset, underscoring their value in early diagnosis and risk stratification. The ongoing research in this field should aim at improving patient outcomes and reducing stroke-related morbidity and mortality by developing a reliable, non-invasive diagnostic tool that can be easily implemented in several healthcare settings, with the ultimate goal of improving stroke management. Full article

(This article belongs to the Special Issue Personalized Prevention and Treatment in Endocrinology, Diabetes and Metabolic Diseases)

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13 pages, 3213 KiB

Open AccessArticle

Bojungikki-Tang Augments Pembrolizumab Efficacy in Human PBMC-Injected H460 Tumor-Bearing Mice

by Se Won Na, Jin-Mu Yi, Heerim Yeo, Sang-Min Park, Mibae Jeong, Jaemoo Chun and Mi-Kyung Jeong

Life 2024, 14(10), 1246; https://doi.org/10.3390/life14101246 - 30 Sep 2024

Abstract

Bojungikki-Tang (BJIKT) is traditionally used to enhance digestive function and immunity. It has gained attention as a supplement to chemotherapy or targeted therapy owing to its immune-boosting properties. This study aimed to evaluate the synergistic anti-tumor effects of BJIKT in combination with pembrolizumab [...] Read more.

Bojungikki-Tang (BJIKT) is traditionally used to enhance digestive function and immunity. It has gained attention as a supplement to chemotherapy or targeted therapy owing to its immune-boosting properties. This study aimed to evaluate the synergistic anti-tumor effects of BJIKT in combination with pembrolizumab in a preclinical model. MHC I/II double knockout NSG mice were humanized with peripheral blood mononuclear cells (PBMCs) and injected subcutaneously with H460 lung tumor cells to establish a humanized tumor model. Both agents were administered to evaluate their impact on tumor growth and immune cell behavior. Immunohistochemistry showed decreased exhaustion markers in CD8(+) and CD4(+) T cells within the tumor, indicating enhanced T cell activity. Additionally, RNA sequencing, transcriptome analysis, and quantitative PCR analysis were performed on tumor tissues to investigate the molecular mechanisms underlying the observed effects. The results confirmed that BJIKT improved T cell function and tumor necrosis factor signaling while suppressing transforming growth factor-β signaling. This modulation led to cell cycle arrest and apoptosis. These findings demonstrate that BJIKT, when combined with pembrolizumab, produces significant anti-tumor effects by altering immune pathways and enhancing the anti-tumor immune response. This study provides valuable insights into the role of BJIKT in the tumor microenvironment and its potential to improve therapeutic outcomes. Full article

(This article belongs to the Section Pharmaceutical Science)

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19 pages, 6160 KiB

Open AccessArticle

Association between Tomographic Characteristics of Pterygium and Preoperative Anterior and Posterior Topography Measured by Anterior Segment Optical Coherence Tomography

by Marina Aguilar-González, Enrique España-Gregori, Isabel Pascual-Camps, M. Dolores Pinazo-Durán and Cristina Peris-Martínez

Life 2024, 14(10), 1245; https://doi.org/10.3390/life14101245 - 29 Sep 2024

Abstract

Background: The utilities of anterior segment optical coherence tomography (AS-OCT) for characterization, differential diagnosis, postoperative monitoring, and evaluation/comparison of surgical techniques in pterygium are described. Through AS-OCT, it is also possible to study the corneal astigmatic effect of pterygium. Our purpose is to [...] Read more.

Background: The utilities of anterior segment optical coherence tomography (AS-OCT) for characterization, differential diagnosis, postoperative monitoring, and evaluation/comparison of surgical techniques in pterygium are described. Through AS-OCT, it is also possible to study the corneal astigmatic effect of pterygium. Our purpose is to study the associations between the anatomical characteristics of pterygium and the corneal topography through AS-OCT. Methods: Fifty eyes with primary pterygium in a tertiary hospital were evaluated before surgery by measuring 10 anatomical variables of pterygium and 13 topographic variables using AS-OCT (Casia 2; Tomey Corp., Nagoya, Japan). Statistical analysis was used to study the association between them. Results: Pterygium classified as flat pattern exhibited lower preoperative values of flat keratometry (K1), real flat keratometry (K1r), average keratometry (AvgK), and real average keratometry (AvgKr) compared to nodular ones. The flat pattern showed greater cylinder (CYL) and real cylinder (CLYr) values. The horizontal corneal invasion proportionally increased CYL and CYLr. Overall, larger anatomical pterygium measurements (limbus thickness (LimbusT), central pterygium thickness (CentreT), head pterygium thickness (HeadT), epithelial thickness at 1 mm (EpitT1mm), stromal thickness at 1 mm (stromT1mm), total thickness at 1 mm (TotalT1mm), total thickness at 2 mm (TotalT2mm), and total thickness at 3 mm (TotalT3mm)) resulted in lower anterior K1, K1r, AvgK, and AvgKr, and posterior K1 and AvgK values. CentreT was greater in astigmatisms against the rule than in oblique ones. Conclusions: This study demonstrates associations between preoperative topography and the NF (nodular or flat) classification of pterygium and its anatomical measurements assessed by AS-OCT. Full article

(This article belongs to the Section Medical Research)

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11 pages, 269 KiB

Open AccessArticle

The Relationship between Sleep Quality and Posture: A Study on University Students

by Adela Badau, Dana Badau, Sebnem Sarvan Cengiz and Ebrar Şevval Coşkun

Life 2024, 14(10), 1244; https://doi.org/10.3390/life14101244 - 28 Sep 2024

Abstract

The aim of this study is to investigate body posture, physical exercises, head–neck relationship, and sleep quality among university students. A total of 96 students, with an average age of 20.86 ± 1.24 years and an average BMI of 23.41 ± 2.56, voluntarily [...] Read more.

The aim of this study is to investigate body posture, physical exercises, head–neck relationship, and sleep quality among university students. A total of 96 students, with an average age of 20.86 ± 1.24 years and an average BMI of 23.41 ± 2.56, voluntarily participated in the study. The REEDCO Posture Evaluation (RPE) was used to assess the participants’ body posture scores. Head and neck measurements were taken using the Apecs-AI Posture Evaluation and Correction System^® (Apecs Posture Analysis Pro Plus Version 8.2.6). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Pearson correlation analysis indicated that increased caffeine consumption was associated with poorer sleep quality (r = 0.267, p < 0.05). Additionally, increased participation in physical activities was associated with improved sleep quality, with those engaging in sports having better sleep quality scores (r = −0.278, p < 0.05). As physical activity increased, REEDCO scores decreased (r = −0.423, p < 0.05), while scores for right head (r = 0.210, p < 0.05) and left head (r = 0.247, p < 0.05) increased. Significant negative correlations were found between REEDCO scores and right head (r = −0.296, p < 0.05) and left head (r = −0.463, p < 0.05) scores. In conclusion, due to the limited number of studies investigating head–neck relationships and sleep quality, definitive conclusions cannot be drawn; further and more comprehensive research is needed. Full article

(This article belongs to the Section Physiology and Pathology)

16 pages, 934 KiB

Open AccessArticle

HLA Diversity in Transylvanian Ethnic Groups: Consequences for Hematopoietic Cell Transplantation

by Lucia Dican, Mihaela Iancu, Florin Ioan Elec, Dan Burghelea, Raluca Timoce, Cristina Sorina Catana, Monica Mihaela Marta, Roxana Liana Lucaciu, Adriana Corina Hangan, Horea Vladi Matei and Luminița-Ioana Iancu Loga

Life 2024, 14(10), 1243; https://doi.org/10.3390/life14101243 - 28 Sep 2024

Abstract

The HLA profile is essential in cell and tissue transplantation, particularly in patients with autoimmune conditions and infections. Due to the extreme polymorphism in certain HLA loci, it also serves as a key tool for population genetic analysis. This study aimed to identify [...] Read more.

The HLA profile is essential in cell and tissue transplantation, particularly in patients with autoimmune conditions and infections. Due to the extreme polymorphism in certain HLA loci, it also serves as a key tool for population genetic analysis. This study aimed to identify the allele and haplotype distributions of HLA class I (A, B, and C) and class II (DRB1) genotypes in unrelated hematopoietic stem cell donors. A retrospective analysis was conducted between 2016 and 2020 on 9832 Transylvanian volunteers, divided into Romanian and Hungarian groups based on self-reported ethnicity. Using PCR-SSO for HLA typing, significant differences were found in allele frequencies between ethnic groups. A total of 19 HLA-A, 31 HLA-B, 14 HLA-C, and 13 HLA-DRB1 distinct allele groups were identified between ethnic groups. Notably, B*18, B*51, and C*12 were more frequent in Romanians, while B*44, B*40, and C*07 were more common in Hungarians. Differences in haplotype distributions were also observed, with HLA-A*02~B*18~C*07~DRB1*11 being significantly more frequent in Romanians. Understanding these population-specific HLA profiles can improve donor matching for hematologic diseases, enhancing patient outcomes and access to life-saving hematopoietic stem cell transplantation. Full article

(This article belongs to the Special Issue Stem Cell Transplantation in Hematologic Malignancies)

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